ATI RN
Genitourinary Review of Systems Questions
Question 1 of 5
Due to its potential for severe hepatoxicity, Nevirapine should NOT be * initiated in:
Correct Answer: D
Rationale: The correct answer is D because Nevirapine is associated with an increased risk of severe hepatoxicity, especially within the first few weeks of treatment initiation. The recommended CD4 cell count thresholds for starting Nevirapine are lower in women compared to men to minimize this risk. In this case, women with CD4 cell counts >250 cells/mm3 and men with CD4 cell counts >450 cells/mm3 should not initiate Nevirapine due to the higher likelihood of developing hepatoxicity. A is incorrect because the CD4 cell count thresholds are too high for both women and men. B is incorrect as it sets the threshold for women too high. C is incorrect because the threshold for men is too high. Thus, D is the most appropriate choice based on the recommended guidelines to minimize the risk of severe hepatoxicity.
Question 2 of 5
Which of the following statement(s) about metronidazole is correct?: *
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Metronidazole is a nitroimidazole antibiotic that requires activation by bacterial reductases to form nitro intermediates. 2. These activated intermediates bind DNA, leading to DNA strand breakage and inhibition of anaerobic bacterial replication. 3. This mechanism of action makes metronidazole effective against anaerobic bacteria. 4. Choice A is incorrect as metronidazole is not the first-line drug for amoebic dysentery or liver abscess - it is mainly used for anaerobic infections. 5. Choice C is incorrect as metronidazole is not the most effective drug for eradicating amoebic cysts in the colon; other drugs like tinidazole are preferred for that purpose. 6. Choice D is incomplete and does not provide any information related to metronidazole's mechanism of action.
Question 3 of 5
Which antibiotic is primarily bacteriostatic but becomes bactericidal at higher * concentrations?:
Correct Answer: C
Rationale: The correct answer is C: Chloramphenicol. At lower concentrations, Chloramphenicol is primarily bacteriostatic, inhibiting bacterial protein synthesis. However, at higher concentrations, it can disrupt the bacterial ribosome, leading to bacterial cell death, making it bactericidal. Erythromycin (A) and Tetracycline (B) are primarily bacteriostatic by inhibiting protein synthesis. Ampicillin (D) interferes with bacterial cell wall synthesis but does not exhibit a concentration-dependent shift to bactericidal activity like Chloramphenicol.
Question 4 of 5
A 70 year old man has severe urinary hesitancy associated with bPH. He has * tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride inhibits 5-alpha reductase, reducing conversion of testosterone to dihydrotestosterone (DHT) in the prostate. This helps shrink the prostate gland, relieving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used for prostate cancer. Flutamide (C) is an antiandrogen for prostate cancer. Ketoconazole (D) is an antifungal, not for BPH. Finasteride is the most appropriate choice for this patient based on mechanism of action and indication.
Question 5 of 5
A patient has very high plasma uric acid and has high risk of developing acute * uric acid nephropathy. Which of the following agent should be avoided?
Correct Answer: B
Rationale: The correct answer is B: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that can worsen hyperuricemia by increasing renal uric acid reabsorption. This can further exacerbate the risk of acute uric acid nephropathy. Ethacrynic acid (A), Hydrochlorothiazide (C), and Furosemide (D) are loop diuretics that can actually help in reducing uric acid levels by increasing its excretion through the urine. Therefore, they would not be contraindicated in this scenario.