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: C

Rationale: The most helpful test in determining the response to highly active antiretroviral therapy (HAART) in an HIV-positive client is a viral load test. A viral load test measures the amount of HIV in the blood by counting the number of copies of the virus present. Monitoring viral load levels over time provides vital information about how well the antiretroviral medications are working in suppressing the replication of the virus. A decrease in viral load indicates a positive response to the therapy, while an increase may suggest treatment failure or the development of drug resistance. Regular monitoring of viral load is a crucial aspect of managing HIV infection and assessing the effectiveness of antiretroviral therapy.

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: B

Rationale: Night blindness is often caused by vitamin A deficiency. Foods rich in vitamin A, such as fortified milk and eggs, are recommended. Skim milk and peas (A), nuts and yeast (C), and enriched breads and cereals (D) are not significant sources of vitamin A.

Correct Answer: D

Rationale: Methyldopa (Aldomet) is commonly used for managing hypertension in pregnant women. It is considered safe during pregnancy and is often the first-line treatment for hypertension in pregnancy. Methyldopa acts by stimulating alpha-adrenergic receptors in the central nervous system, leading to a decrease in peripheral vascular resistance, which helps to lower blood pressure. Other antihypertensive drugs, such as Enalapril and Hydrochlorothiazide, are not recommended during pregnancy as they can cause harm to the fetus. Mannitol is a diuretic used for managing cerebral edema and intraocular pressure but is not typically used for hypertension in pregnancy. Therefore, Methyldopa is the preferred choice for managing hypertension in pregnant patients.