Nokea
Sallie has been taking 10 mg per day of prednisone for the past 6 months. She should be assessed for:
- A. Gout
- B. Iron deficiency anemia
- C. Osteoporosis
- D. Renal dysfunction
Correct Answer: C
Rationale: Chronic prednisone increases osteoporosis risk via bone loss; gout or anemia are less direct.
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Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial evaluation and treatment includes:
- A. Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
- B. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
- C. Rapid strep test and symptomatic care if strep test is negative
- D. Observation only, with further assessment if she worsens
Correct Answer: B
Rationale: Fever and lymphadenopathy suggest a serious lamotrigine hypersensitivity reaction.
When assessing a patient prior to starting a drug regimen it is often necessary to have a baseline kidney function study done. What might kidney impairment indicate in relation to drug therapy?
- A. Pharmacodynamics stable at the therapeutic dose
- B. Contraindication to the use of a drug
- C. Increased dosage of a drug
- D. Decreased adverse effects of a drug
Correct Answer: B
Rationale: Kidney impairment may contraindicate certain drugs due to reduced clearance, risking toxicity.
Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:
- A. Loperamide four times a day throughout the trip
- B. Bismuth subsalicylate with each meal and at bedtime
- C. A prescription for diphenoxylate with atropine to use if she gets diarrhea
- D. None of the above
Correct Answer: B
Rationale: Bismuth subsalicylate prevents traveler's diarrhea when taken prophylactically; loperamide or diphenoxylate are for treatment, not prevention.
Which of the following has a stimulative effect on adrenal glands:
- A. Gonadotropins
- B. Thyrotropic hormone
- C. Adrenocorticotropic hormone
- D. Melanocyt stimulating hormone
Correct Answer: C
Rationale: Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol and other steroids.
Tick the substance which changes the activity of an effector element but doesn't belong to second messengers:
- A. cAMP
- B. cGMP
- C. G-protein
- D. Calcium ions
Correct Answer: C
Rationale: G-protein is a transducer, not a second messenger, unlike cAMP, cGMP, and calcium.