Which of the following anthelmintic acts as a cholinergic agonist in the * nematodes and causes spastic paralysis of the worms?:
- A. Piperazine
- B. Pyrantel pamoate
- C. Mebendazole
- D. Albendazole
Correct Answer: A
Rationale: Rationale:
1. Piperazine is the correct answer as it acts as a cholinergic agonist in nematodes, causing spastic paralysis by mimicking acetylcholine.
2. Pyrantel pamoate works by depolarizing neuromuscular junctions, not through cholinergic agonism.
3. Mebendazole and Albendazole inhibit microtubule synthesis in worms, leading to impaired glucose uptake, not cholinergic effects.
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A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, 'Have you noticed any':
- A. Changes in your urination patterns?
- B. Excessive vaginal bleeding?
- C. Unusual vaginal discharge or itching?
- D. Changes in your desire for intercourse?
Correct Answer: C
Rationale: Rationale:
C is correct because UTI treatment can disrupt the vaginal microbiome, leading to yeast infection symptoms like unusual discharge or itching. A is relevant but focuses on only one aspect. B and D are unrelated to UTI treatment outcomes.
Corticosteroids are absolutely contraindicated in which of the following types * of tuberculosis?
- A. Miliary
- B. Meningeal
- C. Intestinal
- D. Renal
Correct Answer: B
Rationale: The correct answer is B: Meningeal tuberculosis. Corticosteroids are contraindicated in meningeal tuberculosis because they can suppress the immune response, leading to increased bacterial growth and dissemination in the central nervous system. For miliary, intestinal, and renal tuberculosis, corticosteroids can be beneficial in reducing inflammation and improving outcomes.
In the process of renal autoregulation,
- A. the loop of Henle reabsorbs more sodium and chloride ions
- B. the collecting tubule reabsorbs less water
- C. the afferent arterioles dilate, increasing glomerular filtration rate
- D. the efferent arterioles dilate, allowing blood to flow through the kidney faster
Correct Answer: B
Rationale: Step-by-step rationale for choice B being correct:
1. Renal autoregulation maintains a constant glomerular filtration rate (GFR).
2. If the collecting tubule reabsorbs less water, it helps regulate the body's fluid balance.
3. Reabsorbing less water in the collecting tubule helps prevent excessive fluid loss or retention.
4. This process ensures that the body maintains appropriate blood volume and blood pressure.
Summary of why other choices are incorrect:
A: Loop of Henle reabsorbs ions, not more sodium and chloride ions.
C: Afferent arterioles constrict to decrease GFR, not dilate to increase it.
D: Efferent arterioles constrict to maintain GFR, not dilate to allow faster blood flow.
Which of the following fungicidal drug that acts by inhibiting fungal squalene epoxidase enzyme and is the drug of choice for onychomycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinafine
- C. Itraconazole
- D. Amphotericin B
Correct Answer: B
Rationale: Step 1: Terbinafine is a fungicidal drug that inhibits fungal squalene epoxidase enzyme, disrupting fungal cell membrane synthesis.
Step 2: Onychomycosis of toenails is a common fungal infection that terbinafine is specifically effective against.
Step 3: The patient being a 56-year-old woman with diabetes may require a drug with good efficacy and safety profile, making terbinafine an appropriate choice.
Step 4: Griseofulvin (A) works by disrupting microtubule function, not inhibiting squalene epoxidase. Itraconazole (C) is an azole antifungal that inhibits ergosterol synthesis, not squalene epoxidase. Amphotericin B (D) is a polyene antifungal used for systemic mycoses, not onychomycosis.
A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:
- A. If you are menstruating, please use pads to avoid placing anything into the vagina.
- B. Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.
- C. If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.
- D. We would like you to use a mild saline douche before your examination. You may pick this up in our office.
Correct Answer: B
Rationale: The correct answer is B because avoiding intercourse, inserting anything into the vagina, or douching within 24 hours of the appointment helps ensure an accurate Pap smear result. Intercourse, vaginal products, and douching can introduce foreign substances or disrupt the natural vaginal flora, potentially affecting the test results. Option A is incorrect because using pads during menstruation is a general recommendation and not specific to a Pap smear appointment. Option C is incorrect because bringing a sample of discharge is not necessary for a Pap smear. Option D is incorrect because douching is not recommended before a Pap smear as it can alter the vaginal environment.