Answer to Question 1
Correct Answer: 4
Rationale 1: Neither aspirin nor ibuprofen products inhibit the production of histamines in response to the inflammatory process.
Rationale 2: Neither aspirin nor ibuprofen products inhibit platelet production. Both, however, inhibit platelet aggregation.
Rationale 3: Cytokine IL-1 is produced during the inflammatory process. Macrophages, with the processed antigens, combine with cytokine IL-1 to stimulate the helper T cells.
Rationale 4: Aspirin blocks the synthesis of prostaglandins by inhibiting the enzyme cyclooxygenase (COX). Aspirin and the ibuprofen-like NSAIDs block both forms of the enzyme, cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2), by changing their structures and preventing the formation of prostaglandins.
Global Rationale: The anti-inflammatory action of aspirin is caused by the inhibition of COX-1 and COX-2 that leads to reduced prostaglandin synthesis. Ibuprofen and ibuprofen-like drugs all inhibit both COX-1 and COX-2 when used at recommended doses. Neither inhibits platelet production, histamine production, or cytokine IL-1 synthesis.
Answer to Question 2
Correct Answer: 4
Rationale 1: Symptoms include metabolic acidosis, not alkalosis.
Rationale 2: Symptoms of salicylism include respiratory alkalosis, not acidosis.
Rationale 3: Symptoms of salicylism include hyperventilation.
Rationale 4: Symptoms of salicylism include tinnitus.
Global Rationale: Symptoms of salicylism depend upon the dose, but include tinnitus, metabolic acidosis, hyperventilation, respiratory alkalosis (secondary to stimulation of the respiratory center), dehydration, agitation, CNS depression, nausea, and vomiting. Symptoms include metabolic acidosis, respiratory alkalosis, and hyperventilation.