A 75 year old male with BPH has continues to have urinary symptoms of * prostatic obstruction after trial of alpha blocking drug tamsulosin . Dutasteride is added to his therapy,he is also taking hydrochlorothiazide sildenafil and

Correct Answer: D

Rationale: The correct answer is D: Sildenafil. Dutasteride and sildenafil are both metabolized by the same enzymes in the liver, specifically CYP3A4 and CYP2C9. When taken together, sildenafil can increase the blood levels of dutasteride, leading to a higher risk of side effects. Tamsulosin (choice B) is commonly used in combination with dutasteride for BPH without significant interactions. Testosterone (choice C) is not typically used in BPH treatment and does not interact significantly with dutasteride. Therefore, the potential interaction between dutasteride and sildenafil is the reason why choice D is correct.

Correct Answer: C

Rationale: Rationale: Intravenous Plain NSS infusion is the treatment of choice for dilutional hyponatremia, which can occur as a complication of furosemide therapy due to excessive diuresis leading to low sodium levels. This solution helps restore normal sodium levels without affecting the fluid balance. Summary: A: Hypokalemia - Furosemide therapy can cause hypokalemia, which is usually treated with potassium supplements, not NSS infusion. B: Severe dehydration - NSS infusion may be used for severe dehydration but is not specific to furosemide therapy complications. D: None of the above - Incorrect, as C is the correct answer for dilutional hyponatremia.

Correct Answer: B

Rationale: The correct answer is B: albumin. Glomerular capillaries have a filtration barrier that prevents large molecules like albumin from passing into the filtrate. Water (A), urea (C), and sodium ions (D) are smaller molecules that can pass through the filtration barrier and are normally found in the filtrate. Albumin, being a large protein molecule, is normally retained in the blood and not expected to appear in the filtrate. This is essential for maintaining proper blood composition and oncotic pressure.

Correct Answer: C

Rationale: The correct answer is C: Being female. Being female does not increase the risk of developing a UTI. UTIs are more common in females due to shorter urethras. Pregnancy (A) can increase UTI risk due to hormonal changes. Diabetes mellitus (B) can affect the immune system, leading to higher UTI susceptibility. Catheterization (D) introduces bacteria into the urinary tract, significantly increasing the risk of UTIs. Overall, being female alone does not directly increase the risk of UTIs compared to the other factors mentioned.

Correct Answer: A

Rationale: Correct Answer: A Rationale: Identical twin donor and recipient still require immunosuppression due to minor histocompatibility antigens. Failure to suppress the immune system can lead to rejection. Graft rejection may present with symptoms such as graft tenderness, decreased urine output, and increased creatinine levels. Infections are indeed a common cause of morbidity and mortality in renal transplant patients, with a high incidence within the first year post-transplant. Therefore, choice A is incorrect as even identical twin donors and recipients require immunosuppression to prevent rejection.