Nokea
Thiazide diuretics may produce an increase in blood levels of uric acid and: *
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: A
Rationale: Thiazide diuretics decrease urinary excretion of uric acid, leading to increased blood levels. Thiazides also increase potassium reabsorption, potentially causing hyperkalemia. However, the main effect on uric acid levels makes choice A correct. Choices B, C, and D are incorrect as thiazides do not directly impact BUN, urea, or glucose levels.
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The primary role of the phosphate buffer system is to?
- A. buffer stomach acid
- B. buffer carbonic acid formed by carbon dioxide
- C. limit pH changes caused by metabolic and fixed acids
- D. buffer the urine
Correct Answer: C
Rationale: The correct answer is C: limit pH changes caused by metabolic and fixed acids.
1. Phosphate buffer system consists of dihydrogen phosphate (H2PO4-) and hydrogen phosphate (HPO4^2-) ions, which can donate or accept H+ ions to maintain a stable pH.
2. Metabolic and fixed acids produced in the body can lead to pH changes. The phosphate buffer system helps to prevent drastic changes in pH by neutralizing excess H+ ions.
3. Options A, B, and D are incorrect because the phosphate buffer system is not specifically designed to buffer stomach acid, carbonic acid formed by carbon dioxide, or buffer the urine.
Which of the following components of renin-angiotensin-aldosterone system (RAAS) is not correctly paired with its function?
- A. Renin – cleavage of angiotensinogen to angiotensin I
- B. Angiotensin converting enzyme (ACE) – activation of angiotensin I to angiotensin II
- C. Aldosterone – sodium and water reabsorption
- D. Angiotensin II – vasoconstriction and decrease of blood pressure
Correct Answer: D
Rationale: The correct answer is D. Angiotensin II does not decrease blood pressure; it actually increases blood pressure through vasoconstriction. Renin cleaves angiotensinogen to form angiotensin I, and ACE converts angiotensin I to angiotensin II. Aldosterone acts on the kidneys to increase sodium and water reabsorption, leading to increased blood volume and pressure. Therefore, D is incorrect because Angiotensin II causes vasoconstriction and increases blood pressure.
A patient is being treated with furosemide and Digoxin because of CHF. She developed UTI. Which of the following antibiotics should NOT be prescribed?
- A. Cotrimoxazole
- B. Ciprofloxacin
- C. Gentamycin
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is known to have potential nephrotoxicity, which can exacerbate renal dysfunction caused by furosemide. It should be avoided in patients with CHF and UTI. Cotrimoxazole (A) can be used with caution, Ciprofloxacin (B) is generally safe, and Ampicillin (D) is a suitable choice for UTI treatment in this scenario.
Which of the following anthelmintic acts as a cholinergic agonist in the * nematodes and causes spastic paralysis of the worms?:
- A. Piperazine
- B. Pyrantel pamoate
- C. Mebendazole
- D. Albendazole
Correct Answer: A
Rationale: Rationale:
1. Piperazine is the correct answer as it acts as a cholinergic agonist in nematodes, causing spastic paralysis by mimicking acetylcholine.
2. Pyrantel pamoate works by depolarizing neuromuscular junctions, not through cholinergic agonism.
3. Mebendazole and Albendazole inhibit microtubule synthesis in worms, leading to impaired glucose uptake, not cholinergic effects.
A patient has very high plasma uric acid and has high risk of developing acute uric acid nephropathy. Which of the following agent should be avoided?
- A. Ethacrynic acid
- B. Acetazolamide
- C. Hydrochlorothiazide
- D. Furosemide
Correct Answer: D
Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic which can increase uric acid levels in the blood, potentially worsening the patient's condition. Ethacrynic acid (A) is also a loop diuretic and can have similar effects. Acetazolamide (B) is a carbonic anhydrase inhibitor and may increase urinary excretion of uric acid, which can be beneficial in this case. Hydrochlorothiazide (C) is a thiazide diuretic that can actually lower uric acid levels by increasing urinary excretion. Therefore, the best choice to avoid in a patient with high plasma uric acid and risk of acute uric acid nephropathy is furosemide.