A patient with renal impairment and HIV has had a medication ...

[vicotolentino]

A patient with renal impairment and HIV has had a medication change. What drug would be considered the drug of choice for this patient?
 
  A) Atazanivir (Reyataz)
  B) Lopinavir (Kaletra)
  C) Nelfinavir (Viracept)
  D) Ritonavir (Norvir)

Question 2

As a woman goes through menopause what happens? (Select all that apply.)
 
  A) Hypothalamus increases production of gonadotropin-releasing hormone (GnRH)
  B) Reversal of primary sex characteristics
  C) Loss of calcium retention in bones
  D) Serum lipid levels increase
  E) Decreased serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

[IRincones]

Answer to Question 1

C
Feedback:
Nelfinavir is the best choice for a patient with renal impairment because very little of the drug is excreted through the kidney, with most being excreted in feces. The other drugs are all excreted through both the urine and feces, so patients with renal impairment might need dosage adjustments to avoid toxicity.

Answer to Question 2

A, C, D
Feedback:
The follicles contained in the ovary become depleted over time, the ovaries no longer produce estrogen and progesterone, and menopause begins with the cessation of menses. The hypothalamus and pituitary gland produce increased levels of GnRH, FSH, and LH for a while in an attempt to stimulate the ovaries to produce estrogen and progesterone. If that does not happen, the levels of these hormones fall back within a normal range in response to their own negative feedback systems. Menopause is associated with loss of many effects of these two hormones resulting in loss of calcium in the bones, increased serum lipid levels, and maintenance of secondary sex characteristics. Primary sexual characteristics are not impacted.

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