A 68-year-old woman with a long history of sadness, gloom, and weight loss presents to her primary care physician for treatment. She is treated with a selective serotonin reuptake inhibitor. Which of the following statements is true?

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: "Two weeks of therapy are required for mood improvement." The rationale for this being the correct answer lies in the pharmacological mechanism of selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the levels of serotonin in the brain, which helps regulate mood. While it may take several weeks for the full therapeutic effects of SSRIs to be realized, some patients may start experiencing mood improvement as early as two weeks into treatment. Option A, stating "Maximum benefit may require 1 year," is incorrect because while it is true that SSRIs may take several weeks to reach their full efficacy, one year is an excessively long timeframe for most patients to experience significant improvement in their symptoms. Option B, claiming "Most patients require three antidepressants," is incorrect and not a standard practice in the treatment of depression. Typically, healthcare providers aim to find the most effective single antidepressant for a patient before considering multiple medication trials. Option C, suggesting "Twenty percent of patients with adequate doses for 8 weeks respond to therapy," is also incorrect as studies have shown that a larger percentage of patients respond positively to SSRIs within the first few weeks of treatment. Educationally, understanding the time frame for the onset of action and full therapeutic effects of different classes of drugs is crucial for healthcare providers to set appropriate expectations for patients and monitor treatment progress effectively. This knowledge helps optimize patient care and outcomes in the management of depression and other mood disorders.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Slowing of heart rate. Ziprasidone is an atypical antipsychotic medication that can cause QT interval prolongation, which may lead to bradycardia or slowing of the heart rate. Educating the patient about this potential adverse effect is crucial for monitoring and preventing any complications. Option A) Asthenia refers to weakness or lack of energy, which is not a commonly reported side effect of ziprasidone. Option B) Erectile dysfunction is a side effect commonly associated with some other antipsychotic medications but not typically linked to ziprasidone. Option C) Hypertension is also not a common side effect of ziprasidone; in fact, it is more likely to cause hypotension rather than hypertension. In an educational context, understanding the potential adverse effects of medications is essential for healthcare providers to ensure patient safety and adherence to treatment. Educating patients about possible side effects empowers them to recognize and report any concerning symptoms promptly, leading to better treatment outcomes and improved quality of care.

Correct Answer: A

Rationale: Acute morphine toxicity, an overdose scenario, presents a classic triad: coma, pinpoint pupils (miosis), and depressed respiration (choice A). Coma results from profound CNS depression, miosis from parasympathetic overstimulation, and respiratory depression from medullary suppression, often fatal without intervention (e.g., naloxone). Abdominal cramps and diarrhea (choice B) suggest withdrawal, not toxicity. Hypertension and arrhythmias (choice C) align with stimulants, not opioids. Dry mouth and mydriasis (choice D) are anticholinergic signs, opposite to morphine's effects. This triad is critical for rapid diagnosis and treatment in emergency settings, distinguishing opioid toxicity from other syndromes.

Correct Answer: A

Rationale: Acute gout attacks require rapid inflammation reduction. Colchicine (choice B) disrupts microtubule function, reducing neutrophil activity. Indomethacin (choice C), an NSAID, inhibits COX, lowering prostaglandin levels. Glucocorticoids (choice D) suppress inflammation broadly. Allopurinol (choice A), a xanthine oxidase inhibitor, lowers uric acid long-term but doesn't address acute inflammation, making it the exception. This distinction guides acute versus chronic gout management.

Correct Answer: A

Rationale: Colchicine (choice B) treats acute gout by reducing inflammation, Allopurinol (choice C) lowers uric acid long-term, and Sulphinpyrazone (choice D) promotes urate excretion. Thiazide diuretics (choice A) increase uric acid retention, worsening gout, making them the exception. This distinguishes gout management from contraindicated drugs.