A jaundiced 1-day-old premature infant with elevated free bilirubin is seen in the premature baby nursery. The mother had received an antibiotic combination for a urinary tract infection (UTI) 1 week before delivery. Which of the following is the most likely cause of the baby's kernicterus?

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Question 1 of 5

A jaundiced 1-day-old premature infant with elevated free bilirubin is seen in the premature baby nursery. The mother had received an antibiotic combination for a urinary tract infection (UTI) 1 week before delivery. Which of the following is the most likely cause of the baby's kernicterus?

Correct Answer: D

Rationale: Sulfonamides displace bilirubin from albumin, causing kernicterus in neonates.

Question 2 of 5

Which of the following is not correctly matched to mechanism of action?

Correct Answer: B

Rationale: Rivaroxaban is a direct factor Xa inhibitor, not indirect (unlike fondaparinux, which requires antithrombin). Dabigatran directly inhibits thrombin, fondaparinux is correct, and warfarin inhibits vitamin K-dependent factor synthesis.

Question 3 of 5

The following is NOT an advantage of rivaroxiban and dabigatran over warfarin:

Correct Answer: C

Rationale: Rivaroxaban and dabigatran have rapid onset/offset, no INR monitoring, and fewer CYP450 interactions, but both require dose adjustments in renal failure due to renal clearance, unlike warfarin.

Question 4 of 5

Concerning argatroban (direct thrombin inhibitor), the following is Wrong:

Correct Answer: C

Rationale: Argatroban is IV, used in HIT, and not reversed by protamine, but it’s monitored by aPTT, not INR (which is for warfarin).

Question 5 of 5

Reduction in calcium absorption from GIT is associated with the use of:

Correct Answer: D

Rationale: Alendronate (bisphosphonate) and prednisone (glucocorticoid) reduce GI calcium absorption; raloxifene doesn’t, and alfacalcidiol (vitamin D) enhances it.

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