Nokea
The following tetracycline has the potential to cause vestibular toxicity: *
- A. Doxycline
- B. Oxytetracycline
- C. Minocycline
- D. Demeclocycline
Correct Answer: C
Rationale: The correct answer is C, Minocycline. Minocycline has a higher potential for vestibular toxicity compared to other tetracyclines due to its greater lipid solubility, leading to increased penetration of the blood-brain barrier and inner ear. This can result in dizziness, vertigo, and imbalance.
Choice A, Doxycycline, is less likely to cause vestibular toxicity since it has lower lipid solubility and reduced penetration into the inner ear. Choice B, Oxytetracycline, and Choice D, Demeclocycline, also have lower potential for vestibular toxicity compared to Minocycline due to similar reasons. Overall, Minocycline stands out as the correct answer due to its unique pharmacokinetic properties that predispose it to vestibular toxicity.
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The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). What are advantages of PD when compared to HD (select all that apply)?
- A. Less protein loss
- B. Rapid fluid removal
- C. Less cardiovascular stress
- D. Decreased hyperlipidemia
Correct Answer: A
Rationale: The correct answer is A: Less protein loss. Peritoneal dialysis (PD) occurs continuously, allowing for a slower and gentler removal of waste products, leading to less protein loss compared to the intermittent nature of hemodialysis (HD). This is because PD uses the peritoneal membrane as a filter, which is more gentle on proteins.
Rapid fluid removal (B) is actually an advantage of HD, as it can quickly remove excess fluids. Less cardiovascular stress (C) is not a specific advantage of PD over HD, as both types of dialysis can impact cardiovascular health. Decreased hyperlipidemia (D) is not a direct advantage of PD over HD.
Which laboratory result is of most concern for a patient with cystitis?
- A. Serum WBC 9000/mm?
- B. Urinalysis with 1-2 WBCs present
- C. Urine bacteria 100,000 colonies/mL
- D. Serum hematocrit 36%
Correct Answer: C
Rationale: The correct answer is C because a urine bacteria count of 100,000 colonies/mL indicates a significant bacterial infection, which is concerning for cystitis. This result suggests an active infection in the urinary tract, requiring prompt treatment.
A: Serum WBC of 9000/mm³ is within the normal range and may not necessarily indicate an active infection.
B: Urinalysis with 1-2 WBCs present is also within the normal range and may not be indicative of an acute infection.
D: Serum hematocrit of 36% is a measure of the proportion of red blood cells in the blood and is not directly related to cystitis.
Which of the following interferes with mycolic acid synthesis an essential * component of mycobacterial cell walls for which resistance will develop rapidly if the drug is used alone?
- A. Isoniazid
- B. Rifampicin
- C. Pyrazinamide
- D. Ethambutol
Correct Answer: D
Rationale: Mycolic acid synthesis is inhibited by Ethambutol by targeting the enzyme arabinosyltransferase, essential for cell wall synthesis in mycobacteria. Resistance develops slowly with Ethambutol, unlike other choices which target different pathways (A: Isoniazid - inhibits mycolic acid synthesis by targeting InhA enzyme, B: Rifampicin - inhibits RNA polymerase, C: Pyrazinamide - disrupts membrane potential). Ethambutol is essential in combination therapy to prevent resistance.
A 5 year old child has been brought with intestinal obstruction due to clumping of roundworms. Which of the following anthelmintic which administered by orogastric tube can relax the balls of ascaris and relieve the obstruction?
- A. Levamisole
- B. Mebendazole
- C. Pyrantel pamoate
- D. Piperazine
Correct Answer: D
Rationale: The correct answer is D: Piperazine. Piperazine is a paralytic agent that causes relaxation of the muscles of the roundworm (Ascaris), allowing it to be easily expelled from the intestine. By administering piperazine via orogastric tube, the clumped roundworms causing intestinal obstruction can be relaxed, relieving the obstruction. Levamisole, Mebendazole, and Pyrantel pamoate are not effective in relaxing the muscles of the roundworms, making them incorrect choices for this specific scenario.
The best time for a woman of childbearing age to perform breast self-examination is
- A. during her menstrual period
- B. 2 days before the onset of her menstrual period
- C. 1 week after her menstrual period ends
- D. the day her menstrual period begins
Correct Answer: C
Rationale: The best time for a woman of childbearing age to perform breast self-examination is 1 week after her menstrual period ends. This is because breast tissue tends to be less tender and lumpy during this time, making it easier to detect any abnormalities. Performing the examination at this time allows for a more accurate assessment of the breasts. Additionally, hormonal changes during the menstrual cycle can affect breast tissue, so performing the examination post-menstruation reduces the likelihood of false alarms. Choices A, B, and D are not ideal times as breast tenderness and hormonal fluctuations during the menstrual period can make it challenging to accurately detect abnormalities.