A 46-year-old businessman of Caribbean origin is found to have a total serum cholesterol concentration of 6.2 mmol/L, high-density lipoprotein (HDL) of 0.7 mmol/L and triglycerides of 9.4 mmol/L. He drinks no alcohol (ethanol) during the week but admits to eight pints of lager and up to one bottle of rum at weekends. Other chemistries are notable only for a serum glutamic oxaloacetic transaminase (SGOT) level of 72 (upper limit of normal -42 u/L) and gamma glutamyl transferase (GGT) level of 128 (upper limit of normal = 51 u/L). Which of the following is correct?

Correct Answer: B

Rationale: High triglycerides (9.4 mmol/L) and low HDL (0.7 mmol/L) with binge drinking suggest alcohol-induced dyslipidemia. Alcohol typically raises HDL, not lowers it, so that's incorrect. Elevated triglycerides (>5.6 mmol/L) risk pancreatitis, a true statement, worsened by alcohol. Fibrates treat hypertriglyceridemia, but statins address total cholesterol (6.2 mmol/L) first in mixed dyslipidemia. Ezetimibe lowers LDL, not relevant here. Eicosapentaenoic acid reduces triglycerides, not total cholesterol primarily. Pancreatitis risk drives urgent management, linked to his lipid profile and drinking pattern.

Correct Answer: D

Rationale: Luteinizing hormone (LH) from the pituitary stimulates testosterone production in testicular Leydig cells, its primary role in men, driving male physiology. Sperm production is regulated by FSH, not LH. Secondary sex characteristics and sex organ growth depend on testosterone, which LH indirectly supports by controlling its synthesis, not directly managing. Testosterone regulation is LH's specific function, triggering steroidogenesis, essential for fertility and masculinity, distinct from FSH's gamete role.

Correct Answer: B

Rationale: Morphine's higher potency than codeine means less is needed for equal pain relief, a pharmacodynamic fact-e.g., 10 mg morphine matches 60 mg codeine. Allergy isn't potency-related. More adverse effects assume dose equivalence, not potency. Pain relief ties to dose, not potency alone. Potency drives dosing, key for surgical pain control.

Correct Answer: A

Rationale: Combining drugs (e.g., benzos) with nonpharmacological methods (e.g., meditation) balances quick relief and long-term coping, per stress management best practices. Anxiolytics alone risk dependence. Meditation helps but may not suffice. Addressing the cause is ideal but often slow-combined approach leverages both, enhancing outcomes.

Correct Answer: D

Rationale: The patient's chronic springtime symptoms-itchy, watery eyes, and runny nose-point to seasonal allergic rhinitis, a histamine-driven condition. Albuterol is a bronchodilator for asthma, not allergies. Diphenhydramine is an H1 antihistamine, effective but sedating, which may not suit an active steamroller operator. Epinephrine is for acute anaphylaxis, not chronic allergies. Hydroxyzine is another sedating antihistamine, less ideal for daily use. Loratadine (E), a non-sedating H1 antihistamine, effectively blocks histamine receptors, relieving symptoms without drowsiness, making it the most appropriate choice. Given his occupation and chronicity, a non-sedating option is critical for safety and compliance. Loratadine's long-acting, once-daily dosing also fits his reluctance to seek medical care, offering convenience and efficacy. The rationale prioritizes a treatment balancing symptom relief with minimal impact on his daily function, ruling out sedating or irrelevant options.