Which of the following enzymes improves GIT functions (replacement therapy):

Correct Answer: A

Rationale: The correct answer is A: Pepsin. Pepsin is an enzyme that aids in the digestion of proteins in the stomach, improving gastrointestinal (GIT) functions. It breaks down proteins into smaller peptides for absorption. Urokinase is a thrombolytic enzyme used to dissolve blood clots, not related to GIT functions. L-asparaginase is used in cancer treatment by depleting asparagine, not for GIT functions. Lydaze is an enzyme used to break down bacterial cell walls, also unrelated to GIT functions. Therefore, the correct choice is pepsin as it directly enhances GIT functions by aiding in protein digestion.

Correct Answer: B

Rationale: The correct answer is B because alendronate is a second-generation bisphosphonate, not a first-generation one. Alendronate is known to be more potent than EHDP and has a wider therapeutic window. Option A is incorrect as alendronate can cause irritation to the esophagus if not taken correctly. Option C is correct as alendronate reduces osteoclast activity without significantly affecting osteoblasts, making it useful in treating Paget's disease.

Correct Answer: B

Rationale: Loop diuretics inhibit the Na/K/2Cl cotransporter in the thick ascending loop of Henle, while thiazide diuretics act on the NaCl cotransporter in the distal convoluted tubule. Therefore, the correct answer is B. Loop diuretics (A) work differently by targeting a different transporter. Potassium-sparing diuretics (C) inhibit sodium channels in the collecting duct and distal nephron, not the NaCl cotransporter. Carbonic anhydrase inhibitors (D) act on the enzyme carbonic anhydrase in the proximal convoluted tubule and not directly on the NaCl cotransporter.

Correct Answer: D

Rationale: Carbapenems are broad-spectrum antibiotics that are effective against a wide range of both Gram-positive and Gram-negative microorganisms due to their strong activity against various types of bacteria. Option A is incorrect because carbapenems are not limited to only Gram-positive microorganisms. Option B is incorrect as they are effective against both Gram-positive and Gram-negative microorganisms. Option C is incorrect as carbapenems are not exclusively for bacteroide infections. The correct answer, Option D, is supported by the fact that carbapenems have a broad spectrum of activity against a wide range of bacteria.

Correct Answer: D

Rationale: The correct choice is D: Ciprofloxacin. Ciprofloxacin is a fluoroquinolone derivative known for its broad-spectrum antibacterial activity. It inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes for DNA replication. This mechanism leads to bacterial cell death. Chloramphenicol (A) inhibits bacterial protein synthesis, Nitrofurantoin (B) disrupts bacterial cell wall synthesis, and Nalidixic acid (C) inhibits bacterial DNA synthesis. Therefore, only Ciprofloxacin (D) targets DNA replication through gyrase inhibition, making it the correct choice.