Nokea
The commonest type of ureteric calculus is
- A. calcium oxalate
- B. triple phosphate
- C. urate
- D. cysteine
Correct Answer: A
Rationale: The correct answer is A: calcium oxalate. This is because calcium oxalate stones are the most common type of ureteric calculus, accounting for around 75% of cases. They form due to an excess of calcium and oxalate in the urine. Triple phosphate stones (choice B) are more commonly found in the bladder and are associated with urinary tract infections. Urate stones (choice C) are less common and typically seen in patients with gout or acidic urine. Cysteine stones (choice D) are rare and usually seen in patients with a genetic disorder affecting cysteine metabolism.
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Which of the following semisynthetic penicillins which has an extended spectrum of activity against many gram negative bacilli, is acid resistant but not penicillinase resistant?:
- A. Cloxacillin
- B. Amoxicillin
- C. Phenoxymethyl penicillin
- D. Piperacillin
Correct Answer: B
Rationale: The correct answer is B: Amoxicillin. This penicillin has an extended spectrum of activity against gram-negative bacilli, making it effective against a wider range of bacteria. It is acid-resistant, allowing it to be taken orally, but it is not penicillinase-resistant, meaning it can be easily degraded by beta-lactamase enzymes.
A: Cloxacillin is penicillinase-resistant but does not have an extended spectrum against gram-negative bacilli.
C: Phenoxymethyl penicillin is not acid-resistant and does not have an extended spectrum against gram-negative bacilli.
D: Piperacillin has an extended spectrum of activity but is not acid-resistant and is susceptible to penicillinase.
Which of the following fungicidal drug that acts by inhibiting fungal squalene * epoxidase enzyme and is the drug of choice for onymycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinane
- C. Itraconazole
- D. Amphotiricin B
Correct Answer: B
Rationale: Rationale: Terbinafine is the correct answer as it inhibits fungal squalene epoxidase, disrupting ergosterol synthesis in the fungal cell membrane. This drug is specifically effective against onychomycosis in diabetic patients due to its fungicidal action and good nail penetration. Griseofulvin (A) targets microtubules, not squalene epoxidase. Itraconazole (C) inhibits ergosterol synthesis via a different mechanism. Amphotericin B (D) disrupts fungal cell membrane by binding to ergosterol, not squalene epoxidase.
Red man syndrome has been associated with rapid intravenous injection of which of the following antibiotic?
- A. Vancomycin
- B. Clindamycin
- C. Cefoperazone
- D. Piperacillin
Correct Answer: A
Rationale: The correct answer is A: Vancomycin. Red man syndrome is a type of hypersensitivity reaction associated with rapid intravenous infusion of vancomycin. This is due to the release of histamine from mast cells and basophils. Vancomycin is known to cause this syndrome, while the other antibiotics listed do not have a similar association. Clindamycin is more commonly associated with pseudomembranous colitis, Cefoperazone with liver toxicity, and Piperacillin with hypersensitivity reactions like rash or anaphylaxis. Therefore, based on the mechanism of action and clinical evidence, vancomycin is the correct choice for causing red man syndrome.
During the interview, a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be:
- A. Oh, don't worry. Some cyclic vaginal discharge is normal.
- B. Have you been engaging in unprotected sexual intercourse?
- C. I'd like some information about the discharge. What color is it?
- D. Have you had any urinary incontinence associated with the discharge?
Correct Answer: C
Rationale: The correct answer is C because it focuses on gathering more information about the vaginal discharge, which is essential in assessing the patient's condition. By asking about the color of the discharge, the nurse can gather valuable information to help determine if it might be related to a sexually transmitted infection or another issue. This approach shows a patient-centered and thorough assessment.
Choice A is incorrect as it dismisses the patient's concerns without obtaining further information. Choice B jumps to conclusions about unprotected sexual intercourse without first assessing the situation. Choice D is unrelated to the patient's primary concern about vaginal discharge and urinary incontinence.
You should take this medication with meals to avoid stomach ulcers.
- A. TRUE
- B. FALSE
- C. Maybe
- D. Not mentioned
Correct Answer: A
Rationale: The correct answer is A: TRUE. Taking medication with meals can help to prevent stomach ulcers by reducing the direct contact of the medication with the stomach lining. Food acts as a buffer, decreasing the likelihood of irritation or ulcer formation. The other choices are incorrect because B: FALSE implies the opposite, C: Maybe lacks a clear stance, and D: Not mentioned does not provide any useful information to answer the question definitively.