D027 Advanced Pathopharmacological Foundations - Set 5 - Part 1

Correct Answer: Duodenum

Celiac disease prominently damages duodenum and jejunum where iron absorption occurs, causing deficiency despite adequate dietary intake.
Option a is incorrect because stomach produces acid for iron absorption but isn't the primary absorption site damaged.
Option c is incorrect because colon doesn't significantly absorb iron; small intestine damage causes the deficiency.
Option d is incorrect because rectum doesn't participate in iron absorption affected by celiac disease damage.

Correct Answer: Fever, rigidity, altered mental status

Neuroleptic malignant syndrome presents with hyperthermia, muscle rigidity, and altered consciousness requiring emergency treatment and medication discontinuation.
Option b is incorrect because weight gain and sedation are common side effects, not emergency syndrome symptoms.
Option c is incorrect because anticholinergic effects are expected side effects, not life-threatening syndrome features.
Option d is incorrect because these represent extrapyramidal symptoms, not the emergency neuroleptic malignant syndrome.

Correct Answer: Diabetic ketoacidosis

Diabetic ketoacidosis produces fruity breath from acetone production when cells metabolize fat for energy without insulin.
Option a is incorrect because hypoglycemia causes sweating and confusion without the characteristic fruity breath odor.
Option c is incorrect because hyperglycemic hyperosmolar state lacks ketone production causing fruity breath odor.
Option d is incorrect because lactic acidosis doesn't produce the fruity breath characteristic of ketone production.

Correct Answer: Cholinesterase inhibitors

Cholinesterase inhibitors like donepezil prevent acetylcholine breakdown, maintaining neurotransmitter levels supporting memory and cognitive function.
Option a is incorrect because MAO inhibitors treat depression and Parkinson's, not Alzheimer's cognitive symptoms.
Option c is incorrect because dopamine agonists treat Parkinson's disease, not Alzheimer's memory problems.
Option d is incorrect because serotonin antagonists don't address the cholinergic deficit in Alzheimer's disease.

Correct Answer: Negative pressure ventilation

Negative pressure rooms with air exchanges prevent tuberculosis bacilli from spreading to other areas through ventilation.
Option a is incorrect because hand hygiene doesn't prevent airborne tuberculosis transmission requiring respiratory protection.
Option b is incorrect because contact precautions don't address airborne transmission of tuberculosis bacteria.
Option d is incorrect because standard masks insufficiently filter tuberculosis particles; N95 respirators are needed.

Correct Answer: Respiratory muscles

Respiratory muscle weakness causes ventilatory failure, the most life-threatening complication requiring immediate mechanical ventilation support.
Option a is incorrect because ocular weakness causes diplopia and ptosis but isn't immediately life-threatening.
Option c is incorrect because limb weakness impairs mobility but doesn't pose immediate survival threat.
Option d is incorrect because facial weakness affects expression and speech without threatening vital functions.

Correct Answer: Ulcerative colitis

Ulcerative colitis affects only colon and rectum, so total colectomy removes all diseased tissue providing cure.
Option a is incorrect because Crohn's can affect entire GI tract; surgery doesn't cure the disease.
Option c is incorrect because celiac disease requires dietary management, not surgery for treatment.
Option d is incorrect because irritable bowel syndrome is functional, not requiring or benefiting from surgery.

Correct Answer: Dehydration

Dehydration increases blood viscosity and sickling, commonly triggering painful vaso-occlusive crisis requiring IV fluid resuscitation.
Option a is incorrect because while altitude matters, dehydration more commonly triggers crisis in daily life.
Option c is incorrect because moderate exercise is beneficial; dehydration during exercise causes the problem.
Option d is incorrect because stress contributes but dehydration more directly triggers sickling and crisis.

Correct Answer: Loop diuretics

Loop diuretics rapidly reduce fluid overload and pulmonary congestion by promoting diuresis, quickly improving breathing.
Option a is incorrect because beta blockers improve long-term outcomes but don't rapidly relieve pulmonary edema.
Option c is incorrect because ACE inhibitors provide long-term benefits without immediate pulmonary edema relief.
Option d is incorrect because digoxin improves contractility but doesn't rapidly reduce fluid overload.

Correct Answer: Productive cough

Chronic bronchitis characteristically presents with productive cough and sputum production, distinguishing it from emphysema's dry symptoms.
Option a is incorrect because barrel chest occurs with emphysema from air trapping, not chronic bronchitis.
Option c is incorrect because weight loss characterizes emphysema's increased work of breathing, not bronchitis.
Option d is incorrect because hyperresonance indicates emphysema's air trapping, not chronic bronchitis findings.

Correct Answer: Empty stomach

Levothyroxine requires empty stomach administration thirty to sixty minutes before food for optimal absorption.
Option a is incorrect because food significantly reduces levothyroxine absorption, decreasing therapeutic effectiveness.
Option c is incorrect because calcium in milk specifically interferes with thyroid hormone absorption.
Option d is incorrect because exercise timing doesn't affect absorption like empty stomach requirement does.

Correct Answer: Increased fremitus

Consolidation transmits vibrations better, increasing tactile fremitus, while effusion dampens vibration transmission during examination.
Option a is incorrect because decreased fremitus suggests fluid or air, not the solid consolidation described.
Option c is incorrect because shifting dullness indicates free fluid movement, not fixed consolidation.
Option d is incorrect because consolidation produces bronchial breath sounds, not absent sounds like effusion.

Correct Answer: Fluoroquinolones

Fluoroquinolones cause cartilage damage and musculoskeletal abnormalities in developing fetuses, contraindicating use during pregnancy.
Option a is incorrect because penicillins are generally safe during pregnancy without significant fetal risks.
Option b is incorrect because cephalosporins safely treat infections during pregnancy without developmental concerns.
Option d is incorrect because most macrolides except clarithromycin are considered safe in pregnancy.

Correct Answer: Speaking single words

Speaking only single words indicates severe respiratory distress requiring emergency treatment beyond rescue inhaler capabilities.
Option a is incorrect because mild wheezing responds to rescue inhalers without requiring emergency care.
Option b is incorrect because speaking in phrases suggests moderate symptoms manageable with rescue medication.
Option d is incorrect because coughing alone doesn't indicate the severe distress requiring emergency intervention.

Correct Answer: Parathyroid hormone

Secondary hyperparathyroidism from kidney disease causes excessive bone resorption leading to renal osteodystrophy requiring treatment.
Option a is incorrect because thyroid hormone doesn't primarily cause the bone disease in kidney failure.
Option b is incorrect because growth hormone deficiency affects children's growth, not renal osteodystrophy.
Option d is incorrect because cortisol excess causes osteoporosis, not the specific renal osteodystrophy pattern.

Correct Answer: Tyramine-free

MAOIs require tyramine restriction avoiding aged cheeses and cured meats preventing dangerous hypertensive crisis.
Option a is incorrect because sodium restriction isn't specifically required with MAOI therapy for depression.
Option c is incorrect because gluten restriction relates to celiac disease, not MAOI drug interactions.
Option d is incorrect because potassium restriction isn't necessary with MAOIs treating depression.

Correct Answer: Heart

Cardiac iron deposition causes cardiomyopathy and heart failure, the leading cause of death in thalassemia.
Option a is incorrect because liver damage occurs but cardiac complications cause higher mortality rates.
Option c is incorrect because pancreatic damage causes diabetes but isn't the primary mortality cause.
Option d is incorrect because skin bronzing occurs but doesn't pose the mortality risk of cardiac damage.

Correct Answer: Immunocompromised patients

Immunocompromised patients cannot mount adequate vaccine response, requiring passive immunoglobulin for protection after exposure.
Option a is incorrect because healthy children can receive vaccine or recover naturally without immunoglobulin.
Option c is incorrect because elderly adults without immunosuppression don't require immunoglobulin prophylaxis.
Option d is incorrect because healthcare workers should be vaccinated; they don't need immunoglobulin prophylaxis.

Correct Answer: Bowel rest

Bowel rest with NPO status and decompression prevents perforation while medical management stabilizes toxic megacolon.
Option a is incorrect because colonoscopy risks perforation in toxic megacolon and is absolutely contraindicated.
Option c is incorrect because IV, not oral, medications are used during bowel rest for megacolon.
Option d is incorrect because fiber supplements would worsen distension and risk perforation in megacolon.

Correct Answer: Compression stockings

Compression stockings prevent venous pooling in legs, improving venous return and reducing POTS symptoms.
Option a is incorrect because bed rest worsens deconditioning and orthostatic intolerance in POTS patients.
Option c is incorrect because leg elevation helps temporarily but doesn't prevent pooling when standing.
Option d is incorrect because heat therapy causes vasodilation, worsening blood pooling in POTS.