Which of the following diuretics is most widely used to treat mild * hypertension?

Correct Answer: C

Rationale: The correct answer is C: Hydrochlorothiazide. It is a thiazide diuretic commonly used to treat mild hypertension. Thiazide diuretics work by reducing the reabsorption of sodium and water in the kidneys, leading to increased urine production and lower blood pressure. Furosemide (A) is a loop diuretic primarily used for more severe conditions. Spironolactone (B) is a potassium-sparing diuretic often used for conditions like heart failure. Amiloride (D) is also a potassium-sparing diuretic but is not typically used as a first-line treatment for hypertension.

Correct Answer: D

Rationale: The correct answer is D: Spironolactone. Spironolactone is a potassium-sparing diuretic that also acts as an anti-androgen. It can cause gynecomastia, hirsutism, and menstrual disturbances due to its anti-androgenic effects, blocking the action of male hormones like testosterone. Hydrocholorothiazide (A) is a thiazide diuretic that does not typically cause these specific adverse reactions. Bumetanide (B) is a loop diuretic that is not associated with gynecomastia, hirsutism, or menstrual disturbances. Acetazolamide (C) is a carbonic anhydrase inhibitor diuretic that does not commonly lead to these particular side effects.

Correct Answer: D

Rationale: The correct answer is D: interlobular vessel. Blood leaves the glomerulus through the efferent arteriole, which then branches into the peritubular capillaries. These capillaries merge to form the interlobular veins, which ultimately carry the blood away from the nephron and back into the general circulation. The other choices are incorrect because: A: Bone marrow is not directly involved in blood leaving the glomerulus. B: The afferent arteriole brings blood into the glomerulus, it does not carry blood out. C: Kidneys are the site where blood is filtered, not where it leaves the glomerulus.

Correct Answer: B

Rationale: The correct answer is B: Pulmonary edema. Pulmonary edema is not an absolute indication for dialysis in acute renal failure (ARF) as it is primarily managed with oxygen therapy and diuretics. Refractory hyperkalemia >6.5 mmol/l is a life-threatening condition that requires immediate dialysis to remove excess potassium. Encephalopathy indicates severe uremia and is another absolute indication for dialysis. Other options were not provided in the question.

Correct Answer: B

Rationale: The correct answer is B: Acute tubular necrosis (ATN). ATN is the most likely diagnosis due to its common occurrence in critically ill patients with factors like hypotension, sepsis, or nephrotoxic medications. The key characteristic is the damage to the renal tubules leading to acute kidney injury. Prerenal failure (A) is usually due to decreased blood flow to the kidneys, glomerulonephritis (C) involves inflammation of the glomeruli, and postrenal failure (D) is caused by obstruction of urine flow. These conditions are less likely in a critically ill patient compared to ATN.