A 44-year-old male presents for an employment physical and is concerned about testing positive for amphetamines on a drug screen. His current medication list includes metformin, lisinopril, glyburide, and bupropion. The most likely medication cause for a false positive result for amphetamines would be:

Correct Answer: D

Rationale: The correct answer is D, Bupropion. Bupropion is known to potentially cause false-positive results for amphetamines on drug screens due to its structural similarity to amphetamines. Bupropion is a medication commonly used to treat depression and aid in smoking cessation. Metformin (A), Lisinopril (B), and Glyburide (C) are not known to cause false positives for amphetamines. Metformin is used to treat diabetes, Lisinopril is used for hypertension, and Glyburide is used for diabetes. Therefore, the most likely medication cause for a false positive result for amphetamines in this case would be bupropion.

Correct Answer: B

Rationale: The correct answer is B because varicose veins are usually diagnosed based on clinical presentation, such as visible, bulging veins and symptoms like pain or swelling. This is because varicose veins are often easily visible and cause noticeable symptoms. A: Varicose veins are not typically due to congenital valve deformities but rather develop over time due to weakened vein walls and valves. C: Varicose veins can be affected by pregnancy due to hormonal changes and increased pressure on the veins. D: Varicose veins may not necessarily be more symptomatic during ovulation; symptoms can vary based on individual factors.

Correct Answer: D

Rationale: The correct answer is D: Retirement. Retirement is not a known risk factor for suicide in the elderly. Here's the rationale: 1. Chronic pain (choice A) and comorbid physical illness (choice B) are risk factors as they can contribute to feelings of hopelessness and despair. 2. Family history of suicide (choice C) is a significant risk factor due to the genetic and environmental influences. 3. Retirement (choice D) does not directly increase the risk of suicide. In fact, many individuals find purpose and fulfillment in retirement.

Correct Answer: A

Rationale: The correct answer is A: Buspirone (Buspar). Buspirone is not indicated for the treatment of depression; it is primarily used to treat anxiety disorders. SSRIs and TCAs are commonly prescribed for depression due to their ability to increase serotonin levels. Bupropion is an atypical antidepressant that works on norepinephrine and dopamine, making it a suitable option for depression treatment. Buspirone's mechanism of action differs from antidepressants, focusing on serotonin and dopamine receptors rather than directly targeting depression symptoms. Therefore, Buspirone is not a recommended drug class for depression treatment.

Correct Answer: A

Rationale: Step-by-step rationale for why A is correct: 1. Baclofen is a muscle relaxant primarily used for treating muscle spasticity, not muscle spasms. 2. Baclofen acts on GABA receptors in the spinal cord to reduce muscle hyperactivity. 3. Tizanidine, Cyclobenzaprine, and Carisoprodol are all indicated for the treatment of muscle spasms. 4. Tizanidine acts centrally to inhibit excitatory neurotransmitter release, Cyclobenzaprine is a muscle relaxant with sedative effects, and Carisoprodol is a centrally acting skeletal muscle relaxant. Summary: Baclofen is not indicated for the treatment of muscle spasms because it is primarily used for muscle spasticity. Tizanidine, Cyclobenzaprine, and Carisoprodol are more commonly prescribed for muscle spasms due to their mechanisms of action.