Nokea
Which of the following statement(s) about metronidazole is correct?: *
- A. It is a rst line drug for amoebic dysentery as well as amoebic liver abscess
- B. It is activated nitro intermediates bind DNA and inhibit anaerobe replication
- C. It is the most effective drug in eradicating amoebic cysts from the colon
- D. (
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Metronidazole is a nitroimidazole antibiotic that requires activation by bacterial reductases to form nitro intermediates.
2. These activated intermediates bind DNA, leading to DNA strand breakage and inhibition of anaerobic bacterial replication.
3. This mechanism of action makes metronidazole effective against anaerobic bacteria.
4. Choice A is incorrect as metronidazole is not the first-line drug for amoebic dysentery or liver abscess - it is mainly used for anaerobic infections.
5. Choice C is incorrect as metronidazole is not the most effective drug for eradicating amoebic cysts in the colon; other drugs like tinidazole are preferred for that purpose.
6. Choice D is incomplete and does not provide any information related to metronidazole's mechanism of action.
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A patient has very high plasma uric acid and has high risk of developing acute * uric acid nephropathy. Which of the following agent should be avoided?
- A. Ethacrynic acid
- B. Acetazolamide
- C. Hydrochlorothiazide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that can worsen hyperuricemia by increasing renal uric acid reabsorption. This can further exacerbate the risk of acute uric acid nephropathy. Ethacrynic acid (A), Hydrochlorothiazide (C), and Furosemide (D) are loop diuretics that can actually help in reducing uric acid levels by increasing its excretion through the urine. Therefore, they would not be contraindicated in this scenario.
The highest incidence of antibiotic associated pseudomembranous * enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with a high incidence of antibiotic-associated pseudomembranous enterocolitis due to its strong impact on disrupting the normal gut flora, leading to overgrowth of Clostridium difficile. This bacterium can produce toxins causing inflammation and pseudomembrane formation in the colon. Ampicillin (A) can also cause C. difficile infection, but clindamycin is more strongly associated. Chloramphenicol (B) and vancomycin (C) are less commonly associated with pseudomembranous enterocolitis compared to clindamycin.
A 1mm renal calculi in the ureter will most likely impact at
- A. the pelvi-ureteric junction
- B. the vesico-ureteric junction
- C. the pelvic brim
- D. the bladder orifice
Correct Answer: A
Rationale: The correct answer is A: the pelvi-ureteric junction. A 1mm renal calculi is most likely to impact at this location because the pelvi-ureteric junction is the narrowest part of the ureter, making it more susceptible to blockages. The size of the calculi is small enough to get lodged at this site, causing obstruction and symptoms. The other choices are incorrect because the vesico-ureteric junction and bladder orifice are wider areas, less likely to be obstructed by a small calculi. The pelvic brim is not a common site for renal calculi obstruction.
What piece of the patient's medical history supports the diagnosis of a urinary tract infection?
- A. The patient's wife had a urinary tract infection 1 month ago.
- B. The patient has been followed for prostate disease for 2 years.
- C. The patient had intermittent catheterization 6 months ago.
- D. The patient had a kidney stone removed 1 year ago.
Correct Answer: C
Rationale: The correct answer is C because a history of intermittent catheterization increases the risk of urinary tract infections due to potential introduction of bacteria into the urinary system. This directly supports the diagnosis of a urinary tract infection.
A: The wife's history is irrelevant unless the patient had direct contact or shared personal items with her.
B: Prostate disease does not directly correlate with a urinary tract infection.
D: Kidney stones are not directly related to urinary tract infections unless there was an associated infection during the stone removal.
When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would:
- A. Assess the patient for the presence of a herni
- C. Suspect the presence of serous fluid in the scrotum.
- D. Consider this finding normal, and proceed with the examination.
Correct Answer: A
Rationale: The correct answer is A: Assess the patient for the presence of a hernia. When scrotal contents show a red glow with transillumination, it indicates the presence of serous fluid or air, which can occur in a hernia. A hernia can cause the scrotal contents to be illuminated due to the presence of fluid or air. Other choices are incorrect because option C is misleading as serous fluid would not cause transillumination. Option D is incorrect as this finding is not normal and requires further assessment. Option B is incomplete and not related to the finding.