Nokea
Which of the following secretes the antidiuretic hormone?
- A. Lungs
- B. Pituitary gland
- C. Liver
- D. Pineal gland
Correct Answer: B
Rationale: The correct answer is B: Pituitary gland. The antidiuretic hormone (ADH), also known as vasopressin, is produced and secreted by the pituitary gland. This hormone helps regulate water balance in the body by increasing water reabsorption in the kidneys. The other choices, A: Lungs, C: Liver, and D: Pineal gland, do not secrete ADH. Lungs are responsible for gas exchange, the liver performs various metabolic functions, and the pineal gland regulates sleep-wake cycles through melatonin secretion. Therefore, the pituitary gland is the only gland among the options that secretes the antidiuretic hormone.
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Which test is required for a diagnosis of pyelonephritis?
- A. Renal biopsy
- B. Blood culture
- C. Intravenous pyelogram (IVP)
- D. Urine for culture and sensitivity
Correct Answer: D
Rationale: The correct answer is D, Urine for culture and sensitivity. This test is required for a diagnosis of pyelonephritis as it helps identify the specific bacteria causing the infection and determines the most effective antibiotic treatment. Renal biopsy (A) is not typically required for diagnosing pyelonephritis. Blood culture (B) may be helpful in severe cases but is not specific for pyelonephritis. Intravenous pyelogram (IVP) (C) is a radiological test used to visualize the urinary tract but does not confirm the diagnosis of pyelonephritis.
An outbreak of influenza A has just been reported in his community and a 45 year old man is exhibiting initial symptoms of influenza A. Which agent would be the most useful to treat him?
- A. Cidofovir
- B. Famciclovir
- C. Amantadine
- D. Ribavirin
Correct Answer: C
Rationale: The correct answer is C: Amantadine. Amantadine is an antiviral medication that is specifically effective against influenza A virus. It works by blocking the viral ion channel, preventing the virus from entering the host cell. This inhibits viral replication and helps reduce the severity and duration of symptoms.
Choice A, Cidofovir, is used to treat certain DNA viruses but is not effective against influenza A. Choice B, Famciclovir, is used to treat herpes viruses, not influenza A. Choice D, Ribavirin, is an antiviral medication used for respiratory syncytial virus and hepatitis C, but not as effective against influenza A. Therefore, the most appropriate choice in this scenario is Amantadine due to its specific activity against influenza A virus.
A 70 year old man has severe urinary hesitancy associated with BPH. He has tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
- A. Leuprolide
- B. Finasteride
- C. Flutamide
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride is a 5α-reductase inhibitor that reduces the conversion of testosterone to dihydrotestosterone in the prostate, thereby shrinking the prostate gland and improving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used in prostate cancer, not BPH. Flutamide (C) is an antiandrogen used in prostate cancer. Ketoconazole (D) is an antifungal drug and not indicated for BPH.
Which of the following substances does NOT NOT normally be expected to appear in normally pass through from glomerular urine? capillaries into the filtrate?
- A. water
- B. albumin
- C. urea
- D. sodium ions
Correct Answer: B
Rationale: The correct answer is B: albumin. Glomerular capillaries have a filtration barrier that prevents large molecules like albumin from passing into the filtrate. Water (A), urea (C), and sodium ions (D) are smaller molecules that can pass through the filtration barrier and are normally found in the filtrate. Albumin, being a large protein molecule, is normally retained in the blood and not expected to appear in the filtrate. This is essential for maintaining proper blood composition and oncotic pressure.
Superinfections are more common with:
- A. Use of narrow spectrum antibiotics
- B. Short courses of antibiotics
- C. Use of antibiotics that are completely absorbed from the small intestines
- D. Use of antibiotic combinations covering both gram positive and gram negative bacteria
Correct Answer: D
Rationale: The correct answer is D because using antibiotic combinations covering both gram positive and gram negative bacteria can disrupt the balance of normal flora in the body, leading to superinfections. Gram positive and gram negative bacteria have different susceptibility patterns, so using a combination of antibiotics increases the likelihood of killing off a wider range of bacteria, including the beneficial ones. This disruption paves the way for opportunistic pathogens to overgrow and cause superinfections. Choices A, B, and C are incorrect because narrow spectrum antibiotics target specific bacteria, short courses of antibiotics reduce the risk of resistance and overgrowth, and antibiotics completely absorbed from the small intestines have minimal impact on gut flora compared to systemic antibiotics.