Quick Quiz 4 Flashcards

1
Q

Dahlia has asthma, currently at step 2. She continues to have almost daily episodes of wheezing. You understand that the medications she is already on would include

a. a short-acting beta adrenergic medication (inhaler) and an inhaled glucocorticoid.
b. both short and long-acting inhaled beta adrenergic agents.
c. a long-acting beta adrenergic agonist, an inhaled glucocorticoid, a leukotriene modifier, and theophylline.
d. a long-acting beta adrenergic agonist, an inhaled glucocorticoid, and a leukotriene modifier.

A

a. a short-acting beta adrenergic medication (inhaler) and an inhaled glucocorticoid.

At step two, a short acting beta agonist and an inhaled corticosteroid should already have been tried.

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2
Q

Which of the following drugs would increase the effectiveness of opioid therapy for severe post-herpetic neuralgia?

a. an NSAID
b. transdermal fentanyl (Duragesic)
c. nortriptylline (Elavil)
d. topical acyclovir

A

c. nortriptylline (Elavil)

Elavil (nortryptilline) is very effective as an adjuvant therapy for post-herpetic neuralgia. NSAIDs and topical acyclovir are unlikely to change the patient’s perception of pain. The patient is already on an opioid, and adding another opioid (especially fentanyl) isn’t wise because it could lead to excessive sedation.

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3
Q

Dexter is a newly diagnosed, type 2 diabetic. He will begin diet therapy, exercise to help lose weight, and one oral antidiabetic agent. You understand that the most likely agent he will receive is

a. metformin (Glucophage).
b. glipizide (Glucotrol).
c. pioglitazone (Actos).
d. rosiglitazone (Avandia)

A

a. metformin (Glucophage).

Evidence points to the use of metformin initially to attempt to decrease hepatic gluconeogenesis; the other drugs may be used as a second agent if needed.

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4
Q

The neurotransmitter which is deficient in patients with Parkinson’s disease is

a. acetylcholine.
b. norepinephrine.
c. dopamine.
d. serotonin.

A

c. dopamine.

A decrease in dopamine is the pathophysiological basis for Parkinson’s disease.

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5
Q

Prediabetes as a diagnosis will require which form(s) of therapeutic recommendation(s)?

a. a weight loss/control diet
b. an exercise prescription that fits into the patient’s existing health status
c. education about diabetes
d. all of the above

A

d. all of the above

Diet, exercise, and education are the cornerstones of diabetic education, including for those with prediabetes, when preventive efforts may be able to prevent vascular and other organ system dysfunction.

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6
Q

Definitive, chronic treatment of Hashimoto’s thyroiditis will include

a. iodide replacement.
b. thyroid hormone replacement.
c. propylthiouracil.
d. radioactive iodine.

A

b. thyroid hormone replacement.

Hashimoto’s thyroiditis generally results in hypothyroidism, and thyroid hormone replacement (usually as thyroxine) will be needed for life. Iodides are not usually needed in western countries where salt is iodized. The other two options are used for Grave’s disease.

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7
Q

Sally has severe menopausal symptoms that began three months ago. In screening her for the appropriateness of hormone replacement therapy, one risk factor was identified that would raise questions about the advisability of HRT in her case. Which of the following was that risk factor?

a. prior pulmonary thromboembolism
b. systemic hypertension
c. overweight status (BMI, 27)
d. treated Hashimoto’s thyroiditis

A

a. prior pulmonary thromboembolism

Prior venous thromboembolism is a contraindication to HRT.

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8
Q

The drug used in the therapy of COPD that can decrease the secretion of secretions and diminish the hyperresponsiveness of airways is

a. formoterol (Foradil)
b. tiotropium (Spiriva)
c. theophylline (TheoDur)
d. albuterol (Pro-Air)

A

b. tiotropium (Spiriva)

Reducing the cholinergic airway muscular tone can be facilitated by the use of tiotropium (Spiriva), an inhaled anticholinergic agent.

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9
Q

Androgens can cause

a. hepatocellular cancer
b. masculinization in women
c. worsening of acne
d. all of the above.

A

d. all of the above.

Liver cancer, masculinization (including in women) and worsening outbreaks of acne are recognized side effects of androgen therapy.

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