Nokea
When is it not possible to blind a clinical trial using a placebo control group?
- A. in treatments where a convincing placebo treatment would be too dangerous to be ethically acceptable (e.g. surgery)
- B. in treatments where the active participation of the patient is necessary (e.g. physical therapy)
- C. in treatments where the standard placebo may have a deleterious effect on research participants (e.g. for diabetics)
- D. A and B
Correct Answer: D
Rationale: The correct answer is D because both A and B scenarios present limitations to blinding with a placebo control group. In scenario A, using a placebo in dangerous treatments like surgery would be unethical due to potential harm. In scenario B, patient participation is crucial, making it difficult to blind the trial. Option C is incorrect as it specifically mentions a standard placebo potentially harming diabetics, which is not a general rule for all clinical trials.
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A patient has been taking chlorpromazine (Thorazine) for the past 2 weeks. He drools, has hand tremors, and walks with a shuffling gait. The nurse would correctly attribute these behaviors to:
- A. Akinesia
- B. Tardive dyskinesia
- C. Pseudoparkinsonism
- D. Neuroleptic malignant syndrome
Correct Answer: C
Rationale: The correct answer is C: Pseudoparkinsonism. This is because the patient is showing symptoms commonly associated with this condition, such as hand tremors, shuffling gait, and drooling, which are side effects of chlorpromazine. Akinesia (A) refers to a lack of movement, which is not the case here. Tardive dyskinesia (B) is a late-onset side effect of antipsychotic medications, characterized by involuntary movements, not hand tremors. Neuroleptic malignant syndrome (D) is a rare but life-threatening side effect of antipsychotic medications, presenting with fever, muscle rigidity, and altered mental status, not the symptoms described in the question.
Tick the luminal amebecide drug:
- A. Metronidazole
- B. Emetine
- C. Doxycycline
- D. Diloxanide
Correct Answer: D
Rationale: The correct answer is D: Diloxanide. Diloxanide is a luminal amebicide, meaning it acts within the lumen of the intestines to target and eliminate amoebas residing there. This drug is specifically effective against amoebic cysts and is not absorbed systemically. Metronidazole (A) and Emetine (B) are tissue amebicides, which act systemically to target amoebas in tissues. Doxycycline (C) is an antibiotic commonly used for bacterial infections, not for treating amoebiasis. Therefore, Diloxanide (D) is the correct choice for a luminal amebicide drug.
Rickets is:
- A. A deficiency disease resulting from a lack of vitamin D or calcium and from insufficient exposure to sunlight, characterized by defective bone growth and occurring chiefly in children
- B. A disease occurring primarily in adults that results from a deficiency in vitamin D or calcium and is characterized by a softening of the bones with accompanying pain and weakness
- C. A disease characterized by a decrease in bone mass and density, occurring especially in postmenopausal women, resulting in a predisposition to fractures and bone deformities such as a vertebral collapse
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because rickets is indeed a deficiency disease primarily affecting children due to lack of vitamin D, calcium, and sunlight exposure. Here's the rationale:
1. Rickets is characterized by defective bone growth, which aligns with the growth stage of children.
2. Rickets is caused by a lack of vitamin D or calcium, crucial for bone health.
3. Insufficient exposure to sunlight leads to decreased vitamin D synthesis.
4. Other choices are incorrect:
- Choice B describes osteomalacia, a disease in adults, not rickets.
- Choice C describes osteoporosis, a different condition in postmenopausal women.
- Choice D is incorrect since rickets does not encompass all the conditions mentioned.
Benzodiazepine′s usefulness is limited by:
- A. Tolerance
- B. Atropine-like symptoms
- C. Psychotic episodes
- D. Myasthenic syndrome
Correct Answer: A
Rationale: The correct answer is A: Tolerance. Benzodiazepines are known to lead to tolerance, meaning that over time, the body requires higher doses to achieve the same effect. This limits their usefulness as long-term treatment options. Atropine-like symptoms (B) are not associated with benzodiazepines. Psychotic episodes (C) and myasthenic syndrome (D) are also not common side effects of benzodiazepines. Therefore, the correct answer is A as tolerance limits the effectiveness of benzodiazepines over time.
Neuromuscular blockade by both succinylcholine and mivacurium may be prolonged in patients with:
- A. Renal failure
- B. An abnormal variant of plasma cholinesterase
- C. Hepatic disease
- D. Both b and c
Correct Answer: D
Rationale: The correct answer is D (Both B and C). Succinylcholine and mivacurium are metabolized by plasma cholinesterase. An abnormal variant of plasma cholinesterase (B) can lead to prolonged neuromuscular blockade. Additionally, hepatic disease (C) can impair the metabolism of these drugs, further prolonging their effects. Therefore, in patients with both abnormal plasma cholinesterase and hepatic disease, the neuromuscular blockade can be significantly prolonged. Renal failure (A) does not directly impact the metabolism of succinylcholine and mivacurium, so it is not a significant factor in this context.