Help with questions/explanations

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malafurfur

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OK so I came across a few questions that I dont really understand the correct ans- OR perhaps they can be poorly written questions...
Appreciate the help if someone is willing to point out the reasonings! Thanks!!🙂🙂🙂🙂


😕😕😕😕😕

A 65-year-old man is diagnosed with the syndrome of inappropriate ADH secretion (SIADH) in the setting of small cell lung cancer. To treat his SIADH, the patient is started on drug X. He soon begins producing large quantities of dilute urine and drinking copious amounts of water. Despite fluid restriction, the patient continues to produce dilute urine. Laboratory tests reveal an increased serum ADH level, serum hyperosmolarity, and hypernatremia.

Drug X might also be used to treat which of the following?
a) Acute gouty arthritis
b) Conn's disease
c)Enuresis
d) Lyme disease
e) Pheochromocytoma

A 53-year-old woman calls her primary care physician because she wants to begin hormone replacement therapy (HRT). She has read that estrogen replacement therapy is supposed to ease the transition to a postmenopausal state, and that HRT can be cardioprotective, decrease cancer risk, and promote healthy bones.

Which of the following is an indication for this woman to start HRT?
a) To decrease the risk of breast cancer
b) to decrease the risk of DVT and stroke
c) to decrease the risk of mycardial infraction
d) to decrease the risk of osteoporosis
e) to treat vasomotor symptoms

A 37-year-old man presents to the emergency department (ED) with difficulty breathing. He notes that he has been feeling worse over the past few days, but he woke up this morning gasping for breath. He also complains of a productive cough, which he suspects is preventing him from breathing better. On physical examination, bilateral rales and rhonchi are heard upon auscultation of the lungs. X-ray of the chest is ordered, and shows diffuse interstitial infiltrates. Sputum samples confirm a diagnosis of Pneumocystis jiroveci pneumonia. Additionally, HIV tests come back positive. He is placed on several antiretroviral medications to manage his condition. Several weeks later, he returns to his physician for a routine complete blood cell count, which is normal except for a platelet count of 80,000/mm³. His physician suspects that this laboratory finding is caused by one of his HIV medications, which acts by blocking protease in progeny virions.

What medication could have caused his thrombocytopenia?
a) Didansoine
b)Enfuvirtide
c)Indinavir
d)Saquinavir
e)Zidovudine
 
1. Demeclocycline is used to treat SIADH.. it is a tetracycline so it can also be used to treat Lyme disease (really not used for this purpose however)

2. Either D or E.. im leaning towards E

3. Indinavir causes thrombocytopenia (FA)
 
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D D D

I lean towards osteoporosis under the assumption that she's post menopausal at 53...which is kind of implied since she's asking about it. Why are you thinking E? Curiosity.
 
D D D

I lean towards osteoporosis under the assumption that she's post menopausal at 53...which is kind of implied since she's asking about it. Why are you thinking E? Curiosity.

I thought D but then looked up vasomotor symptoms.. and the hot flashes etc can also be treated by estrogen therapy so i guess i second guessed it ..
 
1. Demeclocycline is used to treat SIADH.. it is a tetracycline so it can also be used to treat Lyme disease (really not used for this purpose however)

2. Either D or E.. im leaning towards E

3. Indinavir causes thrombocytopenia (FA)
Thanks for the help!
I also picked D for the osteoporosis, but then looked up "vasomotor" and turn s out E makes sense- then again all of them could be the answer. I got these questions of UsmleRx. IDK if its just me, but some of these questions are just poorly written. I finished 20% of the qbank and I really dont like it.
When you review the questions, majority of the answer choices are always split even- like 36% answered "D" and 30% answer E.
For the HIV- they ask for a protease inhibitor causing Thrombocytopenia .. I looked up Indinavir in FA 12/13 and DIT notes and its not mentioned in any of those sources ( unless I overlooked it ). I googled the side effects of the drug and still didnt find anything. Then came across a paper that mentions thrombocytopenia is very RARE for Indinavir- only 1-3% of the ppl taking it get it.

IDK...I feel like this qbank is getting me more confused instead of helping me
 
Thanks for the help!
I also picked D for the osteoporosis, but then looked up "vasomotor" and turn s out E makes sense- then again all of them could be the answer. I got these questions of UsmleRx. IDK if its just me, but some of these questions are just poorly written. I finished 20% of the qbank and I really dont like it.
When you review the questions, majority of the answer choices are always split even- like 36% answered "D" and 30% answer E.
For the HIV- they ask for a protease inhibitor causing Thrombocytopenia .. I looked up Indinavir in FA 12/13 and DIT notes and its not mentioned in any of those sources ( unless I overlooked it ). I googled the side effects of the drug and still didnt find anything. Then came across a paper that mentions thrombocytopenia is very RARE for Indinavir- only 1-3% of the ppl taking it get it.

IDK...I feel like this qbank is getting me more confused instead of helping me

Its okay.. that thrombocytopenia is actually mentioned in FA 2011 ..probably not important which is why its been taken out in the newer FA's.. i thought usmlerx was good just to go through FA more actively.. don't let it overwhelm you
 
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