Correct Answer: A

Rationale: The correct answer is A: Hematologic spread. In this case, the cancer cells have traveled through the bloodstream to reach the bones and liver. This process is known as hematologic spread, where cancer cells enter the blood vessels and spread to distant organs. Lymphatic circulation (B) involves the spread of cancer cells through the lymphatic system, which is less likely in this scenario. Invasion (C) refers to cancer cells infiltrating nearby tissues, not distant organs. Angiogenesis (D) is the process of new blood vessel formation to support tumor growth, but it does not explain the spread of cancer cells to other organs.

Correct Answer: C

Rationale: Rationale: Ganciclovir is the correct answer for the acute stage of CMV retinitis in AIDS patients. It is an antiviral drug that specifically targets CMV. Ganciclovir works by inhibiting viral DNA synthesis, effectively controlling CMV replication in the eye. Pilocarpine (A) is a miotic used for glaucoma, not for CMV retinitis. Penicillin (B) is an antibiotic effective against bacterial infections, not viral infections like CMV. Gentamicin (D) is an antibiotic used to treat bacterial infections, not viral infections like CMV.

Correct Answer: B

Rationale: The correct answer is B: Circumcision. Paraphimosis occurs when the foreskin is retracted behind the glans and cannot be returned to its original position. Once the inflammation and edema subside, circumcision is typically indicated to prevent recurrence. This procedure removes the foreskin, reducing the risk of future paraphimosis episodes. Needle aspiration of the corpus cavernosum (A) is not indicated for paraphimosis. Abstinence from sexual activity for 6 weeks (C) is not a standard treatment for paraphimosis. Administration of vardenafil (D) is used for erectile dysfunction and not indicated for paraphimosis.

Correct Answer: A

Rationale: The correct order for the massage is to start around the feces (4), then work downwards (1), followed by moving towards the sides (5), then back to the top (2), continuing to the sides again (3), and finally finishing at the top (6). This sequence ensures a thorough and effective massage process. Other choices have different orders that do not follow the logical flow of massaging around the feces and working down as specified in the question.

Correct Answer: C

Rationale: The correct answer is C: The patient's vomiting is unrelated to food intake. In the context of a brain tumor, vomiting that is not related to food intake can indicate increased intracranial pressure affecting the brain's vomiting center. This is known as projectile vomiting. A: Vomiting accompanied by epistaxis (nosebleeds) is more indicative of other conditions like hypertension or nasal issues, not necessarily specific to a brain tumor. B: Vomiting not relieving nausea can be seen in various conditions affecting the gastrointestinal system, not specifically brain tumors. D: Blood-tinged emesis can suggest gastrointestinal bleeding or other issues, but it's not a specific characteristic of vomiting associated with brain tumors.