D027 Advanced Pathopharmacological Foundations - Set 4 - Part 1

Correct Answer: Low-dose inhaled corticosteroid

Step two asthma management adds low-dose inhaled corticosteroids for persistent symptoms despite short-acting bronchodilator use as needed.
Option a is incorrect because increasing albuterol doesn't address underlying inflammation requiring controller therapy for persistent symptoms.
Option c is incorrect because oral prednisone is reserved for severe exacerbations, not routine step-up therapy.
Option d is incorrect because oxygen therapy doesn't treat asthma's inflammatory component requiring controller medications.

Correct Answer: Resolves completely

Gestational diabetes typically resolves after delivery when placental hormones causing insulin resistance are no longer present.
Option a is incorrect because gestational diabetes improves after delivery when pregnancy hormones normalize postpartum.
Option c is incorrect because gestational diabetes doesn't convert to type one diabetes, though type two risk increases.
Option d is incorrect because surgery isn't needed for gestational diabetes, which resolves with delivery.

Correct Answer: Ocular myasthenia

Ocular myasthenia affects only eye muscles causing ptosis and diplopia without generalized muscle weakness symptoms.
Option a is incorrect because generalized myasthenia affects multiple muscle groups beyond just ocular muscles.
Option c is incorrect because bulbar refers to brainstem-controlled muscles for swallowing and speech, not eyes.
Option d is incorrect because respiratory involvement indicates severe generalized disease, not isolated ocular symptoms.

Correct Answer: Beta-amyloid protein

Beta-amyloid protein aggregates form senile plaques between neurons, a hallmark pathological finding in Alzheimer's disease brains.
Option a is incorrect because tau protein forms intracellular neurofibrillary tangles, not the extracellular plaques described.
Option c is incorrect because alpha-synuclein accumulates in Parkinson's disease forming Lewy bodies, not Alzheimer's plaques.
Option d is incorrect because prion proteins cause Creutzfeldt-Jakob disease, not the plaques of Alzheimer's pathology.

Correct Answer: Ten millimeters

Healthcare workers and others at high occupational risk have positive tuberculin tests at ten millimeters induration.
Option a is incorrect because five millimeters positivity applies only to severely immunocompromised individuals, not healthcare workers.
Option c is incorrect because fifteen millimeters applies to low-risk populations without occupational exposure risks.
Option d is incorrect because twenty millimeters exceeds all threshold criteria; any reaction this size is positive.

Correct Answer: IV opioids

Intravenous opioid analgesics provide necessary pain control for severe vaso-occlusive crisis pain in hospitalized patients.
Option a is incorrect because acetaminophen alone is insufficient for the severe pain of sickle cell crisis.
Option c is incorrect because topical lidocaine doesn't penetrate deeply enough for vaso-occlusive pain relief.
Option d is incorrect because aspirin is contraindicated in sickle cell disease due to bleeding risks.

Correct Answer: Cross-contamination risk

Oats often become contaminated with wheat, barley, or rye during processing, making certified gluten-free oats necessary.
Option a is incorrect because pure oats don't naturally contain gluten proteins that trigger celiac disease.
Option c is incorrect because oat allergies are separate from celiac disease's gluten-triggered autoimmune response.
Option d is incorrect because oats don't contain inherently toxic compounds for celiac patients when uncontaminated.

Correct Answer: Below eighty-eight percent

Oxygen saturation persistently below eighty-eight percent or PO2 below fifty-five indicates need for long-term oxygen therapy.
Option a is incorrect because ninety-five percent is within normal range, not requiring supplemental oxygen therapy.
Option b is incorrect because ninety percent is borderline but doesn't meet criteria for continuous oxygen.
Option d is incorrect because eighty percent indicates severe hypoxemia but eighty-eight percent is the threshold.

Correct Answer: Cognitive, autonomic, somatic

Serotonin syndrome presents with altered mental status, autonomic instability, and neuromuscular abnormalities requiring immediate treatment.
Option b is incorrect because these systems aren't the primary triad defining serotonin syndrome's characteristic presentation.
Option c is incorrect because these systems aren't primarily affected in serotonin syndrome's acute presentation.
Option d is incorrect because these aren't the defining features of serotonin syndrome's clinical presentation.

Correct Answer: Potassium

Diuretics cause potassium loss leading to hypokalemia, which triggers dangerous arrhythmias requiring careful monitoring and replacement.
Option a is incorrect because while sodium is affected, potassium changes pose greater arrhythmia risk.
Option c is incorrect because calcium isn't significantly affected by diuretics like potassium depletion is.
Option d is incorrect because while magnesium matters, potassium monitoring is most critical for arrhythmia prevention.

Correct Answer: Tenesmus

Tenesmus describes the painful urgency to defecate with inability to do so, characteristic of ulcerative colitis.
Option a is incorrect because constipation implies infrequent bowel movements, not the urgent ineffective straining of tenesmus.
Option c is incorrect because obstipation means severe constipation with no gas passage, different from tenesmus.
Option d is incorrect because ileus refers to intestinal paralysis, not the urgency and straining of tenesmus.

Correct Answer: Ibuprofen

Ibuprofen worsens varicella lesions and increases secondary infection risk, making acetaminophen the preferred antipyretic choice.
Option a is incorrect because acetaminophen safely treats fever in chickenpox without worsening lesions or complications.
Option c is incorrect because diphenhydramine helps itching without the risks ibuprofen poses in varicella.
Option d is incorrect because cetirizine safely treats itching without the complication risks of ibuprofen.

Correct Answer: Edrophonium test

Edrophonium temporarily improves myasthenia gravis weakness by increasing acetylcholine at neuromuscular junctions, confirming diagnosis.
Option a is incorrect because dopamine levels relate to Parkinson's disease, not myasthenia gravis diagnosis.
Option c is incorrect because thyroid function doesn't specifically diagnose myasthenia gravis despite possible association.
Option d is incorrect because brain MRI doesn't show myasthenia gravis; it's a neuromuscular junction disorder.

Correct Answer: Viral pneumonia

Viral pneumonia characteristically shows diffuse, widespread whitening on chest X-ray unlike bacterial pneumonia's focal consolidation.
Option a is incorrect because bacterial lobar pneumonia shows localized consolidation, not widespread diffuse changes.
Option c is incorrect because fungal infections typically show nodules or cavities, not diffuse whitening patterns.
Option d is incorrect because tuberculosis shows upper lobe cavities, not the diffuse whitening of viral pneumonia.

Correct Answer: Erythropoietin injections

Synthetic erythropoietin replaces the kidney's diminished hormone production, stimulating bone marrow red blood cell formation.
Option a is incorrect because iron helps if deficient but doesn't address the kidney's erythropoietin production failure.
Option c is incorrect because transfusions temporarily increase red cells without addressing the production problem.
Option d is incorrect because B12 treats specific deficiency anemia, not kidney disease's erythropoietin deficiency.

Correct Answer: TSH receptor antibodies

TSH receptor antibodies stimulate the thyroid, causing the hyperthyroidism and associated symptoms of Graves' disease.
Option a is incorrect because TPO antibodies indicate Hashimoto's thyroiditis causing hypothyroidism, not Graves' hyperthyroidism.
Option c is incorrect because thyroglobulin antibodies occur in various thyroid conditions, not specifically Graves' disease.
Option d is incorrect because antinuclear antibodies indicate systemic autoimmune disease, not specifically thyroid disorders.

Correct Answer: Autosomal recessive

Beta thalassemia follows autosomal recessive inheritance, requiring two mutated genes for disease manifestation in offspring.
Option a is incorrect because autosomal dominant would cause disease with one gene copy, unlike thalassemia.
Option c is incorrect because X-linked pattern would predominantly affect males, unlike thalassemia's equal distribution.
Option d is incorrect because mitochondrial inheritance comes only from mothers, not both parents like thalassemia.

Correct Answer: Hormone surge

Early morning hormone surge including cortisol and growth hormone causes dawn phenomenon hyperglycemia requiring insulin adjustment.
Option a is incorrect because insulin overdose would cause hypoglycemia, not the hyperglycemia of dawn phenomenon.
Option c is incorrect because delayed dinner affects bedtime glucose, not the hormonal dawn phenomenon.
Option d is incorrect because exercise typically lowers glucose; it doesn't cause dawn phenomenon hyperglycemia.

Correct Answer: Paresthesia

Paresthesia describes abnormal sensations like pins and needles, tingling, or numbness characteristic of neuropathy conditions.
Option a is incorrect because allodynia means pain from normally non-painful stimuli, not tingling sensations.
Option b is incorrect because hyperalgesia refers to increased pain sensitivity, not pins and needles feelings.
Option d is incorrect because dysesthesia means unpleasant abnormal sensations, broader than specific paresthesia symptoms.

Correct Answer: Positive symptoms

First-generation antipsychotics effectively treat positive symptoms like hallucinations and delusions through dopamine receptor blockade.
Option a is incorrect because negative symptoms like withdrawal respond poorly to first-generation antipsychotic medications.
Option c is incorrect because cognitive symptoms show minimal improvement with first-generation antipsychotic treatment.
Option d is incorrect because mood symptoms require different medications; antipsychotics primarily target psychotic symptoms.