Nokea
Which of the following medications is commonly prescribed for patients with hypertension and chronic kidney disease?
- A. Lisinopril
- B. Furosemide
- C. Metoprolol
- D. Spironolactone
Correct Answer: A
Rationale: The correct answer is A: Lisinopril. Lisinopril is an ACE inhibitor commonly prescribed for patients with hypertension and chronic kidney disease. It helps to reduce blood pressure and protect the kidneys by dilating blood vessels and improving blood flow. Furosemide (B) is a diuretic used to treat fluid retention but not specifically indicated for chronic kidney disease. Metoprolol (C) is a beta-blocker primarily used for heart conditions. Spironolactone (D) is a potassium-sparing diuretic and is not the first-line treatment for hypertension in patients with chronic kidney disease.
You may also like to solve these questions
A 69-year-old female presents to your office for routine primary care. Her elder sister was recently diagnosed with Alzheimer's disease, and she wonders what steps she can take to reduce her own risk of developing dementia. Which of the following statements is true about the prevention of dementia?
- A. There is moderate quality evidence to support daily use of vitamin B12 and fish oil to prevent cognitive decline.
- B. Risk of dementia is modulated by non-modifiable risk factors, such as genetics, family history, and educational attainment, and there are no behavioral interventions that can reduce the risk of dementia.
- C. There is moderate quality evidence to suggest control of cardiovascular and metabolic risk factors, such as blood pressure, weight, and blood sugar, may reduce risk of dementia.
- D. There is moderate to low quality evidence supporting cannabinoids may reduce rates of progression from mild cognitive impairment to dementia.
Correct Answer: C
Rationale: The correct answer is C: There is moderate quality evidence to suggest control of cardiovascular and metabolic risk factors, such as blood pressure, weight, and blood sugar, may reduce the risk of dementia. This statement is true because studies have shown that managing cardiovascular and metabolic risk factors can help reduce the risk of developing dementia. High blood pressure, obesity, and diabetes have been linked to an increased risk of cognitive decline and dementia. By controlling these risk factors through lifestyle changes or medication, individuals can potentially lower their risk of developing dementia.
Choice A is incorrect because while vitamin B12 and fish oil may have some benefits for cognitive health, the evidence supporting their use in preventing dementia is not strong.
Choice B is incorrect because while genetics and family history play a role in dementia risk, there are behavioral interventions, such as maintaining a healthy lifestyle and managing risk factors, that can help reduce the risk of dementia.
Choice D is incorrect because there is not enough strong evidence to support the claim that cannabinoids can reduce rates
What clinical finding in a funduscopic examination is indicative of increased intracranial pressure?
- A. Pulsating veins
- B. Indistinct disk edge
- C. Clear disk edge
- D. Normal retinal appearance
Correct Answer: B
Rationale: The correct answer is B: Indistinct disk edge. Increased intracranial pressure causes papilledema, resulting in swelling and elevation of the optic disk. This leads to a blurred or indistinct disk edge. Pulsating veins (choice A) are seen in conditions like arteriovenous malformations, not specifically indicative of increased intracranial pressure. Clear disk edge (choice C) and normal retinal appearance (choice D) are not consistent with the findings associated with increased intracranial pressure.
Which of the following is the most common presenting sign of substance abuse in adolescents?
- A. Poor school performance
- B. Change in sleep habits
- C. Increased blood pressure
- D. Changes in behavior
Correct Answer: D
Rationale: The correct answer is D: Changes in behavior. This is the most common presenting sign of substance abuse in adolescents because substance use often leads to noticeable changes in behavior, such as irritability, mood swings, aggression, and withdrawal from family and friends. These behavioral changes are typically the first noticeable signs of substance abuse.
A: Poor school performance may be a consequence of substance abuse, but it is not necessarily the most common presenting sign.
B: Change in sleep habits can be a sign of substance abuse, but changes in behavior are more prominent and common.
C: Increased blood pressure is a physical symptom of substance abuse, but changes in behavior are usually more readily apparent and commonly observed in adolescents with substance abuse issues.
When palpating the prostate gland during the rectal exam, the prostate feels tender, swollen, boggy, and warm. This finding is consistent with:
- A. A normal prostate gland
- B. Acute bacterial prostatitis
- C. Benign prostatic hyperplasia
- D. Carcinoma of the prostate
Correct Answer: B
Rationale: The correct answer is B: Acute bacterial prostatitis. This is because the symptoms of tenderness, swelling, bogginess, and warmth are indicative of an acute inflammatory process, which is commonly seen in acute bacterial prostatitis. This condition typically presents with localized prostate tenderness and inflammation due to a bacterial infection. Other choices are incorrect because: A) A normal prostate gland should not exhibit these signs of inflammation. C) Benign prostatic hyperplasia is typically asymptomatic or may present with obstructive urinary symptoms, not acute inflammatory signs. D) Carcinoma of the prostate usually does not present with acute inflammatory findings on palpation.
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
- A. Genital herpes
- B. Condylomata acuminata
- C. Syphilitic chancre
- D. Epidermoid cyst
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cyst. The key features in the clinical scenario that point towards an epidermoid cyst are the presence of painless, firm, non-tender, round, yellow nodules on the labia. These cysts are common in the vulvar area and often arise from blocked hair follicles. The absence of symptoms suggestive of a sexually transmitted infection (STI) such as vaginal discharge, pain with urination, fever, malaise, or night sweats, along with the patient's history of anxiety and the appearance of the nodules being consistent with an epidermoid cyst support this diagnosis.
Choice A: Genital herpes typically presents with painful vesicles or ulcers, which are not described in this case.
Choice B: Condylomata acuminata (genital warts) would present as soft, pink, or flesh-colored growths and are associated with HPV infection, which is not suggested in this scenario.
Choice C: Sy