A 45-year-old woman has just received a kidney transplant. She is placed on several immunosuppressants to prophylactically prevent her body from rejecting the donor organ. Which of the following immunosuppressants interferes with T-cell activation by inhibition of mTOR?

Correct Answer: D

Rationale: Post-transplant immunosuppression targeting mTOR points to sirolimus . It inhibits T-cell proliferation downstream of IL-2, distinct from azathioprine , cyclosporine , methotrexate , and prednisolone (E). Sirolimus's unique action prevents rejection effectively.

Correct Answer: D

Rationale: Nystatin is used to treat oral thrush in infants, a fungal infection often linked to Candida albicans, which can be transmitted between mother and child during breastfeeding. The key instruction for the caregiver is that the breastfeeding mother may also need treatment to prevent reinfection, as Candida can persist on the mother's nipples. This addresses the infection's source comprehensively. Giving medication before feeding may reduce efficacy as milk washes it away too quickly. Water beforehand isn't necessary and could dilute the dose. Using a cotton swab is a technique but not the priority instruction compared to preventing recurrence. Since the correct answer includes multiple options (3, 5), and choice D aligns with the critical need to treat the mother, it's the focus here for its systemic impact on treatment success.

Correct Answer: C

Rationale: Naloxone is the drug used to reverse the effects of an opioid overdose. It is an opioid antagonist that rapidly binds to opioid receptors in the brain, displacing the opioid molecules. By blocking the receptor sites, naloxone can quickly reverse the effects of opioids, such as respiratory depression, sedation, and potential coma. Naloxone is a critical medication in opioid overdose situations as it can restore normal breathing and save a person's life. It is often available in the form of a nasal spray or injection for emergency use. It is essential for first responders, healthcare professionals, and individuals at risk of opioid overdose to have access to naloxone as part of overdose prevention and harm reduction strategies.

Correct Answer: B

Rationale: Alprazolam is a medication commonly used in treating anxiety disorders, panic disorders, and anxiety associated with depression. It belongs to a class of drugs known as benzodiazepines, which act on the central nervous system to produce a calming effect. Alprazolam helps to reduce feelings of anxiety and promote relaxation by enhancing the activity of certain neurotransmitters in the brain. It is not used for relief of drowsiness, bronchospasms, or cardiac arrest.

Correct Answer: A

Rationale: Post-kidney transplant, immunosuppression prevents rejection by targeting T-cell activation. Cyclosporine binds calcineurin, inhibiting its phosphatase activity, which blocks IL-2 transcription, crucial for T-cell proliferation-making it the correct answer. Methotrexate inhibits purine synthesis, affecting rapidly dividing cells, not calcineurin. Prednisolone , a corticosteroid, suppresses inflammation broadly but doesn't target calcineurin. Sirolimus inhibits mTOR, a different pathway, affecting T-cell proliferation downstream, not calcineurin. Temsirolimus (E) is similar to sirolimus. Cyclosporine's specificity to calcineurin aligns with the question's focus, a cornerstone in transplant regimens. Its mechanism disrupts early T-cell signaling, critical for alloimmune responses, unlike the broader or alternative actions of other options. This precision ensures effective prophylaxis while distinguishing it from other immunosuppressants in the list.