A child is prescribed Phenobarbital 18 mg twice a day PO. The child weighs 6 kg. The pediatric dosage range is 5-7 mg/kg/day.

What is the safe maximum dosage per day for this child?

Choice A rationale

Gonorrhea is a sexually transmitted infection caused by the bacterium *Neisseria gonorrhoeae*. This gram-negative diplococcus primarily infects mucous membranes of the reproductive tract, mouth, and rectum, leading to symptoms like discharge and dysuria. It is not caused by a protozoan.

Choice B rationale

Chlamydia is a sexually transmitted infection caused by the obligate intracellular bacterium *Chlamydia trachomatis*. This bacterium infects columnar epithelial cells, particularly in the genitourinary tract, often leading to asymptomatic infections or symptoms like urethritis and cervicitis. It is not a protozoal infection.

Choice C rationale

Trichomoniasis is a sexually transmitted infection caused by the anaerobic flagellated protozoan parasite *Trichomonas vaginalis*. This microorganism infects the urogenital tract, leading to vaginitis in females and urethritis in males, characterized by symptoms like itching, burning, and discharge.

Choice D rationale

Syphilis is a sexually transmitted infection caused by the spirochete bacterium *Treponema pallidum*. This bacterium can disseminate throughout the body, causing a multi-stage disease with diverse clinical manifestations affecting skin, mucous membranes, and internal organs. It is not caused by a protozoan.

Choice A rationale

Post-kidney transplant, immunosuppressive medications are crucial to prevent rejection, which also compromises the immune system. Engaging in contact sports significantly increases the risk of direct trauma to the transplanted kidney, potentially causing injury or rupture, which could necessitate re-transplantation or lead to graft loss.

Choice E rationale

Grapefruit contains furanocoumarins, compounds that inhibit the cytochrome P450 3A4 (CYP3A4) enzyme system in the liver and intestines. Many immunosuppressants, like calcineurin inhibitors (e.g., cyclosporine, tacrolimus), are metabolized by CYP3A4. Inhibition of this enzyme can lead to increased drug concentrations and elevated risk of toxicity.

Choice F rationale

Fluid restriction post-kidney transplant may be necessary, particularly in the immediate postoperative period or if the patient experiences fluid overload or delayed graft function. Excessive fluid intake could contribute to hypertension or pulmonary edema, complicating recovery and potentially stressing the newly transplanted kidney.