Quiz 26 Flashcards
Pertussis tx
The CDC recommends macrolides for primary treatment of pertussis. The preferred antimicrobial regimen is azithromycin for 3–5 days or clarithromycin for 7 days.
Which one of the following antidepressants would be LEAST likely to cause her to gain weight? (check one)
A. Mirtazapine (Remeron) B. Amitriptyline C. Bupropion (Wellbutrin) D. Paroxetine (Paxil) E. Citalopram (Celexa)
Bupropion is the antidepressant least likely to cause weight gain, and may induce modest weight loss. All of the other choices are more likely to cause weight gain. Among SSRIs, paroxetine is associated with the most weight gain and fluoxetine with the least. Mirtazapine has been associated with more weight gain than the SSRIs.
Causes of reactive lymphocytosis
The most common conditions that produce a reactive lymphocytosis are viral infections.
Most notable are Epstein-Barr virus, infectious mononucleosis, and cytomegalovirus. Other viral infections known to cause this finding include herpes simplex, herpes zoster, HIV, hepatitis, and adenovirus.
Bordetella pertussis, which has been known to cause absolute lymphocyte counts of up to 70,000/μL.
Increased pain with which one of the following would be most consistent with lumbar spinal stenosis? (check one)
A. Lumbar spine extension B. Lumbar spine flexion C. Internal hip rotation D. Pressure against the lateral hip and trochanter E. Walking uphill
. Lumbar spine extension
Extension that increases lumbar lordosis decreases the cross-sectional area of the spinal canal, thereby compressing the spinal cord further. Walking downhill can cause this. Spinal flexion that decreases lordosis has the opposite effect, and will usually improve the pain, as will sitting.
Pain with internal hip rotation is characteristic of hip arthritis and is often felt in the groin. Pain in the lateral hip is more typical of trochanteric bursitis. Increased pain walking uphill is more typical of vascular claudication.
Which one of the following is true concerning the use of short-acting inhaled β-agonists for asthma? (check one)
A. They should be given before any inhaled corticosteroid to facilitate lung delivery
B. They are ineffective in patients taking β-blockers
C. They are less effective than oral β-agonists
D. They are less effective than anticholinergic bronchodilators when given with inhaled corticosteroids
E. Their effects begin within 5 minutes and last 4–6 hours
The effects of short-acting inhaled β-agonists begin within 5 minutes and last 4–6 hours. In the past, giving inhaled β-agonists just before inhaled corticosteroids was felt to improve the delivery and effectiveness of the corticosteroids. However, this has been proven to be ineffective and is no longer recommended. β-Blockers do diminish the effectiveness of inhaled β-agonists, but this effect is not severe enough to contraindicate using these drugs together. Oral β-agonists are less potent than inhaled forms. Similarly, anticholinergic drugs cause less bronchodilation than inhaled β-agonists and are not recommended as
first-line therapy.
Which one of the following is true regarding NSAIDs? (check one)
A. They are cardioprotective
B. They should be avoided in persons with cirrhotic liver disease
C. They are not safe in pregnancy
D. They are not safe in lactating women
NSAIDs are prescribed commonly and many are available over the counter. It is important for clinicians to understand when they are not appropriate for clinical use. They should be avoided, if possible, in persons with hepatic cirrhosis (SOR C). While hepatotoxicity with NSAIDs is rare, they can increase the risk of bleeding in cirrhotic patients, as they further impair platelet function. In addition, NSAIDs decrease blood flow to the kidneys and can increase the risk of renal failure in patients with cirrhosis.
NSAIDs differ from aspirin in terms of their cardiovascular effects. They have the potential to increase cardiovascular morbidity, worsen heart failure, increase blood pressure, and increase events such as ischemia and acute myocardial infarction.
There are no known teratogenic effects of NSAIDs in humans. This drug class is considered to be safe in pregnancy in low, intermittent doses, although discontinuation of NSAID use within 6–8 weeks of term is recommended. Ibuprofen, indomethacin, and naproxen are considered safe for lactating women, according to the American Academy of Pediatrics.
generalized anxiety disorder. Tx
treating generalized anxiety
disorder in adults include antidepressants such as imipramine, duloxetine, paroxetine, sertraline,
escitalopram, and venlafaxine.
