Nokea
Which is the most common organism/s causing osteomyelitis in all age groups?
- A. streptococci
- B. staph aureus
- C. gm negatives
- D. hemophilus
Correct Answer: B
Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.
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Which of the following statements regarding weight regulation is TRUE?
- A. Weight regain after weight loss is physiological and not necessarily due to a failure of conscious efforts (to lose weight)
- B. The reward system of weight regulation is homeostatic in nature
- C. Liking' and wanting' of food are mainly conscious processes
- D. In human studies, functional MRI (fMRI) studies have shown deficiency in reward-encoding brain regions and/or over activation in cortical inhibitory networks in obese people
Correct Answer: A
Rationale: Weight bounces back biology, not just willpower; rewards aren't homeostatic, liking's subconscious, fMRI flips, hypothalamus rules. Nurses get this chronic rebound truth.
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
Which of the following condition has low risk of progression to liver cirrhosis:
- A. Hepatic steatosis
- B. Hepatic steatohepatitis
- C. Hepatic steatohepatitis with fibrosis
- D. Chronic hepatitis
Correct Answer: A
Rationale: Steatosis fat sits, low cirrhosis odds; steatohepatitis, fibrosis, chronic, booze burn scar. Nurses mark this chronic liver lite.
Which of the following are not part of the diabetic retinopathy that cause visual impairment in patients with diabetes?
- A. Pre proliferative retinopathy
- B. Macular oedema
- C. Proliferative retinopathy
- D. Macular degeneration
Correct Answer: D
Rationale: Diabetic retinopathy pre-proliferative, edema, proliferative blur eyes from sugar's vessel rot. Macular degeneration's age, not diabetes. Nurses spot this, a chronic sight split.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.