Which of the following was most likely the mechanism of fungal resistance to fluconazole in this patient?

Correct Answer: C

Rationale: Step 1: Fluconazole is metabolized by fungal cytochrome P-450 enzymes. Step 2: Gene-induced changes in these enzymes can lead to decreased drug efficacy. Step 3: Resistance to fluconazole commonly involves alterations in cytochrome P-450 enzymes. Step 4: Therefore, gene-induced changes in fungal cytochrome P-450 enzymes are most likely the mechanism of resistance in this patient. Summary: A is incorrect as topoisomerase II is not a target of fluconazole. B is incorrect as increased metabolism would not lead to resistance. D is incorrect as decreased activity of multiefflux pump would increase drug accumulation, not resistance.

Correct Answer: B

Rationale: The correct answer is B: Stimulating beta-2 adrenergic receptors in the lungs. Albuterol is a beta-2 adrenergic agonist, which means it binds to and activates beta-2 adrenergic receptors in the lungs. By stimulating these receptors, albuterol causes smooth muscle relaxation, leading to bronchodilation and improved airflow in the lungs. This mechanism of action is beneficial in treating asthma by relieving bronchospasms and symptoms of shortness of breath. Choice A is incorrect because albuterol does not inhibit histamine release from mast cells. Choice C is incorrect as albuterol does not increase acetylcholine release in the lungs; in fact, it has the opposite effect by promoting bronchodilation. Choice D is incorrect as albuterol does not block leukotriene receptors; leukotriene receptor antagonists like montelukast are used for that purpose.

Correct Answer: A

Rationale: The correct answer is A: Celecoxib. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed to treat acute pain and inflammation in conditions like osteoarthritis and rheumatoid arthritis. It works by inhibiting the COX-2 enzyme, reducing inflammation and pain. Furosemide (B) is a diuretic used to treat fluid retention, not pain or inflammation. Gabapentin (C) is an anticonvulsant primarily used for nerve pain and seizures, not inflammation. Clonazepam (D) is a benzodiazepine used for anxiety and seizures, not for pain and inflammation.

Correct Answer: A

Rationale: The correct answer is A: Colchicine. Colchicine is used to treat acute gout attacks by reducing inflammation in affected joints. It works by decreasing the inflammatory response caused by the deposition of uric acid crystals in the joints. Colchicine is not used for long-term prevention of gout attacks like Allopurinol, which is a xanthine oxidase inhibitor that lowers uric acid levels. Prednisone is a corticosteroid that can be used to reduce inflammation in gout but is not the first-line treatment. Furosemide is a diuretic used to treat conditions like edema and hypertension, not gout.

Correct Answer: A

Rationale: The correct answer is A: Inhibiting the reabsorption of glucose in the kidneys. Dapagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which prevents the reabsorption of glucose in the kidneys, leading to increased glucose excretion in the urine. This mechanism helps lower blood sugar levels in patients with diabetes. Choices B, C, and D are incorrect because dapagliflozin does not directly impact insulin sensitivity, insulin secretion, or incretin hormone breakdown. It primarily acts on the kidneys to reduce blood glucose levels.