Pharmacological Management of Common Medical Conditions, Exams of Nursing

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child with head lice rx'd with shampoo permethrin still has nits in her can she go to school? - Answers-yes as long as continue home remedy, nit combing and repeat permethrin shampoo in 6 days is diverticular bleeding painful? - Answers-no

• abdominal pains BP recommendation for >65 - Answers-150/ young boy left hip pain afebrile ESR normal WBC normal Radiograph knee and hip normal dx? rx? - Answers-transient synovitis rx: nsaids rx for SVTs but short-term and llong term - Answers-CCB eg verapamil, diltiazem 16 yo

ABFM EXAM

QUESTIONS

AND ANSWERS

fatigue on OCPs low bleed on periods normal TSH normal Hct normal RBC count MCV < what lab test next? - Answers-Hgb electrophoresis

• check beta thalassemia Signs of ALS
• mainly motor sx - Answers-asymmetrical weakness in legs, feet, ankles slurred speech trouble swallowing SOB wt loss mcc urge incontinence in elderly - Answers-detrusor instability which SSRI should be prevented in elderly - Answers-paroxetine
• anticholinergic effects screen for autism at what age in kids? - Answers- 18 - 24months bacterial vaginosis has vagina pH? - Answers->4. 29 yo woman 30weeks gestation received Tdap 3 years ago what vaccine should she receive? - Answers-Tdap again 27 - 36 weeks gestation, regardless of when they last received it rx for acute gout pt has HTN and CKD - Answers-prednisone note: nsaids, colchicine and steroids can be used for acute gout...but prednisone is best in CKD mcc med-induced adverse drug events in US - Answers-anti-coags

most common risk factor for uncomplicated cystitis - Answers-Frequent sexual intercourse others:

• spermicide use
• previous UTI
• new sex partner
  • fam hx UTI in first degree female relative first line rx primary dysmenorrhea - Answers-nsaids surveillance for barett's esophagus without dyspasia - Answers-endoscopy q 3 years best initial rx for keloid - Answers-intralesional corticosteroid injections. rx osteoporosis if 10yr risk of major osteoporotic fracture > ___ % - Answers-20% pt with osteopenia (T <2.5) risk of fracture <20% what meds do you start on - Answers-calcium and vit d supplements test for meniscus tears - Answers-thessaly test This patient has low energy, menstrual irregularities, and a history of stress fractures, BMI <18...is consistent with ______ dx? what test does she need? - Answers-the female athlete triad. She is at risk for altered bone density and needs a bone mineral density test. pt with exercise induced asthma pt can prevent this by? - Answers-albuterol 10-15min before exercise does ankylosing spondylitis improve with exercise and activity? - Answers-yes also note:
• pain worse in evening
• stiffness worse in morning pt wwith ASCVD risk >7.5% should be started on? - Answers-moderate-or-high intensity statin note:
• fibrates don't have effect on CVD and are not part of recommendation guidelines

what diabetes medications are good for prevention of developing DM in pre-diabetes pt

• Answers-metformin "alpha-glucosidase inhibitors (acarbose) orlistat thiazolidinediones most specific sign of peritonsillar abscess - Answers-difficulty opening mouth rx management for concussion - Answers-physical and cognitive rest
• avoid physical activity that exacerbate sx
• avoid activities that require concentration or attention, such as schoolwork and electronics use. lung cancer screening recommendation - Answers-ANNUAL low-dose noncontrast CT Asymptomatic adults 55-80 yo who have a 30-pack-year smoking history and currently smoke or have quit smoking within the past 15 years. non-medical indicated (elective) induction of labor or C-section deliveries should be scheduled at what GA? - Answers-39wks 0 d drug to prevent seizure in alcohol withdrawal - Answers-benzos initial rx allergic rhinitis - Answers-intranasal steroids most effective medication to prevent relapse in alcohol abuse - Answers-naltrexone do not use acamprosate if renal disease what pneumococcal vaccine should 65yo receive - Answers-PCV13 now and PPSV in 1 year mcc hearing loss in newborn - Answers-genetics A 32-year-old female at 12 weeks gestation presents with an itchy vulvar lesion, which you diagnose as external genital warts. Which one of the following would be accurate advice regarding treatment?
  • The recurrence rate is low with treatment
  • Cryotherapy is the most effective treatment

• Treatment should be based on patient preference
• Treatment is effective in preventing congenital transmission - Answers-Treatment of genital warts should be based on patient preference and cost. There is no treatment that is more effective than others, and the recurrence rate for any treatment is relatively high. pt took extra pill prescribed by psychiatrist PMH: depression normal RR, HR diaphoretic resting symmetrical tremor 4+ reflexes dx? - Answers-derotonin syndrome pt SOB d-dimer is positive what test to order next? - Answers-CT angiography of chest pt experience increase in floaters but not light flashes or loss of vision dark spot in the periphery of her right eye - Answers-retinal detachment rx COPD exacerbations - Answers-Prednisone, 40 mg daily for 5 days pt vs ptt - Answers-Prothrombin Time (PT) Partial Thromboplastin Time (PTT) employees with >50 employees need to have what for nursing mothers? - Answers- reasonable unpaid break time to express milk pt with episodic pains in rectum happening for years occur 3-6weeks sharp, cramp-like pain last 1-15min no GI sx PE normal dx? - Answers-proctalgia fugax lesion in forearm looks like actinic keratosis

horn-like projection - Answers-cutaenous horn note: keratoacanthoma- most commonly on the face, grows very rapidly, and often is more nodular with a central pit. pt with allergy (hives) with eggs can they get inactivated flu vaccine - Answers-yes give it The Timed Up and Go test is used to evaluate geriatric patients for? - Answers-risk of falling test: ask the patient to rise from a chair, walk 10 feet, turn, return to the chair, and sit down. pt with acute salpingitis (PID) rx? - Answers-hospitalization + antibiotics pt with rash in belt region went walking in woods recently cause? - Answers-mite larvae - chggers rx asplenic pt with fever - Answers-Urgent parenteral antibiotic therapy

• to prevent sepsis pt with migraine HA and unresponsive to nsaids what rx? - Answers-IV metoclopramide 6mo bronchiolitis rx? - Answers-Nebulized hypertonic saline 65 yo with CAP DP <60mmHg RR >30/min BUN <19 mg/dL rx? - Answers-Hospital admission and treatment with ceftriaxone (Rocephin) plus azithromycin lab test for pertussis - Answers-PCR pertussis does not culture well

when can you introduce peanuts to infant diest - Answers-before 12months

• early introduction reduces peanut allergy which SSRI cause QT prolongation - Answers-citalopram recommended drug for travelers' diarrhea in Asia - Answers-azithromycin recommended drug for traveler's diarrhea in central america and africa - Answers-cipro where should interpreter sit? - Answers-sit next to or slightly behind your patient rx rosacea - Answers-metronidazole lotion/cream/gel ivermectin cream Which one of the following radiologic features is most predictive of malignancy in a solitary pulmonary nodule? Smooth borders A ground-glass appearance Central calcification of the nodule A solid density - Answers-A ground-glass appearance others:

10mm upper lung location

irregular borders no calcifications increasing size over time what HA1c cut off is used for managing elderly pt with DM - Answers-A1c 8 - 9 % most effective meds for fibromylagia - Answers-TCAs young boy still bedwets PE normal next step? - Answers-order UA

• if normal, reassure parents pt with CHF currently on lisinopril, carvedilol what drug should be added on to decrease mortality and risk of hosp?

Digoxin Furosemide Isosorbide dinitrate/hydralazine (BiDil) Losartan (Cozaar) Spironolactone (Aldactone) - Answers-spirinolactone don't add ARB - because never use ACEi with ARB exclusively BF babies need iron supplements from __ months? - Answers-4 months which of the following meds cause vit b12 def? Aspirin Enalapril Metformin Simvastatin Hydrochlorothiazide - Answers-metformin others:

• h1 blocker
• PPi should you screen for cervical cancer in pt with hysterectomy? - Answers-no age of CRC screen - Answers- 50 - 75 pt with acute lumbar pain with radiculopathy no signs of cauda equina syndrome, cancer, infection or fracture is imaging needed? - Answers-no rx: 6 weeks pain meds, PT all infants with down syndrome should be screened for? - Answers-cardiac problems - echocardiogram vision
• congenital cataracts; test with red reflex hearing thyroid hematologic

feeding abnormaliies croup in 2yo child not in severe distress only mild disease rx? - Answers-single dose oral corticosteroid croup in 2 yo child in distress lots of nasopharyngeal mucus severe disease rx? - Answers-Nebulizer treatment with racemic epinephrine intensive glycemic control in T2DM results in - Answers-reduced rate of progression to macroalbuminuria, which is an indicator of the development of diabetic nephropathy. how long should pt remain on anti-coags after PE - Answers-3 months risk factors of SIDS - Answers-side sleeping prone sleeping bed sharing Natev American birth wt <2500g preterm birth rx of carpal tunnel syndrome - Answers-wrist splint NSAIDs s/e TZDs - Answers-fluid retention wt gain peripheral edema high risk non-osteroporotic bone fractures mcc of hypoglycemia in previously stable, well-controlled diabetic patients who have not changed their diet or insulin dosage - Answers-renal disease In its dental recommendations from birth to 5 years of age, the U.S. Preventive Services Task Force recommends fluoride supplementation for what kids when the primary water supply is deficient in fluoride? - Answers-All children starting at 6 months of age baby born at 28weeks gestation now 5weeks old (<1 month)

here for f/u what immunization ppx is recommended - Answers-palivizumab for all infants born before 29weeks pps for RSV 2 - 12 yo boy insidious onset of pain and mild limitation ROM of one hip joint - Answers-Idiopathic osteonecrosis of the hip (Legg-Calvé-Perthes disease) adolescent boy insidious onset of pain and mild limitation ROM of one hip joint - Answers-Slipped capital femoral epiphysis first line for n/v in pregnancy - Answers-vitamin b +/- doxylamine pt with obesity DM peripheral neuropathy seizure d/o newly dx with depression what rx?

• bupropion
• citalopram
• duloxetine
• nortriptyline - Answers-duloxetine pt with HTN wants nonpharmacologic intervention to manage BP - Answers-monitor home BP readings limit sodium 2400mg/day diet veggies, fruits limit alcohol 2drinks/day for men and 1drink/day for women screening rule for AAA - Answers-one time abdominal duplex ultrasound male

65 - 75 yr ever smoked 100 cigarettes in lifetime COPT pt complain of breathlessness uses inhalers - albuterol prn and LABA daily and Anticholinergic daily what can improve his breathing problem?

• Replace his inhaled medications with nebulized alternatives
• Replace his tiotropium with ipratropium (Atrovent)
• Order home oxygen
• Refer for outpatient pulmonary rehabilitation - Answers-Pulmonary rehabilitation
• use for COPD pt who are optimally medically managed
• imrpoved exercise capacity, dyspena and health-related QOL note oxygen only improve mortality but not sx pcos pt amenorrhea obese high testosterone started on lifestyle modifications (wt loss, exercise) what meds can be added as part of initial management? - Answers-metformin
• helps with abnormal menstruation diffuse ST elevations on EKG acute sharp chest pain relieved by leaning fwd rx? - Answers-pericarditis rx: colchicine +/- NSAIDs Severe pain and skin changes outside the realm of cellulitis, including bullae and deeper discoloration, are strong indications of necrotizing fasciitis. +fever

• high HR
• extreme pain movement of joint rx? - Answers-surgical debridement

pt with thyroid nodule >1cm next step? - Answers-measure TSH if results abnormal, do a radionuclide thyroid scan

=2 cases of influenza A (H1N1) in a nursing home is an outbreak what is management? - Answers-Chemoprophylaxis with appropriate medications for all residents 2day old infant with flesh-colored papules with an erythematous base located on the face and trunk, containing eosinophils. what to do? - Answers-observation only benign eruption in newborns self-limiting what is the definition of asymptomatic microscopic hematuria A) >=1 RBCs/hpf B) >=3 RBCs/hpf C) >=10 RBCs/hpf D) A positive dipstick reading for blood - Answers-B) >=3 RBCs/hpf rx dyspnea in terminally ill patient - Answers-morphine opioids others:

• inhaled bronchodilator or steroids for COPD pt
• diuresis for HF pt Which one of the following is associated with treatment of COPD with inhaled corticosteroids? A) An increased risk of monilial vaginitis B) An increased risk of bruising C) Consistent improvement in FEV D) A decreased risk of pneumonia E) Decreased mortality - Answers-An increased risk of bruising, candida infection oropharynx, pneumonia 4 - 6 yo nocturnal pains in thigh, shin or calf no limping no fever no rash

no wt change normal PE normal CBC and ESR dx? rx? - Answers-growing pains no further work up first line rx HTN - Answers-acei arb ccb thiazide severe Dm foot ulcer. rx with: A) Amoxicillin/clavulanate (Augmentin) B) Linezolid (Zyvox) C) Ciprofloxacin (Cipro) D) Ceftriaxone (Rocephin) and levofloxacin (Levaquin) E) Piperacillin/tazobactam (Zosyn) and vancomycin (Vancocin) - Answers- Piperacillin/tazobactam and vancomycin

• covers MRSA, pseudomonas, strep
• covers gram +ve, gram - ve and anerobes 2 - 18 yo BMI categories <5th percentile 5 - 85th percentile 85 - 94th percentile

95 percentile - Answers- 2 - 18 yo BMI <5th percentile - underwt 5 - 85th percentile - nml 85 - 94th percentile - overwt 95 percentile - obese < 2yo BMI categories 95th percentile - Answers-< 2yo BMI categories 95th percentile overwt there is no obese category Which one of the following is true regarding respiratory syncytial virus (RSV) infection?

A) Most infections in the United States occur between August and December B) Corticosteroids should be a routine part of treatment C) The diagnosis is usually based on positive serology D) It is rarely associated with bacterial co-infection - Answers-It is rarely associated with bacterial co-infection Infection: Nov-April Don't use steroids for rx first line rx CAP in infant/school-aged child - Answers-amoxicillin adolescent

• azithromycin to cover m. pneumonaie non-obese 2 - 8 yo child with OSA rx? - Answers-adenotonsillectomy
• peak tonsil growth at this age pt with CKD
• low ferritin
• low hgb
• low hct
• MCV < rx? - Answers-iron supplement
• Ferrous sulfate orally adolescent child (teens) pain in groin or anterior thigh or referred pain to knee

• limping dx? - Answers-slipped capital femoral epiphysis pt with PSD should be started on ____ or ptesent CVD eg MI, stroke - Answers-aspirin clopidogrel older adult
• FABER +FADIR

hip pain dx? - Answers-hip labral tear FABER and FADIR detect intra-articular pathology what are patient oriented outcomes as it related to potential effects of drugs? - Answers- all-cause mortality morbidity symptoms QOL vaccine with increase risk of febrile seizures for children - Answers-mmr facts on influenza vaccine The live attenuated intranasal influenza vaccine is recommended for healthy non- pregnant persons 2- 49 years of age. Live attenuated vaccine is more effective than the inactivated vaccine in children 2- 6 years of age For patients 6-49 years of age either the live attenuated intranasal or the inactivated vaccine is recommended - Answers- cows milk is not recommended in children until what age - Answers-12month pt with lateral dislocation of patella. how do you fix? A) Medially directed pressure on the patella while extending the leg B) Medially directed pressure on the patella while flexing the leg C) Rapid leg extension D) Lateral retinacular release - Answers-A) Medially directed pressure on the patella while extending the leg which one of the following is essential before initiating oral combined hormonal contraception? A) Bimanual pelvic examination B) Clinical breast examination C) Cervical cytology and HPV screening D) Blood pressure measurement E) Weight measurement - Answers-BP measurement

COPD pt on steroids develops pneumonia which of the following pathogens would abx meds cover that would be unlikely in a healthy pt? A) Streptococcus pneumoniae B) Mycoplasma pneumoniae C) Haemophilus influenzae D) Staphylococcus aureus E) Pseudomonas aeruginosa - Answers-pseudomonas terminal ill pt on very high dose of morphine pt report diffuse pain all over body pain occurs when someone touches pt whct is dx? - Answers-Opioid-induced hyperalgesia management

• reducing the current opioid dosage
• eliminating the current opioid and starting another opioid. pt unable to conceive regular periods denies heat/cold tolerance sperm test normal what test to order next? A) Observation for 1 year B) TSH, free T4, and prolactin levels C) Hysterosalpingography D) An estradiol level E) A luteal-phase progesterone level - Answers-A luteal-phase progesterone level
• check progesterone level after ovulation
• should be >5 after Day21 of cycle to indicate ovulation
• if <5, then no ovulation
• need to check TSH, T4 and prolactin for anovulation
• if >5, then need to do hysterosalpingography for any obstruction rx acute flare up/exacerbations of MS - Answers-steroids rx for serotonin syndrome - Answers-benzos
• lorazepam, diazepam if non-responsive to benzos

• cyproheptadine dx of sepsis severe sepsis septic shock - Answers-dx of sepsis - high WBCs severe sepsis - high WBCs and organ dysfunction (Cr >0.5, thrombocytopenia, hyperbilirubinemia) septic shock - hyperlactatemia, hypotension refractory to IV fluids list things that minimize pain of lidocaine injection - Answers-- buffer the solution with sodium bicarbonate
• warm solution to room temp
• inject into subQ tissue
• rapid insertion of needle in skin
• inject slowly and steadily while withdrawing the needle children with what diseases are indicated for second dose of pneumococcal polysaccharide vaccine? - Answers-- sickle cell disease
• anatomic of functional asplenia
• HIV+
• immunocompromised with renal failure or leukemia leading cause of death in RA pts A) Infections B) Coronary artery disease C) Thromboembolic disease D) Lymphoma E) Lung cancer - Answers-CAD what do you advice parents of a 5yo with uncomplicated femoral anteversion (in-toeing)
• Answers-observation Effective treatments for obsessive-compulsive disorder include A) Freudian analysis B) benzodiazepines

C) amphetamine salts D) atypical antipsychotics E) repetitive exposure to fearful stimuli - Answers-repetitive exposure to fearful stimuli rx postherpatic neuralgia - Answers-lidocaine patches capsaicin cream/patches gabapentin po pregablin po amitriptyline po elderly pt intense retro-orbital HA

• neck pain high BP HA continue for hours non contrast CT unremarkable next step? - Answers-LP

• check for SAH 1st line rx of fecal impaction in infant - Answers-An oral osmotic agent such as polyethylene glycol 3350 (MiraLax) school child noted to have head lice when can child return to class - Answers-immediately
• just avoid close contact with other kids
• resume rx with permethrin shampoo + combing Which one of the following is a significant risk factor for esophageal adenocarcinoma? A) Aspirin therapy B) Ibuprofen therapy C) Helicobacter pylori infection D) Obesity E) Crohn's disease - Answers-obesity female dysuria flank pain fever high serum WBCs with PMNs

dipstick is positive for leukocyte esterase UA: <1 RBC and >50 WBCs/hpf dx? rx? - Answers-acute pyelonephritis rx: cipro pt lived on farm in Iowa as a child CXR: lung fields have BB-sized calcifications in a miliary pattern. PPD negative The findings in this patient are most likely a result of A) HIV infection B) histoplasmosis C) coccidioidomycosis D) tuberculosis E) cryptococcosis - Answers-histoplasmosis

• birds,bats pt with hx easy bruising currently asymptomatic Platelets - less than normal A workup is negative for
• autoimmune causes, including Graves disease, HIV, Epstein-Barr virus, cytomegalovirus, varicella zoster, hepatitis C, and Helicobacter pylori dx? rx? - Answers-idipathic (immune) thrombocytopenic purpura rx: steroids Terminally ill cancer patients who receive palliative chemotherapy are are _____ likely to die at home are _____ likely to undergo CPR are _____ likely to undergo mechanical ventilation are referred to hospice ______ (earlier or later) in their disease course - Answers- Terminally ill cancer patients who receive palliative chemotherapy are are less likely to die at home are more likely to undergo CPR

are more likely to undergo mechanical ventilation are referred to hospice later in their disease course rx COPD exacerbation - Answers-Oral prednisone for 5 days tamoxifen vs raloxifene

• breast
• bone
• endometrium - Answers-tamoxifen
• breast: estrogen antagonist
• bone: estrogen agonist
• endometrium: estrogen agonist raloxifene
• breast: estrogen antagonist
• bone: estrogen agonist
• endometrium: estrogen antagonist CI for OCPs - Answers-Age ≥35 years and smoking ≥15 cigarettes per day ●Multiple risk factors for arterial cardiovascular disease (such as older age, smoking, diabetes, and hypertension) ●Hypertension (systolic ≥160 mmHg or diastolic ≥100 mmHg) ●Venous thromboembolism ●Known thrombogenic mutations ●Known ischemic heart disease ●History of stroke ●Complicated valvular heart disease (pulmonary hypertension, risk for atrial fibrillation, history of subacute bacterial endocarditis) ●Systemic lupus erythematosus (positive or unknown antiphospholipid antibodies) ●Migraine with aura at any age ●Breast cancer

●Cirrhosis ●Hepatocellular adenoma or malignant hepatoma CI for Levo (progestin only) - IUD - Answers-hx breast cancer hx liver cancer suspected pregnancy acute pelvic infection severe distortion of uterine cavity what can be given to decrease nighttime cough and improve sleep in children (>1 YEAR)? - Answers-honey

• do not give to children <1yr old how many arteries and vein on umbilical cord - Answers-2 arteries
• originate from internal iliac a 1 vein rx trochanteric bursitis
• lateral hip pain - Answers-steroid injection Treatment of rhabdomyolysis? A) Bicarbonate-containing fluids B) Loop diuretics C) Mannitol D) Parenteral corticosteroids E) Isotonic saline - Answers-isotonic saline
• prevent AKI factors associated with high-risk bite/wounds that requires antibiotics rx? - Answers-bite on hand bite near prosthetic joint bite on a extremity with venous/lymphatic compromise cat bites crush injuries delayed presentation puncture wounds

underlying DM underlying immunosuppression dx criteria of fibromyalgia A) A structured symptom history B) Examination for tender points C) Laboratory testing - Answers-detailed symptom history what vitamin increase absorption of iron - Answers-vitamin c which one of the following NSAIDs would you recommend as being LEAST likely to be associated with an increased risk of myocardial infarction? A) Celecoxib (Celebrex) B) Diclofenac (Zorvolex) C) Ibuprofen D) Meloxicam (Mobic) E) Naproxen (Naprosyn) - Answers-naproxen pt with 4 day history of hoarseness cough +sputum tender sinuses nasal congestion afebrile normal ear and lung exams dx? rx? - Answers-acute laryngitis symptom relief

• most likley viral FEV/FVC ratio in obstructive vs restrictive lung disease - Answers-obstructive <0.7 restrictive >0.7 pt with DOE, crackles in lung fields, dry cough, FEV/FVC ratio >0.7
• signs of restrictive lung disease what drug is cause? A) Lisinopril (Prinivil, Zestril) B) Conjugated estrogens (Premarin) C) Omeprazole (Prilosec)

D) Solifenacin (Vesicare) E) Nitrofurantoin (Macrodantin) - Answers-nitrofurantoin other drugs that cause ILD:

• amiodarone all preg women should be screen for ___ at 11 to 16 weeks - Answers-asymptomatic bacteriuria
• UA and culture signs of autism - Answers-delayed social development language delay abnormal sensitivity to normal noises athlete with low risk stress fracture of tibia counselled on no wt bearing for 5 weeks after 5 weeks, pt can walk with no pain. when can pt return to physical activity? - Answers-after normal physical exam of the tibia most stress fractures heel in 6 - 10 weeks no need for XRay to confirm heel as long as pt has no pain walking, can return to actvitieis <40 yo male blood in semen normal testes and prostate exam pt is sexually active what next? - Answers-get STD screen
• it is normal to see blood in semen in <40yo men rx recommendation for IBS A) Amitriptyline B) Clarithromycin (Biaxin)

C) Loperamide (Imodium) D) Increased intake of insoluble dietary fiber - Answers-TCA SSRI safest influenza vaccine for patient allergic to eggs A) Live attenuated trivalent influenza vaccine B) Recombinant trivalent influenza vaccine C) Inactivated trivalent influenza vaccine D) Inactivated quadrivalent influenza vaccine - Answers-recombinant trivalent influenza vaccine rx for PT with degenerative tear of meniscus A) Referral for meniscectomy B) Corticosteroid injection C) Hylan GF 20 (Synvisc) injection D) Continued physical therapy E) A knee brace - Answers-PT what is true about antioxidants? A) Decreased mortality with vitamin A supplementation B) Decreased mortality with $-carotene supplementation C) Decreased mortality with vitamin E supplementation D) Increased mortality with some antioxidant supplements - Answers-D) Increased mortality with some antioxidant supplements male pt with hypogonadism what labs to order? - Answers-Early morning total serum testosterone what meds should preg women be given if they have hx of pre-ecalampsia - Answers- baby aspirin daily 4 major groups of people that need statin therapy - Answers-(1) individuals with clinical atherosclerotic cardiovascular disease (ASCVD)

• high statin (2) those with primary elevations of LDL-C >190 mg/dL
• high statin (3) patients age 40-75 with diabetes mellitus, an LDL-C level of 70 - 189 mg/dL, and no clinical ASCVD,

• moderate tstain (4) patients age 40-75 without clinical ASCVD or diabetes, an LDL-C level of 70-189 mg/dL, and an estimated 10-year ASCVD risk >7.5%
• high statin which pain med can be used in pt with renal failure - Answers-fentanyl methadone
  • hepatic metabolism rx aseptic olecranon bursitis vs septic olecranon bursitis both present with swelling at elbow - Answers-septic bursitis
• swelling, redness and warmth, fever
• aspiration and antibiotics aseptic bursitis
• swelling oNLY
• compression rx cut off for ankle=brachial index - Answers-<0.90 more severe PAD 0.91 - 0.99 borderline PAD 1 - 1.40 normal

1.5 imcompressible vessels assoc with DM, elderly ppx drug for lyme disease A) Amoxicillin B) Ceftriaxone (Rocephin) C) Cefuroxime axetil (Ceftin) D) Doxycycline E) Clarithromycin (Biaxin) - Answers-doxycycline rx superficial burn (painful patches of erythema and dry skin, no blisters) A) Cleaning the wound with povidone iodine (Betadine) B) Covering the wound with an occlusive dressing C) Applying aloe D) Applying hydrocortisone 1% cream E) Starting broad-spectrum antibiotics - Answers-apply aloe, honey, lotion initial screening for hemochromatosis