Which of the following is not associated with an increased risk for developing epithelial ovarian carcinoma?

Correct Answer: D

Rationale: Late menopause and nulliparity increase ovarian cancer risk due to prolonged ovulation. Early pregnancy (<30) reduces risk by decreasing ovulatory cycles. Oral contraceptives also reduce risk by suppressing ovulation, making it the exception.

Correct Answer: C

Rationale: Low complement levels (C3 and C4) along with significant proteinuria and hematuria indicate systemic lupus erythematosus. Lupus nephritis often presents with these laboratory abnormalities.

Correct Answer: B

Rationale: Anti-CCP (ACPA) is highly specific for rheumatoid arthritis and strongly associated with aggressive, erosive joint disease, unlike ANA (nonspecific), ANCA (vasculitis), or Anti-SSA (Sjogren's), per rheumatology literature.

Correct Answer: B

Rationale: Beta-blockers are advocated in the management of heart failure to inhibit the cardiac effects of sympathetic activation. These drugs are negative inotropes and have the potential to reduce cardiac output. The goal with the use of beta-blockers in heart failure is to reduce cardiac output. Beta-blockers do not affect sodium reabsorption. Angiotensin II and aldosterone enhance sodium and water reabsorption by the kidney, contributing to an elevated blood volume.

Correct Answer: D

Rationale: Holter monitoring (D) assesses arrhythmias over time but is not a primary diagnostic tool for heart failure. Echocardiogram (A), BNP (B), and nuclear stress tests (C) directly evaluate heart function or failure markers.