Patient Management

Question 1

Patient Management for Stroke pt? vs Hypertension?

Answer 1

History of Stroke:
- If within 1 month, delay elective treatment
- Short appt (morning preferred)
- Anxiolytic/ sedative drug
- limit NSAIDs
- limit epinephrine

Hypertension: same stroke, but
- limit NSAIDS only with BAD drugs

Question 2

Patient Management for Hypertension?

Answer 2

• Stress reduction
• Orthostatic hypotension
• Drug interactions

Question 3

Blood pressure readings with recommendations by Dr. Daniel Haas

Question 4

Emergency may happen with patient with hypertension

Question 5

drugs of calcium channels blocker (CCB)

Answer 5

Amlodipine, Nifedipine
Dilitazem
Verapamil

Question 6

calcium channels blocker (CCB) interacts with which antibiotics?
calcium channels blocker (CCB) interacts with NSAIDs or not?

Answer 6

Erythromycine, Clarithromycin
No, only BAD drugs

Question 7

clopidorgel, Asipirin 81mg to treat …..?
Patient management: check …. before surgery (optional)

Answer 7

anti-platelet
bleeding time

Question 8

definition of Diabetes? types of diabetes? Which diabetes is more risk of hypoglycemia?

Diabetics

Answer 8

Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels
(hyperglycemia) and the inability to produce and/or use insulin.

Type 1 : Insulin dependent
Type 2- insulin non-dependent

Question 9

Patient Management for Diabetes

Diabetics

Answer 9

• Short morning appt
• Anxiolytic/ sedative drug
• Confirm the HbAlc level <7% or check Random Blood glucose
• Confirm that patient has taken usual dose of medication and normal meals
• Ask for the history of hospitalization → physical corsultation if yes
• Adjust the dose of insulin, only for cases where patient cannot eat prior and after the procedure
• No Antibiobitc Prophylaxis
• For patient using Sulfonylureas , only avoid ASA.

Question 10

What is the recommended target for HbA1c levels in diabetes management?
a) Below 5%
b) Between 7-8%
c) Between 8-9%
d) Below 7%

Answer 10

Below 7%

Question 11

What does HbA1c measure?

Answer 11

Glycated hemoglobolin

Question 12

Adjust the dose of insulin, only for when…..

Answer 12

patient cannot eat prior and after the procedure.

Question 13

When should antibiotic prophylaxis be used in diabetic management?
a) Before every medical procedure
b) Only for emergency situations
c) Only for cases of uncontrolled diabetes
d) Never

Answer 13

Never

Question 14

What is the recommended action if a patient has a history of hospitalization?

Answer 14

call 911

Question 15

Diabetics using …… need to avoid ….

Answer 15

Sulfonylureas

ASA

Question 16

Sulfonylureas: drug names ending with ….

Answer 16

-ide
Chlorpropamide, Tolazamide, Tolbutamide
Glipizide, Glyburide, Glipmepriride

Question 17

Hypoglycemia, commonly known as —

Answer 17

insulin shock

Question 18

Hyperglycemia, commonly known as —

Answer 18

Diabetic coma

Question 19

signs and symptoms of hypoglycemia vs hyperglycemia

Answer 19

hypoglycemia: hungry, cold and sweating, shaking/ tremor, nausea, anxiety, seizure and coma
hyperglycemia: fruity breath, red face, hot and very dry mouth/skin. Increased thirst;
Frequent urination

Question 20

Management of hypoglycemia

Answer 20

conscious pt: oral glucose
unconscious pt: 911+ IV glucagone

Question 21

why call 911 if pt is hypoglycemia and unconscious? (vs syncope)

Answer 21

CNS maybe damaged and fatal (glucose <20mg/dl)

Question 22

Management of hyperglycemia

Answer 22

conscious pt: refer to hospital
unconscious pt: 911