Nokea
Which hormone plays a central role in determining the rate of sodium reabsorption and potassium secretion?
- A. Insulin
- B. aldosterone
- C. BNP
- D. ANP
Correct Answer: B
Rationale: The correct answer is B: aldosterone. Aldosterone is a hormone produced by the adrenal glands that regulates sodium reabsorption and potassium secretion in the kidneys. It increases the reabsorption of sodium and water while promoting the excretion of potassium. This helps maintain electrolyte balance and blood pressure.
A: Insulin mainly regulates blood sugar levels by promoting glucose uptake into cells.
C: BNP (Brain Natriuretic Peptide) is involved in regulating fluid balance and blood pressure but not specifically sodium reabsorption.
D: ANP (Atrial Natriuretic Peptide) also plays a role in regulating fluid balance and blood pressure, but it promotes sodium excretion instead of reabsorption.
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A 52-year-old patient states that when she sneezes or coughs she wets herself a little. She is very concerned that something may be wrong with her. The nurse suspects that the problem is:
- A. Dysuria.
- B. Stress incontinence.
- C. Hematuria.
- D. Urge incontinence.
Correct Answer: B
Rationale: The correct answer is B: Stress incontinence. This is the most likely issue because the patient leaks urine during activities that increase intra-abdominal pressure, such as sneezing or coughing. Stress incontinence is due to weakened pelvic floor muscles and sphincter, leading to leakage with exertion. Dysuria (choice A) is painful urination, not related to leakage. Hematuria (choice C) is blood in urine, not related to leakage. Urge incontinence (choice D) involves a sudden, strong urge to urinate and is not triggered by sneezing or coughing.
Isoniazid is a primary antitubercular agent that:
- A. Requires pyridoxine (Vit B6) supplementation
- B. Penetrates the BBB and enters the brain useful in TB meningitis
- C. Causes ocular complications that are reversible if the drug is discontinued
- D. May be ototoxic and nephrotoxic
Correct Answer: A
Rationale: Step-by-step rationale for choice A being correct:
1. Isoniazid can lead to pyridoxine deficiency.
2. Pyridoxine supplementation helps prevent neurotoxicity.
3. Thus, isoniazid therapy requires pyridoxine supplementation.
Summary of why other choices are incorrect:
B: Isoniazid does not effectively penetrate the BBB.
C: Ocular complications of isoniazid are generally irreversible.
D: Ototoxicity and nephrotoxicity are not common side effects of isoniazid.
Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.
A 1mm renal calculi in the ureter will most likely impact at
- A. the pelvi-ureteric junction
- B. the vesico-ureteric junction
- C. the pelvic brim
- D. the bladder orifice
Correct Answer: A
Rationale: The correct answer is A: the pelvi-ureteric junction. A 1mm renal calculi is most likely to impact at this location because the pelvi-ureteric junction is the narrowest part of the ureter, making it more susceptible to blockages. The size of the calculi is small enough to get lodged at this site, causing obstruction and symptoms. The other choices are incorrect because the vesico-ureteric junction and bladder orifice are wider areas, less likely to be obstructed by a small calculi. The pelvic brim is not a common site for renal calculi obstruction.
What is a factor that contributes to an increased incidence of urinary tract infections in aging women?
- A. Length of the urethra
- B. Larger capacity of bladder
- C. Relaxation of pelvic floor and bladder muscles
- D. Tight muscular support at the urinary sphincter
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Aging causes relaxation of pelvic floor and bladder muscles.
2. This relaxation can lead to incomplete emptying of the bladder.
3. Residual urine in the bladder can increase the risk of UTIs.
4. Therefore, relaxation of pelvic floor and bladder muscles contributes to increased UTI incidence.
Summary of Incorrect Choices:
A: Length of the urethra - Longer urethra typically reduces UTI risk by providing more distance for bacteria to travel.
B: Larger capacity of bladder - Larger bladder capacity does not directly increase UTI risk.
D: Tight muscular support at the urinary sphincter - Tight support does not directly impact UTI risk; relaxation is the key factor.