Which macrolide antibiotic that can be given once a day for 3 days for empirical treatment of ENT, respiratory and genital infections?

Correct Answer: B

Rationale: The correct answer is B: Azithromycin. It is preferred for short-term treatment due to its long half-life allowing once-daily dosing. Azithromycin has a broad spectrum of activity against many pathogens causing ENT, respiratory, and genital infections. It is well-tolerated and has fewer drug interactions. Other choices like A: Erythromycin have a higher frequency of dosing and more side effects. C: Clarithromycin and D: Roxithromycin are not typically given once daily for 3 days.

Correct Answer: B

Rationale: The main reason for using combination therapy in TB treatment is to delay or prevent the emergence of resistance. Step 1: TB is caused by Mycobacterium tuberculosis, which has a high mutation rate leading to drug resistance. Step 2: With combination therapy, multiple drugs target different aspects of the bacteria's lifecycle, making it harder for resistance to develop. Step 3: This approach ensures that if one drug becomes ineffective due to resistance, others can still be effective. Summary: Choice B is correct as it directly addresses the issue of resistance, which is a critical concern in TB treatment. Choices A, C, and D are incorrect because reducing side effects, increasing antimycobacterial activity, and providing prophylaxis against other bacterial infections are not the primary reasons for using combination therapy in TB.

Correct Answer: A

Rationale: The correct answer is A: Spironolactone. Spironolactone is a potassium-sparing diuretic that works by antagonizing aldosterone, which is responsible for the symptoms of hypertension, edema, hypernatremia, and hypokalemia seen in adrenal tumor. By blocking aldosterone receptors, spironolactone helps to reduce sodium reabsorption and potassium excretion, thus counteracting the hormonal effects. Bumetanide (choice B) and Furosemide (choice C) are loop diuretics that primarily work by inhibiting sodium reabsorption in the loop of Henle and are unlikely to be as effective in this scenario. Acetazolamide (choice D) is a carbonic anhydrase inhibitor that works in the proximal tubule and is not indicated for the specific hormonal effects seen in this case.

Correct Answer: D

Rationale: Thiazide diuretics can lead to hyperglycemia by reducing insulin sensitivity. This can result in increased blood glucose levels. Thiazides also elevate uric acid levels by reducing its excretion. Therefore, the correct answer is D (Glucose). Incorrect choices: A (Potassium) - Thiazides typically cause hypokalemia, not hyperkalemia. B (BUN) and C (Urea) - Thiazides may cause a slight increase in BUN and serum creatinine levels due to reduced kidney function, but not as significantly as glucose levels.

Correct Answer: D

Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic which can increase uric acid levels in the blood, potentially worsening the patient's condition. Ethacrynic acid (A) is also a loop diuretic and can have similar effects. Acetazolamide (B) is a carbonic anhydrase inhibitor and may increase urinary excretion of uric acid, which can be beneficial in this case. Hydrochlorothiazide (C) is a thiazide diuretic that can actually lower uric acid levels by increasing urinary excretion. Therefore, the best choice to avoid in a patient with high plasma uric acid and risk of acute uric acid nephropathy is furosemide.