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What is a cause of primary hypothyroidism in adults?
- A. Malignant or benign thyroid nodules
- B. Surgical removal or failure of the pituitary gland
- C. Surgical removal or radiation of the thyroid gland
- D. Autoimmune-induced atrophy of the thyroid gland
Correct Answer: D
Rationale: Primary hypothyroidism in adults is commonly caused by autoimmune diseases such as Hashimoto's thyroiditis, which leads to thyroid tissue destruction.
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Through which opening does the food leave the stomach?
- A. The pyloric sphincter
- B. The ilea caecal valve
- C. The pelvic sphincter
- D. The pylorus sphincter
Correct Answer: A
Rationale: The correct answer is A: The pyloric sphincter. This is because the pyloric sphincter is the muscular valve located at the lower end of the stomach that controls the flow of partially digested food (chyme) into the small intestine. It regulates the release of food from the stomach into the duodenum for further digestion and absorption.
Summary of incorrect choices:
B: The ilea caecal valve - This valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine), not the stomach.
C: The pelvic sphincter - This sphincter is associated with the rectum and anus, not the stomach.
D: The pylorus sphincter - Similar to the correct answer, but the correct term is pyloric sphincter.
Myxedema, Graves’ disease, and cretinism are:
- A. hypothyroid disorders.
- B. due to a deficiency of TSH.
- C. disorders of the thyroid gland.
- D. best treated with T3 and/or T4.
Correct Answer: C
Rationale: Rationale: Myxedema, Graves' disease, and cretinism are all disorders directly related to the thyroid gland, involving either hypo or hyperactivity. Myxedema and cretinism are hypothyroid disorders, while Graves' disease is a hyperthyroid disorder. Thus, the correct answer is C. Choice A is incorrect as Graves' disease is a hyperthyroid disorder. Choice B is incorrect as these disorders are not solely due to a deficiency of TSH. Choice D is incorrect as treatment can vary depending on the specific disorder and may not always involve T3 and/or T4.
You are a resident in a hospital in a very poor part of the world. Their drug selection is limited. A patient presents with acute cardiac failure, for which your preferred drug is dobutamine, given intravenously. However, there is none available. Which of the following other drugs, or combination of drugs, would be a suitable alternative?
- A. Dopamine (at a very high dose)
- B. Ephedrine
- C. Ephedrine plus propranolol
- D. Norepinephrine plus phentolamine
Correct Answer: D
Rationale: The correct answer is D: Norepinephrine plus phentolamine. Norepinephrine is a potent vasopressor that can increase blood pressure and cardiac output in acute cardiac failure. Phentolamine is an alpha-blocker that can help counteract the vasoconstrictive effects of norepinephrine.
Rationale:
1. Norepinephrine: Increases blood pressure and cardiac output, improving perfusion to vital organs in acute cardiac failure.
2. Phentolamine: Counteracts the vasoconstrictive effects of norepinephrine, preventing excessive vasoconstriction.
Summary:
A: Dopamine at a very high dose may not be as effective as norepinephrine in acute cardiac failure.
B: Ephedrine is a less potent vasopressor compared to norepinephrine.
C: Ephedrine plus propranolol combination may lead to conflicting effects on blood pressure and heart rate
Which change in vital signs would you instruct a nursing assistant to report immediately for a patient with hyperthyroidism?
- A. Increased and rapid heart rate
- B. Decreased systolic blood pressure
- C. Increased respiratory rate
- D. Decreased oral temperature
Correct Answer: A
Rationale: Increased and rapid heart rate is a critical sign of hyperthyroidism and requires immediate reporting, as it could indicate an exacerbation of the condition or potential complications.
What is the distance travelled by the car in the 20 s shown?
- A. 80 m
- B. 100 m
- C. 160 m
- D. 200 m
Correct Answer: C
Rationale: The correct answer is C: 160 m. To calculate distance traveled, we use the formula: distance = speed x time. In this case, the speed of the car is 8 m/s (given in the graph) and the time is 20 s. Therefore, distance = 8 m/s x 20 s = 160 m. Choice A is incorrect as it is too low. Choice B is incorrect as it does not account for the full 20 s. Choice D is incorrect as it is too high based on the given speed and time.