Nokea
Which of the following are the characteristics of masked hypertension?
- A. High home BP more than three days in a week
- B. Normal office BP and high home BP
- C. High office BP and normal home BP
- D. Normal office BP and normal home BP
Correct Answer: B
Rationale: Masked hypertension hides normal office readings (<140/90) clash with high home BP (>135/85), dodging detection, yet hiking cardiovascular risk. High home BP alone lacks context; high office with normal home is white-coat hypertension. Normal both ways is healthy; high both is overt hypertension. This sneaky pattern demands home monitoring to unmask, as office calm misses real-world spikes, pushing clinicians to dig deeper for treatment, a silent chronic threat exposed by dual settings.
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Which is FALSE regarding PCP pneumonia in AIDS?
- A. it is usually only seen when the CD4 count <200
- B. prophylaxis should be given in all pts with CD4 count <200
- C. CXR characteristically shows bilateral diffuse infiltrates
- D. Once a patient has had it they are unlikely to get it again
Correct Answer: D
Rationale: PCP relapse haunts AIDS CD4 <200 stays vulnerable, not a one-off. Prophylaxis holds below 200, CXR's diffuse or blank 20%, all true. Nurses know this chronic lung leech bites again sans lifelong guard.
When using induced hypotension during orthognathic surgery:
- A. Mean arterial blood pressure may be reduced to 30% of normal in patients of ASA grade I.
- B. The stress response to surgery is attenuated.
- C. Drugs that cause relative bradycardia are useful adjuncts.
- D. The desired effects of clonidine are mediated by αâ‚-adrenoceptors.
Correct Answer: C
Rationale: Induced hypotension in orthognathic surgery reduces bleeding, enhancing visibility. Mean arterial pressure (MAP) drops to 50-65 mmHg (not 30% of normal, ~20-25 mmHg, which risks ischemia), safe in ASA I patients with monitoring. Stress response attenuation occurs with deep anaesthesia, not hypotension alone. Bradycardia-inducing drugs (e.g., β-blockers, remifentanil) stabilize haemodynamics, aiding controlled hypotension by lowering cardiac output safely. Clonidine, an α₂-agonist (not αâ‚), reduces sympathetic outflow, supporting hypotension and sedation. Invasive monitoring mitigates pressure injury risk. Bradycardia's role enhances technique precision, minimizing transfusion needs while maintaining perfusion in healthy patients.
In patients who are awake during craniotomy, appropriate statements include:
- A. For a temporal lesion, neurosurgeons are likely to require the sitting position.
- B. A tracheal tube is likely to be used.
- C. A urinary catheter is likely to be inserted.
- D. Intraoperative seizures are likely to occur during cortical mapping.
Correct Answer: C
Rationale: Awake craniotomy allows functional mapping and patient cooperation. The sitting position is rare due to air embolism risks and is not specific to temporal lesions; supine or lateral positions are standard. A tracheal tube is avoided to maintain airway control via less invasive means (e.g., nasal cannula), as patients must remain responsive. A urinary catheter is routine for longer procedures to manage fluid balance and patient comfort, given immobility and duration. Patient anxiety is common but manageable, not an absolute contraindication. Seizures can occur during cortical mapping due to electrical stimulation, but likely' overstates frequency; they're a risk, not a certainty. The urinary catheter's inclusion reflects practical perioperative care, ensuring monitoring and comfort without interrupting the procedure's focus on brain function preservation.
Foam cells are a prominent feature of atherosclerosis. Question: Foam cells develop as a result of which of the following options?
- A. Uptake of LDL in macrophages
- B. Uptake of LDL by LDL-R
- C. Uptake of ox-LDL by scavenger receptors
- D. Uptake of LDL by scavenger receptors
Correct Answer: C
Rationale: Foam cells ox-LDL via scavenger receptors stuff macrophages, not plain LDL or LDL-R. Nurses see this, a chronic plaque birth.
A 44 year old man with type 2 DM and hyperlipidemia is currently taking daily simvastatin 40 mg. His lipid profile repeated 12 weeks after treatment shows the following results: Total cholesterol 4.2 mmol/L, HDL-cholesterol 0.9 mmol/L, LDL-cholesterol 2.2 mmol/L, Triglyceride 2.4 mmol/L. Which lipid regulating drug should be MOST appropriately added?
- A. Colestyramine
- B. Omega 3 fatty acid
- C. Fenofibrate
- D. Nicotinic acid
Correct Answer: C
Rationale: Simvastatin's cut LDL to 2.2, but triglycerides linger at 2.4 above 1.7's ideal and HDL's low at 0.9. Fenofibrate slashes triglycerides, lifts HDL, a perfect next step for this type 2 mix. Colestyramine binds bile, not triglycerides; omega-3 helps less here; nicotinic acid's harsh; ezetimibe's LDL focus misses. Nurses see this combo statin plus fibrate as a chronic lipid tune-up, dodging heart risks tied to diabetes.