Nokea
The first physical sign associated with puberty in boys is:
- A. Height spurt
- B. Penis lengthening
- C. Sperm production
- D. Pubic hair development
Correct Answer: E
Rationale: I'm sorry, but it seems there might be a mistake in the question as there is no option E provided. However, I can provide a rationale for each option based on the typical sequence of physical changes during puberty in boys. The first physical sign associated with puberty in boys is usually pubic hair development (D), followed by penis lengthening (B), height spurt (A), and lastly sperm production (C). Pubic hair development is often the initial visible sign of puberty due to hormonal changes. Height spurt and penis lengthening occur later in puberty, while sperm production typically begins towards the end of puberty.
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A 70 year old man requires treatment with an alpha-blocker for overflow incontinence due to enlarged prostate. Which of the following alpha blocking drugs is most appropriate drug to prescribe that will not affect his blood pressure significantly?
- A. Prazosin
- B. Phentolamine
- C. Tamsulosin
- D. Terazosin
Correct Answer: C
Rationale: The correct answer is C: Tamsulosin. It is the most appropriate alpha-blocker for the elderly man with enlarged prostate and overflow incontinence because of its selective action on alpha-1A receptors in the prostate, leading to relaxation of smooth muscle without significantly affecting blood pressure.
Rationale:
1. Prazosin (Choice A) and Terazosin (Choice D) are non-selective alpha-blockers that can cause significant blood pressure lowering due to their action on alpha-1 receptors in blood vessels, which may not be suitable for this patient.
2. Phentolamine (Choice B) is also a non-selective alpha-blocker that can lead to significant blood pressure reduction, making it unsuitable for this patient.
3. Tamsulosin (Choice C) is a selective alpha-1A blocker, primarily acting on the prostate, with minimal impact on blood pressure, making it the most appropriate choice for this patient.
A patient with severe infectious disease is being treated with aminoglycoside antibiotics. Which of the following diuretic should be avoided for this patient because of the serious side effect shared by both drugs?
- A. Furosemide
- B. Hydrochlorothiazide
- C. Spironolactone
- D. Acetazolamide
Correct Answer: A
Rationale: The correct answer is A: Furosemide. Aminoglycoside antibiotics can cause ototoxicity and nephrotoxicity. Furosemide, a loop diuretic, also has the potential to cause ototoxicity and nephrotoxicity. Therefore, combining aminoglycosides with furosemide can increase the risk of these serious side effects.
B: Hydrochlorothiazide is a thiazide diuretic that does not share the same severe side effects as aminoglycosides.
C: Spironolactone is a potassium-sparing diuretic and does not have the same side effects as aminoglycosides.
D: Acetazolamide is a carbonic anhydrase inhibitor diuretic and does not share the same severe side effects as aminoglycosides.
Which of the following antimicrobial which acts by interfering with DNA function in the bacteria and can cure most cases of uncomplicated gonorrhea?:
- A. Chloramphenicol
- B. Ciprofloxacin
- C. Streptomycin
- D. Erythromycin
Correct Answer: B
Rationale: The correct answer is B: Ciprofloxacin. Ciprofloxacin is a fluoroquinolone antibiotic that interferes with DNA function in bacteria by inhibiting DNA gyrase and topoisomerase IV enzymes. This mechanism of action prevents bacterial DNA replication and repair, leading to bacterial cell death. Ciprofloxacin is effective in treating gonorrhea due to its ability to target and kill Neisseria gonorrhoeae, the bacteria causing gonorrhea.
A: Chloramphenicol inhibits bacterial protein synthesis, not DNA function.
C: Streptomycin disrupts bacterial protein synthesis by binding to the ribosome, not DNA function.
D: Erythromycin inhibits bacterial protein synthesis by binding to the ribosome, not DNA function.
Which antileprosy drug that both suppresses lepra reaction and reversal * reaction?:
- A. Dapsone
- B. Rifampin
- C. Clofazimine
- D. Minocycline
Correct Answer: C
Rationale: Step 1: Clofazimine is the correct answer because it is known to suppress both lepra reaction and reversal reaction in leprosy treatment.
Step 2: Dapsone is mainly used to treat leprosy but does not specifically target lepra reaction.
Step 3: Rifampin is effective against leprosy but does not have a direct impact on lepra reactions.
Step 4: Minocycline can be used in leprosy treatment but does not have the same dual action as clofazimine.
The highest incidence of antibiotic associated pseudomembranous enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with the highest incidence of antibiotic-associated pseudomembranous enterocolitis due to its broad-spectrum activity that disrupts the normal gut flora, leading to overgrowth of Clostridium difficile. Ampicillin, Chloramphenicol, and Vancomycin are also associated with pseudomembranous enterocolitis, but the highest incidence is seen with Clindamycin due to its stronger impact on gut flora imbalance.