Following a 14-day course of broad-spectrum antibiotics for the ...

[nautica902]

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a 60-year-old woman has developed watery diarrhea.
 
  Her care team attributes this to likely elimination of normal intestinal flora by the antibiotics. What other phenomena is most likely accompanying her low levels of normal flora?
  A)
  Decreased mineral and nutrient absorption; decreased carbohydrate metabolism
  B)
  Decreased pH of the stomach; increased pH of the lower GI tract
  C)
  Decreased fermentation of undigestible dietary residue; decreased vitamin absorption
  D)
  Proliferation of vitamin K; lower GI bleeding

Question 2

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease?
 
  A)
  Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.
  B)
  Acute tubular necrosis is associated with impaired drug reabsorption through the tubular epithelium.
  C)
  Decreased retention by the kidneys often renders normal drug dosages ineffective.
  D)
  Dialysis removes active metabolites from circulation minimizing therapeutic effect.

[olderstudent]

Answer to Question 1

Ans:
C

Feedback:

Central among the functions of normal intestinal flora are the fermentation of dietary components that are not digestible and the facilitation of vitamin absorption. Mineral and nutrient absorption as well as carbohydrate metabolism are less likely to be affected, while vitamin K production would likely decrease somewhat. pH is unlikely to be affected.

Answer to Question 2

Ans:
A

Feedback:

A decrease in plasma proteins, particularly albumin, that occurs in many persons with renal failure results in less protein-bound drug and greater amounts of free drug. Drug elimination problems do not stem as directly from impaired tubular reabsorption, decreased retention, or the process of dialysis.

[nautica902]

Thank you

[olderstudent]

Happy to help you