A 55 year old man with kidney stones has been placed on a diuretic to decrease calcium excretion. However after a few weeks, he develops an attack of gout. Which diuretic is he taking?

Correct Answer: C

Rationale: The correct answer is C: Hydrochlorothiazide. Hydrochlorothiazide is a thiazide diuretic that works by reducing calcium excretion and increasing uric acid levels, which can lead to gout attacks in susceptible individuals. Furosemide (choice A) is a loop diuretic that does not increase uric acid levels. Spironolactone (choice B) is a potassium-sparing diuretic and does not affect calcium or uric acid levels significantly. Triamterene (choice D) is also a potassium-sparing diuretic and does not impact calcium or uric acid levels in the same way as hydrochlorothiazide.

Correct Answer: C

Rationale: Acetazolamide is a carbonic anhydrase inhibitor that reduces intraocular pressure by decreasing aqueous humor production, making it effective in treating glaucoma. It is not commonly used as a diuretic due to its short duration of action and side effects. Therefore, choice C is correct. Choices A, B, and D are incorrect as acetazolamide is not indicated for liver cirrhosis, CHF, or kidney failure. Liver cirrhosis typically requires diuretics to manage ascites, CHF is managed with loop diuretics, and kidney failure may require different types of diuretics based on the underlying cause.

Correct Answer: C

Rationale: The correct answer is C: Encourage fluid intake of 3000 mL/day. This is important post-nephrolithotomy to prevent urinary stasis and aid in flushing out potential stone fragments. Adequate hydration also helps in preventing urinary tract infections. Administering IV fluids and blood transfusions (A) may be necessary in certain cases, but not specifically indicated for this scenario. Administering narcotic analgesics (B) may be required for pain management, but it does not address the underlying issue of preventing complications. Suggesting herbs or spices (D) is unrelated and may not be recommended due to potential interactions with medications.

Correct Answer: C

Rationale: The correct answer is C because hematuria (blood in urine) and change in urinary pattern are classic symptoms of bladder cancer. Hematuria is the most common presenting symptom. Weight loss and low back pain (choice A) are more indicative of advanced stages of cancer. Fatigue and anemia (choice B) are nonspecific symptoms. Difficulty initiating urinary stream and nocturia (choice D) may be seen in other conditions but are not specific to bladder cancer.

Correct Answer: D

Rationale: The correct answer is D because soaking in a tub with bubble bath can exacerbate cystitis symptoms due to potential irritation from the bubble bath chemicals. This can worsen the patient's condition. A, B, and C are correct statements. A promotes proper hydration, B encourages regular emptying of the bladder to prevent bacterial growth, and C suggests a potential remedy for cystitis by consuming cranberry juice.