Nokea
Sustained use of this drug results in increased plasma urate concentrations:
- A. Furosemide (Lasix)
- B. Acetazolamide (Diamox)
- C. Both of the above
- D. Neither of the above
Correct Answer: C
Rationale: Sustained use of furosemide and acetazolamide can lead to increased plasma urate concentrations. Furosemide inhibits uric acid secretion, while acetazolamide impairs renal excretion of uric acid. Therefore, both drugs can result in elevated plasma urate levels. Choice C is correct. Choice A is incorrect because furosemide does not decrease plasma urate concentrations. Choice B is incorrect because acetazolamide does not lower plasma urate concentrations. Choice D is incorrect as both drugs can increase plasma urate levels.
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Which of the following actions most likely mediated the therapeutic effect of both drugs in the patient's disease?
- A. Decreased intestinal reabsorption of bile acids
- B. Decreased conversion of cholesterol to bile acids
- C. Decreased synthesis of cholesterol by the liver
- D. Upregulation of hepatic low-density lipoprotein (LDL) receptors
Correct Answer: D
Rationale: The correct answer is D: Upregulation of hepatic low-density lipoprotein (LDL) receptors. This action is most likely to mediate the therapeutic effect of both drugs in the patient's disease because it would increase the clearance of LDL cholesterol from the bloodstream, leading to decreased cholesterol levels. By upregulating LDL receptors on hepatocytes, more LDL particles are taken up by the liver, reducing circulating LDL levels and lowering the risk of cardiovascular disease.
Choices A, B, and C are incorrect because they do not directly address the mechanism of action of the drugs in lowering cholesterol levels. Decreased intestinal reabsorption of bile acids (Choice A) may affect cholesterol absorption but is not the primary mechanism of action for most cholesterol-lowering drugs. Decreased conversion of cholesterol to bile acids (Choice B) and decreased synthesis of cholesterol by the liver (Choice C) do not target the clearance of LDL cholesterol from the bloodstream, which is the key therapeutic goal in managing hyperchole
Which of the following psychostimulants acts centrally mainly by blocking adenosine receptors?
- A. Meridil
- B. Caffeine
- C. Amphetamine
- D. Sydnophen
Correct Answer: B
Rationale: The correct answer is B: Caffeine. Caffeine acts centrally mainly by blocking adenosine receptors. Adenosine normally inhibits the release of neurotransmitters, but when adenosine receptors are blocked by caffeine, this inhibition is reduced, leading to increased alertness and wakefulness.
Meridil (A), Amphetamine (C), and Sydnophen (D) do not primarily act by blocking adenosine receptors. Meridil is a sympathomimetic amine, Amphetamine is a psychostimulant that primarily acts by increasing the release of dopamine and norepinephrine, and Sydnophen is a stimulant drug.
Relationship between arterial blood pressure (BP), cardiac outpur (CO) and peripheral vascular resistance (PVR) can be described as
- A. BP = COxPVR
- B. BP = CO / PVR
- C. BP = PVR / CO
- D. None of the above
Correct Answer: A
Rationale: The formula BP = CO x PVR is a fundamental principle in cardiovascular physiology, where blood pressure is the product of cardiac output and peripheral vascular resistance.
A teaching plan for a patient taking lithium should include instructions to:
- A. maintain normal salt and fluids in the diet.
- B. drink twice the usual daily amount of fluid.
- C. have regular laboratory studies of liver function.
- D. avoid eating aged cheese
Correct Answer: A
Rationale: Step 1: Lithium is a mood stabilizer that can cause dehydration and increase the risk of toxicity.
Step 2: Maintaining normal salt and fluids helps prevent dehydration and maintains lithium levels.
Step 3: Drinking excessive fluids (B) can lead to lithium toxicity.
Step 4: Regular liver function tests (C) are not necessary for monitoring lithium therapy.
Step 5: Avoiding aged cheese (D) is unrelated to lithium therapy.
Summary: Choice A is correct as it directly addresses the need to maintain hydration and normal salt levels to prevent lithium toxicity. Choices B, C, and D are incorrect as they are either unnecessary or unrelated to lithium therapy.
A 57-year-old man with a 40 pack-year history of smoking develops small cell lung cancer. He begins to show signs of hyponatremia, and his urine is highly concentrated. The diagnosis of SIADH is made. Administration of which of the following metal ions may help?
- A. Cobalt
- B. Iron
- C. Lithium
- D. Magnesium
Correct Answer: C
Rationale: Lithium can treat SIADH by reducing renal response to ADH, correcting hyponatremia.