Nokea
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.
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By the age of 7 months, the infant is able to do all the following EXCEPT
- A. transfer object from hand to hand
- B. actively bounces
- C. uses radial palm grasp
- D. cruises
Correct Answer: D
Rationale: Cruising typically occurs later, around 9-10 months.
Hyperparathyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction would experience:
- A. Heat intolerance and systolic
- B. Diastolic hypertension and widened hypertension pulse pressure
- C. Weight gain and heat intolerance
- D. Anorexia and hyper-excitability
Correct Answer: A
Rationale: Hyperparathyroidism is caused by increased levels of parathyroid hormone (PTH), not thyroxine. The effects of hyperparathyroidism include increased calcium levels in the blood, which can lead to symptoms such as heat intolerance and systolic hypertension. Systolic hypertension is when the top number in a blood pressure reading is elevated. This is why option A (heat intolerance and systolic hypertension) is the correct choice for a client with hyperparathyroidism. Options B, C, and D do not accurately reflect the symptoms associated with this endocrine dysfunction.
Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:
- A. Cell division or mitosis during the M phase of the cell cycle.
- B. Normal cellular processes during the S phase of the cell cycle.
- C. The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific).
- D. One or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle- nonspecific).
Correct Answer: D
Rationale: Antimetabolites interfere with the synthesis of nucleic acids, specifically RNA and DNA. By disrupting one or more stages of RNA and/or DNA synthesis, antimetabolites disrupt the normal cellular processes required for cell division and replication, ultimately leading to inhibition of cell proliferation. This makes them effective agents in targeting rapidly dividing cells, such as cancer cells, which rely heavily on nucleic acid synthesis for their rapid growth. The mechanism of action of antimetabolites is cell cycle-nonspecific, meaning they can affect cells at various stages of the cell cycle rather than being specific to a particular phase like M or S phase.
Which of the following is an adverse reaction to glipizide (Glucotrol)?
- A. Headache
- B. Hypotension
- C. Constipation
- D. Photosensitivity
Correct Answer: B
Rationale: Hypotension, which is low blood pressure, can be an adverse reaction to glipizide (Glucotrol). Glipizide is a medication used to treat type 2 diabetes by helping to control blood sugar levels. Hypotension could occur as a side effect of glipizide, causing symptoms such as dizziness, lightheadedness, and fainting. If a patient experiences hypotension while taking glipizide, medical attention should be sought immediately to address this potentially serious adverse reaction.
The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate for child abuse
Correct Answer: B
Rationale: Further history may help differentiate normal behavior from developmental concerns.