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NEW QUESTION: 1
Your patient is a 58-year-old male who presents with onset of severe substernal chest pain and shortness of breath. An ECG reveals an acute STEMI, and he is on his way to the cardiac catheterization suite for percutaneous coronary intervention.
Which of the following drugs used in acute coronary syndromes treated with PCI must undergo oxidation by hepatic P450 enzymes to an active form?
A. Ticlopidine
B. Warfarin
C. Aspirin
D. Clopidogrel
E. Eptifibatide
Answer: D
Explanation:
Explanation
Clopidogrel and ticlopidine are ADP receptor pathway inhibitors. The irreversible inhibition of the ADP- dependent pathway of platelet activation is thought to be the result of covalent modification and inactivation of the platelet P2Y ADP receptor. This receptor is coupled to the inhibition of adenylyl cyclase. Both drugs are prodrugs and undergo conversion to active metabolites in the liver. However, clopidogrel must undergo oxidation by hepatic P450 enzymes to its active form. This is significant because many drugs are metabolized the hepatic P450 enzymes, including statins, and clopidogrel may interact with these medications. Clopidogrel is a second-generation thienopyridine and ticlopidine is a first-generation thienopyridine. Both drugs are indicated in combination with aspirin to prevent stent thrombosis. Eptifibatide is a GPIIb-IIIa receptor antagonist that is used to treat unstable angina and non-ST segment elevation myocardial infarction.
Eptifibatide is also used to reduce ischemic events in patients who are undergoing percutaneous coronary intervention. The drug is a synthetic peptide that directly antagonizes the GPIIb-IIIa receptor on the platelet.
Aspirin is an antiplatelet drug that works by inhibition of synthesis of prostaglandins. Prostaglandin G2 is the result of a synthesis pathway that is activated by platelets and endothelial cells, and results in localized vasoconstriction and induction of platelet aggregation, as well as causing release of platelet granules. Warfarin is an anticoagulant that acts on vitamin K-dependent reactions in the coagulation pathway. Vitamin K is necessary for hepatic synthesis of coagulation factors II, VII, IX and X, protein C and protein S.
Vitamin K- dependent carboxylation is necessary for induction of enzymatic activity of these coagulation factors. Take- home message: Clopidogrel, a second-generation thienopyridine ADP receptor pathway inhibitor, is indicated in combination with aspirin to prevent stent thrombosis in patients who undergo percutaneous coronary intervention after myocardial infarction. Clopidogrel is a prodrug that must undergo oxidation by hepatic P450 enzymes, and therefore may affect the activity of statins and other drugs dependent on the hepatic P450 enzymes.

NEW QUESTION: 2
5ノードのAzure Kubernetes Service（AKS）クラスターで実行されるソリューションがあります。クラスターはNseries仮想マシンを使用します。
Azure Batch AIプロセスは1日に1回実行され、まれにオンデマンドで実行されます。
クラスターが使用されていないときにクラスター構成を維持するためのソリューションを推奨する必要があります。ソリューションに計算コストが発生してはいけません。
推奨事項に何を含めるべきですか？
A. クラスターを1つのノードにダウンスケールします
B. クラスターを削除します
C. クラスターをゼロノードにダウンスケールします
Answer: A
Explanation:
Explanation
An AKS cluster has one or more nodes.
References:
https://docs.microsoft.com/en-us/azure/aks/concepts-clusters-workloads

NEW QUESTION: 3
The Orange Book is founded upon which security policy model?
A. The Bell LaPadula Model
B. TEMPEST
C. The Biba Model
D. Clark-Wilson Model
Answer: A
Explanation:
From the glossary of Computer Security Basics:
The Bell-LaPadula model is the security policy model on which the Orange Book requirements are based. From the Orange Book definition, "A formal state transition model of computer security policy that describes a set of access control rules. In this formal model, the entities in a computer system are divided into abstract sets of subjects and objects. The notion of secure state is defined and it is proven that each state transition preserves security by moving from secure state to secure state; thus, inductively proving the system is secure. A system state is defined to be 'secure' if the only permitted access modes of subjects to objects are in accordance with a specific security policy. In order to determine whether or not a specific access mode is allowed, the clearance of a subject is compared to the classification of the object and a determination is made as to whether the subject is authorized for the specific access mode."
The Biba Model is an integrity model of computer security policy that describes a set of rules. In this model, a subject may not depend on any object or other subject that is less trusted than itself.
The Clark Wilson Model is an integrity model for computer security policy designed for a commercial environment. It addresses such concepts as nondiscretionary access control, privilege separation, and least privilege. TEMPEST is a government program that prevents the compromising electrical and electromagnetic signals that emanate from computers and related equipment from being intercepted and deciphered.
Source: RUSSEL, Deborah & GANGEMI, G.T. Sr., Computer Security Basics, O'Reilly,
1991.
Also: U.S. Department of Defense, Trusted Computer System Evaluation Criteria (Orange
Book), DOD 5200.28-STD. December 1985 (also available here).