Nokea
Which of the following is the most appropriate choice of treating * aspergillosis?
- A. Terbinan
- B. Amphotericin B
- C. Flucytosine
- D. Itraconazole
Correct Answer: B
Rationale: Answer B, Amphotericin B, is the most appropriate choice for treating aspergillosis due to its broad-spectrum antifungal activity, especially against Aspergillus species. It is often used for severe or systemic infections when other options are ineffective. Terbinafine (A) is more commonly used for dermatophyte infections, while Flucytosine (C) is typically used for certain yeast infections. Itraconazole (D) may be effective against some Aspergillus strains but is generally considered less effective than Amphotericin B for severe cases.
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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.
Which of the following new drug is indicated in managing SIADH , non - * peptide and competitive antagonist of ADH 's water sparing effects in the collecting ducts of nephron?
- A. Mannitol
- B. Bumetanide
- C. Spironolactone
- D. Conivaptan
Correct Answer: D
Rationale: The correct answer is D: Conivaptan. Conivaptan is a non-peptide competitive antagonist of ADH, specifically targeting the V2 receptors in the collecting ducts of the nephron. This mechanism of action inhibits ADH's water-sparing effects, making it an effective treatment for SIADH.
A: Mannitol is an osmotic diuretic used for conditions like cerebral edema and acute kidney injury, not specifically for SIADH.
B: Bumetanide is a loop diuretic used for conditions like heart failure and hypertension, not for managing SIADH.
C: Spironolactone is a potassium-sparing diuretic used for conditions like heart failure and hypertension, not for treating SIADH.
In summary, Conivaptan is the correct choice for managing SIADH due to its specific mechanism of action as a competitive antagonist of ADH in the collecting ducts, while the other options are
A 32-year-old woman presents with vaginal bleeding and lower abdominal pain. The nurse suspects an ectopic pregnancy. Which of the following is the most common risk factor for ectopic pregnancy?
- A. Previous pelvic surgery.
- B. Endometriosis.
- C. Tubal ligation.
- D. Pelvic inflammatory disease.
Correct Answer: D
Rationale: The correct answer is D: Pelvic inflammatory disease (PID). PID can lead to scarring and narrowing of the fallopian tubes, increasing the risk of ectopic pregnancy. This is because the fertilized egg may get stuck in the narrowed tube, leading to an ectopic pregnancy.
A: Previous pelvic surgery is a risk factor, but it is not the most common one for ectopic pregnancy.
B: Endometriosis can also affect fallopian tubes but is not the most common risk factor for ectopic pregnancy.
C: Tubal ligation is a form of contraception that reduces the risk of pregnancy but does not increase the risk of ectopic pregnancy.
In summary, PID is the most common risk factor for ectopic pregnancy due to its potential to cause fallopian tube scarring and narrowing, leading to the implantation of the fertilized egg outside the uterus.
Thiazide diuretics may produce an increase in blood levels of uric acid and:
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: D
Rationale: Thiazide diuretics can lead to hyperglycemia by reducing insulin sensitivity. This can result in increased blood glucose levels. Thiazides also elevate uric acid levels by reducing its excretion. Therefore, the correct answer is D (Glucose).
Incorrect choices:
A (Potassium) - Thiazides typically cause hypokalemia, not hyperkalemia.
B (BUN) and C (Urea) - Thiazides may cause a slight increase in BUN and serum creatinine levels due to reduced kidney function, but not as significantly as glucose levels.
A 20 year old male patient is diagnosed with Chaga’s disease, American trypanosomiasis. Which drug would be the most appropriate for this patient?
- A. Nifurtimox
- B. Metronidazole
- C. Suramin
- D. Chloroquine
Correct Answer: A
Rationale: The correct answer is A: Nifurtimox. Nifurtimox is the first-line treatment for Chagas disease caused by Trypanosoma cruzi. It is effective in treating both acute and chronic phases of the disease by reducing parasitemia. Metronidazole (B) is used for anaerobic bacterial infections, not trypanosomiasis. Suramin (C) is used for African trypanosomiasis, not American trypanosomiasis. Chloroquine (D) is used for malaria, not trypanosomiasis. Therefore, A is the most appropriate choice for this patient.