Regarding renal colic secondary to calculi:
- A. Females are more commonly affected than males
- B. 50% of calculi are radio-opaque
- C. It may present without haematuria
- D. There is a 20% chance of recurrence by 5 years
Correct Answer: C
Rationale: The correct answer is C because renal colic can present without hematuria. Renal colic is typically associated with severe flank pain caused by ureteral stones. Hematuria is a common symptom but not always present. This is due to the stone's location and size affecting the degree of irritation and damage to the urinary tract. Therefore, the absence of hematuria does not exclude the possibility of renal colic. Choices A, B, and D are incorrect. Females are not more commonly affected than males, calculi can be either radio-opaque or radio-lucent, and the recurrence rate by 5 years is closer to 50% rather than 20%.
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Which of the following components of renin-angiotensin-aldosterone system (RAAS) is not correctly paired with its function?
- A. Renin – cleavage of angiotensinogen to angiotensin I
- B. Angiotensin converting enzyme (ACE) – activation of angiotensin I to angiotensin II
- C. Aldosterone – sodium and water reabsorption
- D. Angiotensin II – vasoconstriction and decrease of blood pressure
Correct Answer: D
Rationale: The correct answer is D. Angiotensin II does not decrease blood pressure; it actually increases blood pressure through vasoconstriction. Renin cleaves angiotensinogen to form angiotensin I, and ACE converts angiotensin I to angiotensin II. Aldosterone acts on the kidneys to increase sodium and water reabsorption, leading to increased blood volume and pressure. Therefore, D is incorrect because Angiotensin II causes vasoconstriction and increases blood pressure.
Thiazide diuretics may produce an increase in blood levels of uric acid and: *
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: A
Rationale: Thiazide diuretics decrease urinary excretion of uric acid, leading to increased blood levels. Thiazides also increase potassium reabsorption, potentially causing hyperkalemia. However, the main effect on uric acid levels makes choice A correct. Choices B, C, and D are incorrect as thiazides do not directly impact BUN, urea, or glucose levels.
The primary role of the phosphate buffer system is to?
- A. buffer stomach acid
- B. buffer carbonic acid formed by carbon dioxide
- C. limit pH changes caused by metabolic and fixed acids
- D. buffer the urine
Correct Answer: C
Rationale: The correct answer is C: limit pH changes caused by metabolic and fixed acids.
1. Phosphate buffer system consists of dihydrogen phosphate (H2PO4-) and hydrogen phosphate (HPO4^2-) ions, which can donate or accept H+ ions to maintain a stable pH.
2. Metabolic and fixed acids produced in the body can lead to pH changes. The phosphate buffer system helps to prevent drastic changes in pH by neutralizing excess H+ ions.
3. Options A, B, and D are incorrect because the phosphate buffer system is not specifically designed to buffer stomach acid, carbonic acid formed by carbon dioxide, or buffer the urine.
Which of the following drug used in the treatment of filariasis?
- A. Diethylcarbamazine
- B. Albendazole
- C. Levamisole
- D. Piperazine
Correct Answer: A
Rationale: Diethylcarbamazine is the correct answer for treating filariasis because it targets the microfilariae, adult worms, and larvae of filarial parasites. It is specifically designed to kill these parasites and is considered the drug of choice for filariasis treatment. Albendazole, Levamisole, and Piperazine are not effective against filarial parasites and are used for different types of infections or conditions. Albendazole is mainly used for treating intestinal worms, Levamisole is used for parasitic infections in animals, and Piperazine is used for treating pinworm infections. Thus, only Diethylcarbamazine directly targets and eliminates filarial parasites, making it the correct choice for filariasis treatment.
Which of the following fungicidal drug that acts by inhibiting fungal squalene epoxidase enzyme and is the drug of choice for onychomycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinafine
- C. Itraconazole
- D. Amphotericin B
Correct Answer: B
Rationale: Step 1: Terbinafine is a fungicidal drug that inhibits fungal squalene epoxidase enzyme, disrupting fungal cell membrane synthesis.
Step 2: Onychomycosis of toenails is a common fungal infection that terbinafine is specifically effective against.
Step 3: The patient being a 56-year-old woman with diabetes may require a drug with good efficacy and safety profile, making terbinafine an appropriate choice.
Step 4: Griseofulvin (A) works by disrupting microtubule function, not inhibiting squalene epoxidase. Itraconazole (C) is an azole antifungal that inhibits ergosterol synthesis, not squalene epoxidase. Amphotericin B (D) is a polyene antifungal used for systemic mycoses, not onychomycosis.