MCQS 232-234 :A patient with chronic hypertension , well managed with ACE inhibitors , finds out that she has just become pregnant

 

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Question:232
A patient with chronic hypertension , well managed with ACE inhibitors , finds out that she has just become pregnant

a) immediate delivery
b) intravenous Hydralazine
c) alpha-blocker
d) Labetolol
e) change current treatment immediately
f) diuretic
g) Methyldopa
h) calcium antagonist
i) angiotensin-converting enzyme inhibitors
j) angiotensin II receptor antagonist

 

Question:233
in a hypothermic cardiopulmonary bypass operation the surgeon plans to accurately monitor heparin levels. Which is the most reliably reproducible test ideal for this purpose?

a) Platelet count
b) Clot retraction
c) Tourniquet test
d) Bleeding time
e) Prothrombin time (PT)
f) Activated partial thromboplastin time
g) Venous clotting time
h) Activated whole blood clotting time
i) Thrombin time
j) Plasma fibrinogen

 

Question:234
This disease is caused by a defect in the chloride channel in the cell membrane of epithelial cells.

a) Tuberculosis
b) bronchiectasis
c) Cystic fibrosis
d) pulmonary hemosiderosis
e) Mitral stenosis
f) Aspergillosis
g) Wegeners
h) Goodpastures
i) Pulmonary embolism
j) Non-small cell bronchogenic carcinoma

Question:232
Correct Answer: E

Explanation:
If a woman with chronic (pre-existing) hypertension has her antihypertensive treatment continued during pregnancy, it is advisable to switch to one that is recommended for use during pregnancy. In particular, ACE inhibitors and angiotensin II receptor antagonists must be stopped <br>

 

Question:233
Correct Answer: H

Explanation:
Activated whole blood clotting time The activated clotting time (ACT) is routinely used for monitoring of heparin effects during cardiopulmonary bypass The test is claimed to be very reproducible. It can be used for coagulation defect screening and to monitor heparin therapy. It is said to have approximately the same sensitivity as the APTT in coagulation defects, and in heparin assay it is more linear than APTT at greater heparin effects. Method: Whole blood is drawn into a vacuum tube containing a contact factor activator. The tube is incubated in a heat block at 37°C and tilted every 5 seconds. The normal upper limit is about 2 minutes. Disadvantages are the need for a portable heating unit and inability to automate the procedure (that the test is done at the bedside is considered by its proponents to be an advantage). The test is not sensitive to platelet variations

 

Question:234
 
Correct Answer: C

Explanation:
The defect in cystic fibrosis is a blocked or closed chloride channel in the cell membrane of epithelial cells. This blockage traps chloride ions inside the cell and draws sodium ions and water into the cell. This process results in dehydration of mucous secretions and an abnormal ion and water environment surrounding the cell that may inactivate cell defense mechanisms and promote bacterial growth


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