D027 Advanced Pathopharmacological Foundations - Set 3 - Part 1

Correct Answer: Levothyroxine therapy

Levothyroxine provides synthetic thyroid hormone replacement, effectively treating hypothyroidism symptoms including cold intolerance and metabolic slowing.
Option a is incorrect because propylthiouracil treats hyperthyroidism by blocking thyroid hormone production, worsening hypothyroid symptoms.
Option c is incorrect because methimazole also treats hyperthyroidism, not the hormone deficiency in hypothyroidism.
Option d is incorrect because liothyronine is typically combined with levothyroxine, not used alone for replacement.

Correct Answer: Acyclovir

Acyclovir effectively reduces chickenpox severity when administered within twenty-four hours of rash onset in varicella-zoster infection.
Option a is incorrect because amoxicillin treats bacterial infections, not the viral varicella-zoster causing chickenpox.
Option c is incorrect because prednisone suppresses immunity and can worsen viral infections like chickenpox.
Option d is incorrect because cephalexin is an antibiotic for bacterial infections, not viral chickenpox treatment.

Correct Answer: Wandering risk increased

Moderate Alzheimer's stage shows increased wandering risk, confusion about time and place, requiring growing supervision levels.
Option a is incorrect because mild forgetfulness characterizes early stage, not the moderate stage requiring assistance.
Option b is incorrect because complete dependence occurs in severe late stage, not moderate Alzheimer's disease.
Option d is incorrect because subtle memory lapses occur in early stage, not moderate stage with functional decline.

Correct Answer: Four drug regimen

Isoniazid, rifampin, ethambutol, and pyrazinamide constitute standard four-drug tuberculosis treatment preventing resistance development during therapy.
Option a is incorrect because single antibiotics cause resistance; multiple drugs are essential for tuberculosis treatment.
Option b is incorrect because two drugs are insufficient for initial active tuberculosis treatment and resistance prevention.
Option d is incorrect because five drugs exceed standard therapy unless dealing with resistant tuberculosis strains.

Correct Answer: Faster onset

Insulin aspart acts within ten to twenty minutes, providing rapid mealtime coverage with less hypoglycemia than regular insulin.
Option a is incorrect because aspart has shorter, not longer, duration making it better for meal coverage.
Option c is incorrect because aspart does peak at one to three hours; glargine has no peak.
Option d is incorrect because aspart requires multiple daily doses with meals, not once daily administration.

Correct Answer: Rice products

Rice products are naturally gluten-free and safe for celiac patients, unlike wheat, barley, and rye containing gluten.
Option a is incorrect because wheat flour contains gluten proteins that damage intestinal lining in celiac disease.
Option b is incorrect because barley malt contains gluten and must be avoided in celiac disease diet.
Option d is incorrect because rye bread contains gluten proteins triggering autoimmune response in celiac patients.

Correct Answer: Low calcium

Low calcium from insufficient parathyroid hormone causes tetany, muscle twitching, and neuromuscular irritability in hypoparathyroidism.
Option a is incorrect because high calcium indicates hyperparathyroidism with different symptoms like kidney stones.
Option c is incorrect because high phosphate alone doesn't cause tetany without accompanying low calcium levels.
Option d is incorrect because while low magnesium causes similar symptoms, it's not specific to hypoparathyroidism.

Correct Answer: Prophylactic penicillin

Prophylactic penicillin prevents pneumococcal infections in sickle cell infants with compromised splenic function and immunity.
Option a is incorrect because iron supplements are avoided in sickle cell disease due to iron overload risks.
Option c is incorrect because while folic acid helps, it doesn't prevent the pneumococcal infections threatening infants.
Option d is incorrect because routine transfusions aren't given prophylactically, only for severe anemia or crises.

Correct Answer: Anticoagulants

Anticoagulants treat pulmonary embolism causing pleural effusion by preventing clot extension and allowing natural clot resolution.
Option a is incorrect because antibiotics treat parapneumonic effusion from infection, not pulmonary embolism-related fluid.
Option b is incorrect because diuretics treat heart failure effusions, not those from pulmonary embolism.
Option d is incorrect because steroids reduce inflammation but don't address the thrombotic cause of PE effusion.

Correct Answer: Plasmapheresis treatment

Plasmapheresis removes circulating antibodies against acetylcholine receptors, providing temporary improvement in myasthenia gravis symptoms.
Option a is incorrect because thymectomy provides long-term benefit by removing antibody source, not immediate improvement.
Option c is incorrect because radiation therapy isn't used for myasthenia gravis autoimmune antibody management.
Option d is incorrect because chemotherapy isn't standard treatment for myasthenia gravis antibody reduction.

Correct Answer: SNRI medication

SNRIs affect both serotonin and norepinephrine, offering alternative mechanism for patients intolerant to SSRI side effects.
Option a is incorrect because switching SSRIs likely produces similar side effects due to same mechanism.
Option c is incorrect because benzodiazepines treat anxiety symptoms but don't address underlying depression effectively.
Option d is incorrect because antipsychotics aren't first-line depression treatment unless psychotic features are present.

Correct Answer: Former smoker

Former smokers with COPD benefit from macrolide antibiotics like azithromycin for exacerbation prevention as maintenance therapy.
Option a is incorrect because current smokers need smoking cessation first; macrolides are specifically recommended for former smokers.
Option c is incorrect because age doesn't determine macrolide benefit; smoking history is the key factor.
Option d is incorrect because gender doesn't influence macrolide effectiveness for COPD exacerbation prevention.

Correct Answer: Erythropoietin

Kidney disease reduces erythropoietin production, causing anemia that requires synthetic erythropoietin replacement therapy for correction.
Option a is incorrect because thyroid hormone deficiency causes different symptoms, not the anemia of kidney disease.
Option c is incorrect because growth hormone doesn't directly regulate red blood cell production like erythropoietin.
Option d is incorrect because cortisol affects inflammation and metabolism, not red blood cell production.

Correct Answer: Inhaled fluticasone

Inhaled fluticasone delivers corticosteroids directly to airways, minimizing systemic absorption and side effects in children.
Option a is incorrect because oral prednisone has significant systemic effects including growth suppression in children.
Option c is incorrect because IV methylprednisolone causes systemic effects and is reserved for severe exacerbations.
Option d is incorrect because intramuscular steroids have systemic effects and aren't used for maintenance therapy.

Correct Answer: Orbital inflammation

Autoimmune orbital tissue inflammation and expansion cause exophthalmos, the characteristic bulging eyes in Graves' disease.
Option a is incorrect because general fluid retention doesn't specifically cause the orbital changes of exophthalmos.
Option c is incorrect because increased intracranial pressure causes different eye findings, not exophthalmos.
Option d is incorrect because extraocular muscle weakness causes diplopia, not the forward eye displacement.

Correct Answer: Gram-positive cocci

Streptococcus pneumoniae appears as gram-positive cocci in pairs or chains on sputum gram stain examination.
Option a is incorrect because gram-negative rods suggest different bacteria like Klebsiella or Pseudomonas, not Streptococcus.
Option c is incorrect because acid-fast bacilli indicate tuberculosis mycobacteria, not typical pneumonia bacteria.
Option d is incorrect because fungal hyphae suggest fungal pneumonia, not bacterial Streptococcus pneumoniae infection.

Correct Answer: Heart rate increase

Heart rate increase exceeding thirty beats per minute without orthostatic hypotension during tilt testing confirms POTS diagnosis.
Option a is incorrect because blood pressure drop indicates orthostatic hypotension, which excludes POTS diagnosis.
Option c is incorrect because syncope suggests other autonomic disorders; POTS typically doesn't cause fainting.
Option d is incorrect because nausea is a symptom but not the diagnostic criterion for POTS confirmation.

Correct Answer: Everyone eligible

Annual influenza vaccination is recommended for all eligible individuals over six months old for community-wide protection.
Option a is incorrect because while elderly are high-risk, vaccination benefits all age groups, not just elderly.
Option b is incorrect because children need protection but adults also benefit from annual influenza vaccination.
Option c is incorrect because universal vaccination provides better community protection than targeting only high-risk groups.

Correct Answer: Regular transfusions

Regular blood transfusions maintain adequate hemoglobin levels, preventing severe anemia and allowing normal childhood development.
Option a is incorrect because antibiotics treat infections but don't address the fundamental hemoglobin deficiency.
Option c is incorrect because vitamins alone cannot correct the genetic hemoglobin production defect.
Option d is incorrect because exercise programs don't address the severe anemia limiting growth and development.

Correct Answer: Contraction versus relaxation

Systolic dysfunction involves impaired contraction while diastolic dysfunction involves impaired relaxation and filling of ventricles.
Option a is incorrect because valve dysfunction causes different types of heart failure, not systolic/diastolic classification.
Option b is incorrect because rhythm disturbances can occur with either type but don't define the classification.
Option d is incorrect because heart rate changes occur in both types and don't distinguish systolic from diastolic.