The drug of choice for controlling postpartum haemorrhage is

Correct Answer: B

Rationale: In the context of postpartum hemorrhage, the drug of choice for controlling bleeding is Methylergometrine (Option B). Methylergometrine is an ergot alkaloid that acts on smooth muscle in the uterus, leading to vasoconstriction and uterine contraction, thereby reducing bleeding after childbirth. Option A, Oxytocin, is commonly used to induce or augment labor by stimulating uterine contractions but is not as effective in controlling postpartum hemorrhage as Methylergometrine. Option C, Dihydroergotamine, is primarily used to treat migraines and is not the drug of choice for postpartum hemorrhage. Option D, Prostaglandin E2, may be used in cases of postpartum hemorrhage refractory to other treatments, but it is not the first-line drug for this condition. Educationally, it is crucial for healthcare providers to understand the appropriate pharmacological interventions for postpartum hemorrhage to provide optimal care for postpartum women. Understanding the mechanisms of action and specific indications for each drug is essential in ensuring safe and effective management of postpartum hemorrhage, a potentially life-threatening complication of childbirth.

Correct Answer: A

Rationale: Estrogens are steroid hormones responsible for various physiological functions in the body, including maintaining bone health. Option A, "Block bone resorption," is the correct answer because estrogens help to inhibit bone breakdown by osteoclasts, thus preserving bone density and strength. This action is crucial in preventing conditions like osteoporosis. Option B, "Maintain negative calcium balance," is incorrect. Estrogens actually help maintain a positive calcium balance by promoting calcium absorption in the intestines, reducing renal calcium excretion, and enhancing calcium deposition in bones. Option C, "Decrease HDL levels," is also incorrect. Estrogens are known to increase HDL (high-density lipoprotein) levels, which is considered beneficial for heart health as HDL helps to remove excess cholesterol from the bloodstream. Option D, "Increase bile acid secretion," is not a direct effect of estrogens. Estrogens do influence cholesterol metabolism and may impact bile composition, but they do not directly increase bile acid secretion. In an educational context, understanding the pharmacological effects of estrogens is essential for healthcare professionals, especially when managing conditions like hormonal imbalances, menopausal symptoms, or osteoporosis. Knowing the correct actions of estrogens can guide appropriate prescribing practices and patient education regarding potential side effects and benefits.

Correct Answer: A

Rationale: In this question on endocrine pharmacology, the correct answer is A) Mesterolone. Mesterolone is a synthetic androgen and anabolic steroid that is used to treat low testosterone levels in men. It is not associated with feminization because it does not have estrogenic effects. This is why feminization is not a side effect of mesterolone. The other options (B) Testosterone cypionate, (C) Testosterone, and (D) Testosterone propionate are forms of testosterone, a naturally occurring hormone in the body. Testosterone can be converted into estrogen in the body through a process called aromatization. When testosterone is converted into estrogen, it can lead to feminizing effects such as gynecomastia (breast enlargement in males) and other feminizing characteristics. This is why these forms of testosterone can potentially cause feminization as a side effect. From an educational standpoint, understanding the side effects of different hormonal medications is crucial for healthcare professionals, especially when prescribing or administering these medications to patients. This knowledge helps in assessing and managing potential adverse effects and ensuring safe and effective treatment outcomes for patients with endocrine disorders.

Correct Answer: D

Rationale: In this question, the correct answer is D) All of the above. Angiotensin increases peripheral resistance through multiple mechanisms. A) Direct vasoconstriction: Angiotensin can directly cause vasoconstriction of blood vessels, leading to an increase in peripheral resistance. This mechanism helps regulate blood pressure by narrowing the vessels. B) Catecholamine release from adrenal medulla: Angiotensin can stimulate the release of catecholamines like adrenaline from the adrenal medulla. These hormones further contribute to vasoconstriction and increased peripheral resistance. C) Noradrenaline release from sympathetic nerve terminals: Angiotensin can also trigger the release of noradrenaline from sympathetic nerve terminals. Noradrenaline acts on alpha-adrenergic receptors to constrict blood vessels, adding to the overall increase in peripheral resistance. Educational context: Understanding how angiotensin affects peripheral resistance is crucial in the context of endocrine pharmacology. Medications targeting the renin-angiotensin-aldosterone system are commonly used to manage conditions like hypertension. Knowledge of these mechanisms helps healthcare professionals make informed decisions when prescribing or administering such medications.

Correct Answer: C

Rationale: The correct answer is C) Administer subcutaneous insulin 0.1 unit/kg/hour. In the management of diabetic ketoacidosis (DKA), insulin therapy is crucial to lower blood glucose levels and reverse ketosis. Subcutaneous insulin infusion helps regulate glucose levels effectively and safely. This approach allows for gradual reduction of blood glucose without causing rapid shifts that can lead to complications like cerebral edema. Option A is incorrect because while fluid replacement is essential in DKA, the initial fluid of choice is typically 0.45% saline to avoid rapid changes in serum osmolality. Option B, bladder catheterization, is not the priority in this scenario unless there are specific indications such as monitoring urine output. Option D, administering sodium bicarbonate based on arterial pH, is not recommended routinely due to potential risks like paradoxical cerebrospinal fluid acidosis. In an educational context, understanding the rationale behind the management of DKA is vital for nurses and healthcare providers. It highlights the importance of insulin therapy in correcting the underlying metabolic abnormalities in DKA while emphasizing the need to approach fluid and electrolyte management judiciously to prevent complications. This knowledge is crucial for safe and effective care delivery in acute settings.