Nokea
Rickets is:
- A. A deficiency disease resulting from a lack of vitamin D or calcium and from insufficient exposure to sunlight, characterized by defective bone growth and occurring chiefly in children
- B. A disease occurring primarily in adults that results from a deficiency in vitamin D or calcium and is characterized by a softening of the bones with accompanying pain and weakness
- C. A disease characterized by a decrease in bone mass and density, occurring especially in postmenopausal women, resulting in a predisposition to fractures and bone deformities such as a vertebral collapse
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because rickets is indeed a deficiency disease primarily affecting children due to lack of vitamin D, calcium, and sunlight exposure. Here's the rationale:
1. Rickets is characterized by defective bone growth, which aligns with the growth stage of children.
2. Rickets is caused by a lack of vitamin D or calcium, crucial for bone health.
3. Insufficient exposure to sunlight leads to decreased vitamin D synthesis.
4. Other choices are incorrect:
- Choice B describes osteomalacia, a disease in adults, not rickets.
- Choice C describes osteoporosis, a different condition in postmenopausal women.
- Choice D is incorrect since rickets does not encompass all the conditions mentioned.
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When is it not possible to blind a clinical trial using a placebo control group?
- A. in treatments where a convincing placebo treatment would be too dangerous to be ethically acceptable (e.g. surgery)
- B. in treatments where the active participation of the patient is necessary (e.g. physical therapy)
- C. in treatments where the standard placebo may have a deleterious effect on research participants (e.g. for diabetics)
- D. A and B
Correct Answer: D
Rationale: The correct answer is D because both A and B scenarios present limitations to blinding with a placebo control group. In scenario A, using a placebo in dangerous treatments like surgery would be unethical due to potential harm. In scenario B, patient participation is crucial, making it difficult to blind the trial. Option C is incorrect as it specifically mentions a standard placebo potentially harming diabetics, which is not a general rule for all clinical trials.
Side effects of sulphonylureas are less than those of biguanides. This considerations is:
- A. TRUE
- B. FALSE
- C. All of the above
- D. None of the above
Correct Answer: B
Rationale: Step 1: Sulphonylureas can cause hypoglycemia, weight gain, and gastrointestinal issues.
Step 2: Biguanides can cause gastrointestinal issues and lactic acidosis.
Step 3: Biguanides have fewer side effects compared to sulphonylureas.
Step 4: Therefore, the statement that side effects of sulphonylureas are less than biguanides is FALSE.
Summary: Choice B is correct because biguanides have fewer side effects than sulphonylureas, making the statement false. Choices A, C, and D are incorrect because the statement is not true for all options.
Route of administration of 25-hydroxyvitamin D3 (calcifediol) is:
- A. Oral
- B. Subcutaneous
- C. Intravenous
- D. Intranasal
Correct Answer: A
Rationale: The correct answer is A: Oral. Calcifediol is typically administered orally because it undergoes hepatic hydroxylation to form the active form of vitamin D, calcitriol. Subcutaneous (B) and intravenous (C) routes would bypass this necessary metabolic step. Intranasal (D) administration is not a common route for vitamin D supplementation. Therefore, oral administration ensures proper metabolism and bioavailability of calcifediol.
The client has a heart rate of 40 with electrical activity beginning at the AV node. What type of rhythm is the client having?
- A. Normal sinus rhythm
- B. Atrial flutter
- C. Atrial fibrillation
- D. Junctional escape rhythm
Correct Answer: D
Rationale: A rate of 40 bpm originating from the AV node (no P waves) is a junctional escape rhythm, a backup pacemaker.
A 75-year-old man with a history of intermittent angina presents to his primary physician. The anginal attacks are becoming more frequent, and therapy is considered for this reason. His blood pressure is 160/95 mm Hg. Which of the following agents would be least likely to be administered as a first-line agent for this patient?
- A. Diltiazem
- B. Nifedipine
- C. Nitroglycerine
- D. Ranolazine
Correct Answer: D
Rationale: Ranolazine is a second-line agent for chronic angina, targeting sodium channels, while diltiazem, nifedipine, nitroglycerin, and verapamil are first-line due to vasodilation or heart rate control.