Nokea
The most common treatment for Helicobacter pylori is a triple therapy, interpreted as
- A. 2 antibiotics and proton pump inhibitor for 7-14 days
- B. 3 different antibiotics for 7-20 days
- C. 3 rounds of the same antibiotic over 3 weeks
- D. 2 proton pump inhibitors and 1 antibiotic for 7-14 days
Correct Answer: A
Rationale: Triple therapy for H. pylori typically includes 2 antibiotics and a proton pump inhibitor for 7-14 days.
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A patient presents with an elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of:
- A. Nephrotic syndrome
- B. Acromegaly
- C. Cushing’s syndrome
- D. Parkinson’s disease
Correct Answer: B
Rationale: Acromegaly is characterized by enlargement of bones and soft tissues, leading to features like a prominent jaw and forehead.
A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide, chlorthalidone, and acetaminophen. What would be your first step in therapy?
- A. Stop glyburide
- B. Stop chlorthalidone
- C. Stop acetaminophen
- D. Start topical vaginal lubricant
Correct Answer: D
Rationale: Topical vaginal lubricants can help alleviate vaginal dryness and improve sexual function.
A patient calls the nurse practitioner and states that he missed his morning daily dose of warfarin, 5 mg, yesterday and today. The nurse practitioner instructs the patient to:
- A. Wait until tomorrow and resume daily dosing of warfarin 5 mg
- B. Take warfarin 10 mg now
- C. Take warfarin 5 mg now, warfarin 5 mg at 5 pm today, and resume the daily warfarin 5 mg dose in the morning as scheduled
- D. Take warfarin 5 mg now and resume the warfarin 5 mg daily dose in the morning as scheduled
Correct Answer: D
Rationale: The patient should resume the usual warfarin dose and avoid doubling it.
A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph nodes for metastatic sampling. The patient wants to know if he should have chemotherapy. Should he?
- A. Yes because without knowing his complete staging it would be safer.
- B. No because he can be followed with serial carcinoembryonic antigens and CT scans.
- C. Yes because the severe bleeding indicates advanced disease.
- D. No because he is too old and will not likely have any problems during his lifetime.
Correct Answer: B
Rationale: Follow-up with serial carcinoembryonic antigens and CT scans is appropriate after resection of localized disease.
Which of the following is true about tolterodine?
- A. It should be avoided in men with prostatic hypertrophy.
- B. It increases the risk of constipation compared with oral oxybutynin.
- C. It acts by ablating detrusor spasms.
- D. It has greater risk of adverse effects with its twice-daily formulation.
Correct Answer: C
Rationale: Tolterodine is an anticholinergic that reduces detrusor spasms to alleviate symptoms of overactive bladder.