Nokea
Which agent should not be part of the management of generalized tetanus?
- A. metronidazole
- B. penicillin
- C. midazolam
- D. tetanus immunoglobulin
Correct Answer: B
Rationale: Tetanus penicillin's old school, metronidazole's better for Clostridium now; midazolam calms, Ig neutralizes, labetalol steadies. Nurses skip this chronic bug zapper.
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Oxygen radicals play a role in the development of which of the following options?
- A. Diabetic dyslipidaemia
- B. Insulin resistance
- C. Mitochondrial dysfunction
- D. B+C
Correct Answer: D
Rationale: Oxygen radicals torch cells insulin resistance via inflammation, mitochondrial dysfunction via damage. Dyslipidaemia rides along, not direct nurses see this duo, a chronic stress pair.
Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors were shown to reduce albuminuria and proteinuria by X%. What is X?
- A. 10--30
- B. 20-40
- C. 30-50
- D. 40-60
Correct Answer: C
Rationale: SGLT-2 inhibitors, used in type 2 diabetes, reduce albuminuria and proteinuria by 30-50%, as evidenced in trials like CREDENCE and DAPA-CKD. They lower glomerular hyperfiltration by inhibiting glucose and sodium reabsorption in the proximal tubule, decreasing intraglomerular pressure and thus protecting kidney function. This 30-50% reduction is significant in slowing chronic kidney disease (CKD) progression, a key benefit beyond glycemic control. Lower ranges (10-30%, 20-40%) underestimate this effect, while higher ranges (40-60%) may apply to specific subgroups but aren't the average. This renal protection makes SGLT-2 inhibitors a cornerstone in managing diabetic nephropathy, vital knowledge for physicians optimizing chronic disease outcomes.
What is the relationship between hyperlipidaemia and non-alcoholic steatohepatitis (NASH)?
- A. Hyperlipidaemia contributes to the development of NASH
- B. NASH contributes to the development of hyperlipidaemia
- C. There is no relationship between hyperlipidaemia and NASH
- D. Answers 1 and 2 are correct
Correct Answer: D
Rationale: NASH and hyperlipidaemia dance both ways high lipids pile fat, NASH pumps them back, a chronic loop. No split or null fits nurses track this lipid-liver ping-pong.
Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.
The spinothalamic and dorsal column sensation are examined as part of a neurological examination. One of the items belonging to dorsal column sensation is the sense of vibration, which is examined by means of a tuning fork. Question: What is the required frequency of this tuning fork?
- A. 512 Hz
- B. 256 Hz
- C. 128 Hz
- D. 64 Hz
Correct Answer: C
Rationale: Vibration check 128 Hz hums right, dorsal column's sweet spot, not higher or lower. Nurses tune this, a chronic nerve test.