Nokea
The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?
- A. Skin on the scrotum is taut.
- B. Left testicle hangs lower than the right testicl
- D. Scrotal skin has yellowish 1-cm nodules that are firm and nontender.
Correct Answer: D
Rationale: The correct answer is D because the presence of yellowish 1-cm nodules that are firm and nontender on the scrotal skin could indicate a serious issue such as testicular cancer or a benign condition like sebaceous cysts. Further evaluation is necessary to rule out malignancy or infection.
A: Skin on the scrotum being taut is a normal finding.
B: Left testicle hanging lower than the right is a common anatomical variation, not a cause for concern.
C: The absence of information makes it impossible to determine if this finding requires follow-up.
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Regarding renal colic secondary to calculi:
- A. Females are more commonly affected than males
- B. 50% of calculi are radio-opaque
- C. It may present without haematuria
- D. There is a 20% chance of recurrence by 5 years
Correct Answer: C
Rationale: The correct answer is C because renal colic can present without hematuria. Renal colic is typically associated with severe flank pain caused by ureteral stones. Hematuria is a common symptom but not always present. This is due to the stone's location and size affecting the degree of irritation and damage to the urinary tract. Therefore, the absence of hematuria does not exclude the possibility of renal colic. Choices A, B, and D are incorrect. Females are not more commonly affected than males, calculi can be either radio-opaque or radio-lucent, and the recurrence rate by 5 years is closer to 50% rather than 20%.
Tubular reabsorption
- A. eliminates wastes from the body
- B. occurs mostly in the distal convoluted tubule
- C. usually helps control blood pH by removing H+ from the filtrate
- D. returns 99% of the water filtered from the glomerulus to the blood
Correct Answer: D
Rationale: The correct answer is D because tubular reabsorption refers to the process of reabsorbing substances, including water, from the renal tubules back into the bloodstream. This process occurs mainly in the proximal convoluted tubule and loop of Henle, not the distal convoluted tubule as stated in choice B. Choice A is incorrect because tubular reabsorption does not specifically eliminate wastes; that is the role of tubular secretion. Choice C is incorrect because tubular reabsorption does not directly control blood pH by removing H+ ions from the filtrate; that is primarily done through the kidneys' buffering systems. Overall, choice D is the most accurate as it reflects the primary function of tubular reabsorption in returning water back to the blood.
Which macrolide antibiotic that can be given once a day for 3 days for empirical treatment of ENT, respiratory and genital infections?
- A. Erythromycin
- B. Azithromycin
- C. Clarithromycin
- D. Roxithromycin
Correct Answer: B
Rationale: The correct answer is B: Azithromycin. It is preferred for short-term treatment due to its long half-life allowing once-daily dosing. Azithromycin has a broad spectrum of activity against many pathogens causing ENT, respiratory, and genital infections. It is well-tolerated and has fewer drug interactions. Other choices like A: Erythromycin have a higher frequency of dosing and more side effects. C: Clarithromycin and D: Roxithromycin are not typically given once daily for 3 days.
Imipenem has the broadest spectrum of activity currently available to beta-lactams. This include antimicrobial activity against the following organisms EXCEPT:
- A. Staphylococcus aureus
- B. Staphylococcus epidermidis
- C. Pseudomonas aeruginosa
- D. Mycoplasma pneumoniae
Correct Answer: D
Rationale: The correct answer is D: Mycoplasma pneumoniae. Imipenem, a carbapenem antibiotic, has broad-spectrum activity against Gram-positive, Gram-negative, anaerobic, and some atypical bacteria. Mycoplasma pneumoniae is an atypical bacteria lacking a cell wall, making it resistant to beta-lactam antibiotics like imipenem. Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa are all susceptible to imipenem due to their cell wall composition.
Acetazolamide is not frequently used as diuretic but the current indication is * in the treatment of:
- A. Liver cirrhosis
- B. CHF
- C. Glaucoma
- D. Kidney failure
Correct Answer: C
Rationale: Acetazolamide is a carbonic anhydrase inhibitor commonly used in treating glaucoma due to its ability to decrease intraocular pressure. The drug works by reducing the production of aqueous humor in the eye. This mechanism makes it an effective treatment for glaucoma. In contrast, liver cirrhosis (choice A) is typically managed with diuretics that act on the kidneys to reduce fluid accumulation. CHF (choice B) is commonly treated with loop diuretics to reduce fluid overload and improve cardiac function. Acetazolamide is not indicated for treating heart failure. Kidney failure (choice D) may require diuretics to manage fluid balance, but acetazolamide is not the first-line treatment in this condition. Therefore, the correct answer is C, as acetazolamide's current indication is in the treatment of glaucoma.