Meds

Question 1

Steven Johnsons syndrome: disorder of the Skin and mucus membrane
Which drug should be started on low dosage?

Answer 1

Lamotrigine (Lamictal)

Question 2

80 year old with progressive weakness.
CBC, UA, ESR are normal
High Creatinine Kinase
Cause?

Answer 2

Statin induced Myopathy!!!

PMR with give elevated ESR

Question 3

Patient on parenteral Morphine, Increasing dose still in severe pain
DX and Tx?

Answer 3

Opioid induced hyperalgesia

• Morphine receptors are saturated!
• decrease morphine dose

Question 4

How to minimize Lidocaine injection

Answer 4

Buffer with sodium bicarbonate

Question 5

Guy with gynecomastia

Drug that can cause it?

Answer 5

Spirinolactone because it can bind to androgen and progesterone causing it

Question 6

Post herpetic neuralgia

Tx?

Answer 6

Lidocaine patch

Question 7

Prolong PPI Use

Risk?

Answer 7

Osteoporosis

H.Pylori infection

Question 8

Urticaria: highly pruritic raised wheals on extremities and torso
TX?

Answer 8

H1- histamine blocker!

2nd gen are less drowsy!

Question 9

Sympathomimetic decongestant like pseudoephedrine and phenlyephrine in elderly causes?

Answer 9

Worsen existing urinary obstruction

Question 10

Iron def anemia with iron

How to improve iron absorption

Answer 10

Take Vit C

Question 11

NSAID that least likely to increase risk of MI?

Answer 11

Naproxen

NSAID increases BP 2nd to salt and water retention properties

Question 12

Meds that can cause Interstitial lung disease

Answer 12

Amiodarone

Nitrofurantoin - can induce pneumonitis

Question 13

Egg allergy

What is the safest flu vaccine

Answer 13

Recombinant trivalent - no egg

Question 14

Med that can lower the risk of pre eclampsia

Answer 14

Aspirin 60-80 mg daily

Question 15

Preferred pain meds in ESRD?

Answer 15

Fentanyl - 99% hepatic metabolism

Question 16

Medication with a higher risk of death due to stroke or sudden cardiac death in patients with dementia?

Answer 16

Seroquel ( Quetiapine)

Question 17

Meds for Smoking Cessation?

Answer 17

Verenicline (chantix) can cause nightmares
Bupropion (Wellbutrin) - CI in seizures
Nortriptyline ( Pamelor)

Question 18

Bisphophonate side effects in Osteoporosis

Answer 18

Can cause atypical femoral shaft fractures

- will not effect Vit D and phosphates

Question 19

Class of diabetic medication that blocks glucose reabsorption by the kidneys causing GU infection?

Answer 19

SGLT2 inhibitors - Invokana

Question 20

Patient with Hyperthyroidism with a low WBC count.

What meds can cause it?

Answer 20

Methimazole–> can cause agranulocytosis; can cause Inc fetal abnormalities

If pregnant, give PTU

Question 21

55 y/o male with VF. Hx of antibiotic use 3 days ago

What antibiotic?

Answer 21

Azithromycin; can prolong QT –> VF

Question 22

Medication that can be use for SVT that can be use Acutely and Long term?

Answer 22

CaCB- Verapamil

Question 23

Pt with terminal cancer and Hepatic dysfunction has musculoskeletal and neuropathic pain, What medications should you avoid?

Answer 23

Methadone: metabolized and cleared by liver

Question 24

Second Generation H1 Antihistamine that is sedating?

Answer 24

Cetirizine (Zyrtec) - potent histamine antagonist

Question 25

NOAC with reversal?

Answer 25

Dabigatran(Pradaxa)–> Idarucizumab (Praxbind)

Question 26

Female on Methimazole.

Adverse RON?

Answer 26

Agranulocytosis = hepatotoxic

Question 27

Meds that is most effective for Alcohol relapse

Answer 27

Naltrexone

Question 28

Antidepressant to avoid in the Elderly

Answer 28

Paroxetine –. More anticholinergic effects

1st line to give–> venlafaxine , Bupropion ( also good for smoking cessation), Mirtazapine

Question 29

Patient with Gout attack and CKD stage 4!

TX?

Answer 29

1. Prednisone!

1st line: NSAID: Indomethacin – but PT has CKD, Colchicine, Corticosteroids

Allopurinol and Probenacid are NOT advisable for Acute treatment; may be use to prevent attacks

Question 30

44 y/o male started on Lisinopril
Has facial, lip and tongue edema
DX?
TX?

Answer 30

1. Angiodedema from Increased bradykinin not histamine!

2. Give Bradykinin receptor antagonist –> Icatibant (Firazyr)

Question 31

Drugs that cause Bronchiolitis Obliterans Organizing Pneumonia?

Answer 31

Amiodarone + Bleomycin + Gold + MTX

Question 32

Meds for travelers diarrhea if going to:
India?(S.Asia and SEA)?
South and Central America?

Answer 32

Azithromycin for SEA : for campylobacter

Cipro for Central America

Question 33

Patient with DM
Found out to have low Vit B12
What meds caused it?

Answer 33

Metformin- decrease absorption by 30%

Question 34

Patient with PE 2 weeks after surgery for uterine fibroids, no significant PMX
How long should the patient be on anticoagulant therapy?

Answer 34

3 months

Question 35

Antiemetic drug that blocks domaine stimulation in the chemoreceptors trigger zone for gastroenteritis?

Answer 35

Metoclopramide

Question 36

Drug that decreases Vit D levels in long term use

Answer 36

Phenytoin- increases metabolism of Vit D

Thiazides will increase Vit D

Question 37

Side effects of colchicine?

Answer 37

Nausea, vomiting, diarrhea

Question 38

Patient with Fibromyalgia.

What muscle relaxant can be used and why?

Med that can improve sleep, pain and well being?

Answer 38

Cyclobenzaprine- structurally like TCA; can increase inhibitory of serotonin and norepinephrine

Tramadol can be use for sleep, pain and well being

Question 39

Risperidone side effects on female?

Answer 39

Elevated prolactin causing amenorrhea