Nokea
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.
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Which statement best describes Zidovudine:
- A. Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection
- B. Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia
- C. Peripheral neuropathy is a specific adverse reaction to Zidovudine
- D. Zidovudine is converted by cellular enzymes to an active form
Correct Answer: zidovudine diphosphate
Rationale: The correct answer is D: Zidovudine is converted by cellular enzymes to an active form (zidovudine diphosphate). Zidovudine itself is a prodrug that needs to be metabolized by cellular enzymes to its active form, zidovudine diphosphate, which inhibits HIV replication by acting as a nucleoside reverse transcriptase inhibitor. This active form is essential for its antiretroviral activity.
Incorrect Choices:
A: Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection - This is incorrect because zidovudine is commonly used in combination with other antiretrovirals as a first-line treatment for HIV infection, not as an alternative treatment.
B: Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia - This is incorrect because zidovudine is primarily used in
A 45-year-old mother of two children is seen at the clinic for complaints of “losing my urine when I sneeze.†The nurse documents that she is experiencing:
- A. Urinary frequency.
- B. Enuresis.
- C. Stress incontinence.
- D. Urge incontinence.
Correct Answer: C
Rationale: The correct answer is C: Stress incontinence. This type of incontinence is characterized by leakage of urine during activities that increase intra-abdominal pressure, such as sneezing, coughing, or laughing. In this case, the woman is experiencing urine loss specifically when she sneezes, which aligns with the definition of stress incontinence. Other choices are incorrect because urinary frequency (choice A) refers to a frequent need to urinate, enuresis (choice B) is involuntary urination during sleep, and urge incontinence (choice D) is the sudden, strong need to urinate followed by involuntary leakage.
Which of the following is true of nephrons?
- A. they are the functional units of the kidneys
- B. the proximal convoluted tubules allow the kidney to concentrate or dilute urine
- C. there are about a million nephrons in each kidney
- D. both a and c are correct
Correct Answer: D
Rationale: Step 1: Identify key characteristics of nephrons - functional units of kidneys, responsible for urine formation.
Step 2: Confirm accuracy of statements - A: Nephrons are functional units. C: About a million nephrons in each kidney.
Step 3: Combine statements - A + C = D, confirming both are correct.
Step 4: Justify choice D - correct because nephrons are indeed functional units and there are approximately a million in each kidney.
Summary: B is incorrect as the proximal convoluted tubules are not solely responsible for urine concentration/dilution. Choice D is correct as it combines the accurate statements from A and C.
Due to its potential for severe hepatotoxicity, Nevirapine should NOT be initiated in:
- A. Women with CD4 cell counts >150 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- B. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- C. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >500 cells/mm3
- D. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >450 cells/mm3
Correct Answer: B
Rationale: The correct answer is B. Nevirapine has a higher risk of severe hepatotoxicity in patients with higher CD4 cell counts. Choice B specifies a lower threshold for CD4 cell counts in women compared to men, which aligns with the caution needed for initiating Nevirapine. Choices A, C, and D have higher CD4 cell count thresholds for both women and men, which would increase the risk of hepatotoxicity if Nevirapine is initiated in those patients. Therefore, Choice B is the most appropriate option to minimize the risk of hepatotoxicity when initiating Nevirapine.
The first step in urine production
- A. is called reabsorption.
- B. moves water and solutes from the renal tubules into the peritubular capillaries.
- C. is called secretion.
- D. occurs as water and solutes move from the glomerulus to the glomerular capsul
Correct Answer: D
Rationale: The correct answer is D because the first step in urine production occurs as water and solutes move from the glomerulus to the glomerular capsule during the process of filtration. This initial step involves the passive movement of water and small solutes through the filtration membrane in the glomerulus. Reabsorption (choice A) occurs later in the process when useful substances are reclaimed from the filtrate. Choice B is incorrect as it describes the process of reabsorption, not the initial step. Choice C is also incorrect as secretion is the process of actively transporting substances from the blood into the renal tubules, not the first step in urine production.