Nokea
Which of the following would be an appropriate therapeutic adjustment for the patient with hypermagnesemia, vomiting, and heart failure?
- A. Add potassium supplementation and reduce the digoxin dose
- B. Add atropine and reduce the digoxin dose
- C. Increase the furosemide dose and reduce the digoxin dose
- D. Discontinue digoxin and start losartan
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Hypermagnesemia can exacerbate heart failure.
2. Vomiting may further worsen magnesium levels.
3. Digoxin toxicity is a concern in hypermagnesemia.
4. Discontinuing digoxin is crucial to avoid adverse effects.
5. Starting losartan can help manage heart failure without worsening hypermagnesemia.
Summary:
A: Adding potassium may worsen hypermagnesemia.
B: Atropine is not indicated for hypermagnesemia or heart failure.
C: Increasing furosemide may lead to electrolyte imbalances.
D: Discontinuing digoxin and starting losartan is the appropriate therapeutic adjustment.
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A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after 1 or 2 sublingual nitroglycerin tablets and rest. What type of angina is he experiencing?
- A. Classic
- B. Variant
- C. Unstable
- D. Prinzmetal’s
Correct Answer: A
Rationale: The correct answer is A: Classic angina. This type of angina is characterized by chest pain occurring predictably with exertion and relieved by rest or nitroglycerin. In this case, the golfer experiences pain at the end of games, consistent with exertional angina. Variant angina (B) occurs at rest due to coronary artery spasm. Unstable angina (C) is characterized by chest pain at rest that is new or changing in pattern. Prinzmetal's angina (D) is also due to coronary artery spasm but typically occurs at rest and is not necessarily related to exertion.
Hypertriglyceridemia denotes high blood levels of triglycerides. It has been associated with atherosclerosis, even in the absence of hypercholesterolemia (high cholesterol levels). This consideration is:
- A. TRUE
- B. FALSE
- C. All
- D. None
Correct Answer: A
Rationale: The correct answer is A: TRUE. Hypertriglyceridemia is indeed associated with atherosclerosis, even without high cholesterol levels. Triglycerides play a role in the development of atherosclerosis by contributing to the formation of plaque in the arteries. High levels of triglycerides can lead to inflammation and damage to the arterial walls, promoting the development of atherosclerosis. Therefore, the statement is true. Choices B, C, and D are incorrect because they do not accurately reflect the relationship between hypertriglyceridemia and atherosclerosis as described in the question stem.
What happened in the 10 years after the United Nations Office of Drug Control (UNODC) proclaimed as their slogan in 1998, “A drug-free world: We can do it!”?
- A. The global production and sale of heroin was cut in half by tough anti-drug trafficking measures.
- B. The production and sale of heroin doubled worldwide.
- C. A conglomerate of 42 dissenting nations, led by Bolivia, started campaigning for the repeal of the Single Convention on Narcotic Drugs.
- D. 4000 illegal opium farms were registered as legal opium farms (producing opium for the legal pharmaceutical industry).
Correct Answer: B
Rationale: The correct answer is B because the statement "A drug-free world: We can do it!" is an unrealistic and overly ambitious goal. In reality, the production and sale of heroin worldwide did not decrease significantly; instead, it doubled in the 10 years following the slogan. This outcome highlights the complexity and challenges of tackling drug issues globally.
A is incorrect because tough anti-drug trafficking measures alone cannot cut global heroin production and sale in half significantly.
C is incorrect because a conglomerate of dissenting nations campaigning for the repeal of the Single Convention on Narcotic Drugs is not directly related to the UNODC slogan outcome.
D is incorrect because the conversion of illegal opium farms to legal ones does not address the overall increase in global heroin production and sale.
Indicate the nootropic agent useful in disorders of brain circulation:
- A. Aspirin
- B. Pyracetam
- C. Warfarin
- D. All the above
Correct Answer: B
Rationale: The correct answer is B: Pyracetam. Pyracetam is a nootropic agent that is known for its benefits in enhancing cognitive function and improving brain circulation. It works by increasing blood flow and oxygen utilization in the brain, making it useful in disorders of brain circulation.
A: Aspirin is a common pain reliever and anti-inflammatory drug, but it is not specifically classified as a nootropic agent for brain circulation disorders.
C: Warfarin is an anticoagulant medication that helps prevent blood clots, but it is not a typical choice for enhancing brain circulation or cognitive function.
D: "All the above" is incorrect as only Pyracetam is specifically known for its benefits in disorders of brain circulation, making it the correct choice in this scenario.
Regarding verapamil, which one of the following statements is false?
- A. Angina pectoris is an important indication for the use of verapamil
- B. Contraindicated in the asthmatic patient
- C. Relaxes vascular smooth muscle
- D. Slows the depolarization phase of the action potential in AV nodal cells
Correct Answer: B
Rationale: Verapamil is not contraindicated in asthma; it primarily affects cardiac and vascular smooth muscle, not bronchial smooth muscle, unlike beta-blockers.