Nokea
Which is incorrect of renal transplant patients?
- A. Identical twin donor and recipient, require no immunosuppression..
- B. Graft rejection may present with graft tenderness, decreased urine output and increased
- D. Infection is the most common cause of morbidity and mortality in the early stages, with 80% developing infection in the first year.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Identical twin donor and recipient still require immunosuppression due to minor histocompatibility antigens. Failure to suppress the immune system can lead to rejection. Graft rejection may present with symptoms such as graft tenderness, decreased urine output, and increased creatinine levels. Infections are indeed a common cause of morbidity and mortality in renal transplant patients, with a high incidence within the first year post-transplant. Therefore, choice A is incorrect as even identical twin donors and recipients require immunosuppression to prevent rejection.
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One of your patients is awaiting laboratory results for kidney function. The patient has recently recovered from a streptococcal throat infection. The patient has most likely developed symptoms of:
- A. Pyelonephritis.
- B. Nephrolithiasis.
- C. Chronic renal failure.
- D. Glomerulonephritis.
Correct Answer: D
Rationale: The correct answer is D: Glomerulonephritis. Streptococcal infection can lead to poststreptococcal glomerulonephritis (PSGN), an immune-mediated inflammation of the glomeruli in the kidneys. This results in hematuria, proteinuria, hypertension, and edema. Pyelonephritis (choice A) is a bacterial infection of the kidneys, not related to streptococcal infection. Nephrolithiasis (choice B) is the formation of kidney stones, which is not directly linked to streptococcal infection. Chronic renal failure (choice C) is a long-term decline in kidney function, not typically caused by streptococcal infection.
The following tetracycline has the potential to cause vestibular toxicity: *
- A. Doxycline
- B. Oxytetracycline
- C. Minocycline
- D. Demeclocycline
Correct Answer: C
Rationale: The correct answer is C, Minocycline. Minocycline has a higher potential for vestibular toxicity compared to other tetracyclines due to its greater lipid solubility, leading to increased penetration of the blood-brain barrier and inner ear. This can result in dizziness, vertigo, and imbalance.
Choice A, Doxycycline, is less likely to cause vestibular toxicity since it has lower lipid solubility and reduced penetration into the inner ear. Choice B, Oxytetracycline, and Choice D, Demeclocycline, also have lower potential for vestibular toxicity compared to Minocycline due to similar reasons. Overall, Minocycline stands out as the correct answer due to its unique pharmacokinetic properties that predispose it to vestibular toxicity.
The process by which water is reabsorbed by following solutes when they are reabsorbed is called
- A. obligatory water reabsorption
- B. facultative water reabsorption
- C. osmotic water reabsorption
- D. renin-angiotensin water reabsorption
Correct Answer: B
Rationale: The correct answer is B: facultative water reabsorption. This process occurs in the collecting ducts of the nephron in the kidney, where water reabsorption is regulated based on the body's hydration levels. When solutes like sodium are reabsorbed, water follows passively through aquaporin channels, adjusting the amount of water reabsorbed according to the body's needs.
A: Obligatory water reabsorption refers to the constant reabsorption of water in the proximal tubule and descending loop of Henle, not regulated based on hydration levels.
C: Osmotic water reabsorption is a general term referring to the movement of water based on osmotic gradients, not specifically regulated by solute reabsorption.
D: Renin-angiotensin water reabsorption involves the renin-angiotensin-aldosterone system in response to low blood pressure, focusing on sodium reabsorption rather than direct regulation of
A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if these changes could be attributable to the hormone replacement therapy (HRT) she started 3 months earlier. The nurse should tell her:
- A. HRT is at such a low dose that side effects are very unusual.
- B. HRT has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.
- C. Vaginal bleeding with HRT is very unusual; I suggest you come into the clinic immediately to have this evaluated.
- D. It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week.
Correct Answer: B
Rationale: The correct answer is B because hormone replacement therapy (HRT) commonly causes side effects such as fluid retention, breast tenderness, and vaginal bleeding. This information is important for the nurse to communicate to the patient, as it aligns with the symptoms the woman is experiencing. Choice A is incorrect as even low doses of HRT can still result in side effects. Choice C is incorrect because vaginal bleeding with HRT is not very unusual and does not necessitate immediate evaluation unless it is severe. Choice D is incorrect as adjusting the dose without proper evaluation could be dangerous and is not the appropriate first step in addressing the patient's concerns.
Which of the following drug should be used only as clinical curative but not as prophylactic in malaria?:
- A. Pyrimethamine + sulfadoxine
- B. Proguanil
- C. Primaquine
- D. Mefloquine
Correct Answer: C
Rationale: The correct answer is C: Primaquine. Primaquine is used for clinical curative treatment of malaria, particularly for the eradication of hypnozoites in Plasmodium vivax and Plasmodium ovale infections. It is not used as a prophylactic drug due to its potential side effects, such as hemolysis in individuals with G6PD deficiency.
Choice A (Pyrimethamine + sulfadoxine) is a combination used for both treatment and prophylaxis.
Choice B (Proguanil) is used for prophylaxis and treatment.
Choice D (Mefloquine) is used for both prophylaxis and treatment of malaria.