A 13-year-old boy presents to his pediatrician with a 1-day history of frothy brown urine. He says that he believes he had strep throat some weeks ago, but he was not treated with antibiotics as his parents were worried about him experiencing harmful side effects. His blood pressure is 148/96 mm Hg, heart rate is 84/min, and respiratory rate is 15/min. Laboratory analysis is notable for elevated serum creatinine, hematuria with RBC casts, and elevated urine protein without frank proteinuria. His antistreptolysin O titer is elevated, and he is subsequently diagnosed with post-streptococcal glomerulonephritis (PSGN). His mother is distraught regarding the diagnosis and is wondering if this could have been prevented if he had received antibiotics. Which of the following is the most appropriate response?
AAntibiotic therapy decreases the severity of PSGN.
BOnce a patient is infected with a nephritogenic strain of group A streptococcus, the development of PSGN cannot be prevented.
CAntibiotic therapy only prevents PSGN in immunosuppressed patients.
DAntibiotic therapy may decrease the risk of developing PSGN.
EAntibiotic therapy can prevent the development of PSGN.
A 62-year-old man comes to the physician for a follow-up examination. One month ago, therapy with lisinopril was initiated for treatment of hypertension. His blood pressure is 136/86 mm Hg. Urinalysis shows a creatinine clearance of 92 mL/min. The patient's serum creatinine concentration is most likely closest to which of the following values?
A1.7 mg/dL
B1.1 mg/dL
C2.0 mg/dL
D1.4 mg/dL
E2.3 mg/dL
A 26-year-old man comes to the emergency department because of a 1-week history of worsening fatigue, nausea, and vomiting. Six weeks ago, he was diagnosed with latent tuberculosis and appropriate low-dose pharmacotherapy was initiated. Physical examination shows right upper quadrant tenderness and scleral icterus. Laboratory studies show elevated aminotransferases. Impaired function of which of the following pharmacokinetic processes is the most likely explanation for this patient's symptoms?
AAcetylation
BGlucuronidation
CHydrolysis
DSulfation
EReduction
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