A 6-year-old boy presents to his pediatrician for followup of recurrent hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. Which of the following drugs would decrease the amount of asthma attacks by preventing an arachidonic acid derivative from binding to its receptor?

Correct Answer: D

Rationale: Asthma attacks in this case are driven by inflammation, often mediated by leukotrienes, which are arachidonic acid derivatives. The goal is to reduce the frequency of attacks by targeting this pathway. Aspirin inhibits cyclooxygenase (COX), reducing prostaglandins but not leukotrienes, and may even worsen asthma in some patients. Celecoxib is a selective COX-2 inhibitor, also irrelevant to leukotrienes. Ipratropium is an anticholinergic bronchodilator, effective for acute symptom relief but not prophylaxis via arachidonic acid pathways. Montelukast is a leukotriene receptor antagonist, directly preventing leukotrienes from binding to their receptors, thus reducing inflammation and attack frequency. Zileuton (E), while a leukotriene synthesis inhibitor, isn't the best choice here as the question specifies receptor binding prevention, not synthesis inhibition. Montelukast aligns perfectly with the mechanism described, making it the correct answer.

Correct Answer: B

Rationale: The most common side effect of insulin therapy is hypoglycemia, which occurs when the blood sugar levels drop too low. Insulin helps lower blood sugar levels by promoting the uptake of glucose into cells, but an excessive dose of insulin or changes in diet and physical activity can lead to hypoglycemia. Symptoms of hypoglycemia may include shakiness, sweating, dizziness, confusion, and hunger. It is important for individuals using insulin to be aware of the signs and symptoms of hypoglycemia and be prepared to treat it promptly with fast-acting glucose sources. Regular monitoring of blood sugar levels can help prevent and manage episodes of hypoglycemia.

Correct Answer: D

Rationale: Oxymetazoline acts fast; adherence prevents rebound . Days is wrong. D ensures safe use, making it key.

Correct Answer: B

Rationale: Converting atrial fibrillation (AF) to sinus rhythm requires cardioversion or antiarrhythmics. Digoxin controls rate, not rhythm, ineffective for conversion. Atenolol, a beta-blocker, and diltiazem, a calcium channel blocker, manage rate, not rhythm restoration. Lidocaine treats ventricular arrhythmias. Amiodarone, a class III antiarrhythmic, prolongs repolarization, effectively converting AF to sinus rhythm, especially in acute settings, outperforming others. Its broad-spectrum action is key in AF management, balancing efficacy and safety.

Correct Answer: A

Rationale: While Propranolol is commonly used to treat conditions such as hypertension and certain heart-related issues, it is also used off-label for the treatment of post-traumatic stress disorder (PTSD). Propranolol has shown efficacy in reducing the intensity of emotional memories and symptoms associated with PTSD by blocking the effects of stress hormones. It is believed to help alleviate symptoms such as anxiety and hyperarousal in individuals with PTSD. However, it is important to note that the off-label use of Propranolol for PTSD should only be done under the guidance and supervision of a healthcare professional.