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A 65-year-old woman presents to the clinic due to constipation for the past two weeks. She describes her stool as hard and bullet-like. The patient had no significant past medical history. The patient does not smoke but drinks alcohol socially. Her blood pressure is 110/70 mmHg, pulse rate is 70/min, and temperature is 37.5°C. Physical examination is within normal. The patient used over-the-counter medication for her constipation. Docusate sodium belongs to which of the following class of drugs?
A 65-year-old woman presents to the clinic due to constipation for the past two weeks. She describes her stool as hard and bullet-like. The patient had no significant past medical history. The patient does not smoke but drinks alcohol socially. Her blood pressure is 110/70 mmHg, pulse rate is 70/min, and temperature is 37.5°C. Physical examination is within normal. The patient used over-the-counter medication for her constipation. Docusate sodium belongs to which of the following class of drugs?
A 65-year-old woman presents to the clinic due to constipation for the past two weeks. She describes her stool as hard and bullet-like. The patient had no significant past medical history. The patient does not smoke but drinks alcohol socially. Her blood pressure is 110/70 mmHg, pulse rate is 70/min, and temperature is 37.5°C. Physical examination is within normal. The patient used over-the-counter medication for her constipation. Docusate sodium belongs to which of the following class of drugs?
A 65-year-old woman presents to the clinic due to constipation for the past two weeks. She describes her stool as hard and bullet-like. The patient had no significant past medical history. The patient does not smoke but drinks alcohol socially. Her blood pressure is 110/70 mmHg, pulse rate is 70/min, and temperature is 37.5°C. Physical examination is within normal. The patient used over-the-counter medication for her constipation. Docusate sodium belongs to which of the following class of drugs?
JJ is a 72-year-old female patient with lower-risk myelodysplastic neoplasms (LR-MDS) characterized by symptomatic anemia that is transfusion dependent. Her erythropoietin (EPO) level is 200 mU/mL and cytogenetic analysis reveals a deletion on the long arm of chromosome 5 [5q (del(5q))] abnormality. Her platelets and neutrophil counts are normal. Which of the following treatment options is most appropriate for JJ?
JJ is a 72-year-old female patient with lower-risk myelodysplastic neoplasms (LR-MDS) characterized by symptomatic anemia that is transfusion dependent. Her erythropoietin (EPO) level is 200 mU/mL and cytogenetic analysis reveals a deletion on the long arm of chromosome 5 [5q (del(5q))] abnormality. Her platelets and neutrophil counts are normal. Which of the following treatment options is most appropriate for JJ?
A 34-year-old woman presents for advice on contraceptive options. She had a baby one month ago via spontaneous vaginal delivery and has been using condoms since the delivery. Her medical history was significant for pulmonary embolism and a deep venous thrombosis (DVT) four years ago, chronic liver disease, migraine without aura, coronary artery disease, and polycystic ovarian syndrome (PCOS). She admits to smoking tobacco. She denies drinking alcohol or using illicit drugs. Her family history is negative for breast and gynecologic cancer. Physical examination reveals a blood pressure of 112/78 mmHg, a pulse of 78/min, a respiratory rate of 12 breaths/min, and a temperature of 37 C (98.6 F). Which of the following patient factors is an absolute contraindication to the use of oral contraceptive pills in this patient?
A 34-year-old woman presents for advice on contraceptive options. She had a baby one month ago via spontaneous vaginal delivery and has been using condoms since the delivery. Her medical history was significant for pulmonary embolism and a deep venous thrombosis (DVT) four years ago, chronic liver disease, migraine without aura, coronary artery disease, and polycystic ovarian syndrome (PCOS). She admits to smoking tobacco. She denies drinking alcohol or using illicit drugs. Her family history is negative for breast and gynecologic cancer. Physical examination reveals a blood pressure of 112/78 mmHg, a pulse of 78/min, a respiratory rate of 12 breaths/min, and a temperature of 37 C (98.6 F). Which of the following patient factors is an absolute contraindication to the use of oral contraceptive pills in this patient?
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The current standard of care in the treatment of patients who suffered a recent myocardial infarction (STEMI) is to initiate therapy with a class of hypolipidemic drugs, irrespective of baseline LDL-C levels. This is because several clinical trials (e.g. JUPITER, PROVE IT-TIMI 22) have documented reduced all-cause mortality and reduced incidence of rehospitalization. These beneficial outcomes have been attributed to "pleotrophic" beneficial drug effects including reduced oxidative stress, and reduced vascular inflammation. Which drug class has these characteristics?
The current standard of care in the treatment of patients who suffered a recent myocardial infarction (STEMI) is to initiate therapy with a class of hypolipidemic drugs, irrespective of baseline LDL-C levels. This is because several clinical trials (e.g. JUPITER, PROVE IT-TIMI 22) have documented reduced all-cause mortality and reduced incidence of rehospitalization. These beneficial outcomes have been attributed to "pleotrophic" beneficial drug effects including reduced oxidative stress, and reduced vascular inflammation. Which drug class has these characteristics?
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What electrolyte imbalance can occur if a patient takes captopril with a potassium-sparing diuretic
What electrolyte imbalance can occur if a patient takes captopril with a potassium-sparing diuretic
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A 65-year-old man visits his healthcare practitioner complaining of fatigue and weight loss. The results of a fecal occult blood test are positive. A colonoscopy was performed which revealed a mass in the sigmoid colon. A PET scan reveals metastases to the liver. The healthcare provider then discusses treatment options with the patient, which includes an infusion of a monoclonal antibody. The monoclonal antibody is targeted against a cellular factor that plays a role in wet age-related macular degeneration (AMD). Which of the following is the target of the monoclonal antibody?
A 65-year-old man visits his healthcare practitioner complaining of fatigue and weight loss. The results of a fecal occult blood test are positive. A colonoscopy was performed which revealed a mass in the sigmoid colon. A PET scan reveals metastases to the liver. The healthcare provider then discusses treatment options with the patient, which includes an infusion of a monoclonal antibody. The monoclonal antibody is targeted against a cellular factor that plays a role in wet age-related macular degeneration (AMD). Which of the following is the target of the monoclonal antibody?
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A 27-year-old man presents to the office due to shortness of breath during exercises. He has no chest pain and never experienced a loss of consciousness or palpitations. The patient does not take any medications. He does not use tobacco or illicit drugs; however, he drinks 2 to 3 beers on the weekend. His mother had breast cancer, and his paternal uncle died suddenly at a young age. The patient's body temperature is 37 C (98.6 F), blood pressure is 145/90 mm Hg, a pulse is 80 beats/min, and respiratory rate is 16 breaths/min. On chest auscultation, a systolic ejection murmur that increases with the Valsalva maneuver is noted. Lungs are clear to auscultation. Echocardiography shows the increased thickness of the interventricular septum (IVS) and systolic anterior motion of the mitral valve; the left ventricle ejection fraction is 76%. What is the best next step in the management of this patient?
A 27-year-old man presents to the office due to shortness of breath during exercises. He has no chest pain and never experienced a loss of consciousness or palpitations. The patient does not take any medications. He does not use tobacco or illicit drugs; however, he drinks 2 to 3 beers on the weekend. His mother had breast cancer, and his paternal uncle died suddenly at a young age. The patient's body temperature is 37 C (98.6 F), blood pressure is 145/90 mm Hg, a pulse is 80 beats/min, and respiratory rate is 16 breaths/min. On chest auscultation, a systolic ejection murmur that increases with the Valsalva maneuver is noted. Lungs are clear to auscultation. Echocardiography shows the increased thickness of the interventricular septum (IVS) and systolic anterior motion of the mitral valve; the left ventricle ejection fraction is 76%. What is the best next step in the management of this patient?
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Several different drugs are known to increase the effect & toxicity of digoxin when given concomitantly. This is of great concern because of digoxin's very low therapeutic index (~2) and potentially life-threatening toxicity. A drug that does NOT significantly increase either digoxin levels or effect is:
Several different drugs are known to increase the effect & toxicity of digoxin when given concomitantly. This is of great concern because of digoxin's very low therapeutic index (~2) and potentially life-threatening toxicity. A drug that does NOT significantly increase either digoxin levels or effect is:
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A 23-year-old woman presents to the clinic with a left eye infection. She states that it started a few days ago and has gradually worsened. Her vision has not been affected, but her eye feels a little itchy. Her vital signs reveal blood pressure 122/80 mmHg, pulse 90/min, respiratory rate 14/min, and temperature 99.5°F (37,5°C). She has a past medical history significant for cystic fibrosis, type 2 diabetes mellitus, and IgA nephropathy. Tobramycin ophthalmic solution is considered for her eye infection. Which of the following is most appropriate to be checked before prescribing this medication?
A 23-year-old woman presents to the clinic with a left eye infection. She states that it started a few days ago and has gradually worsened. Her vision has not been affected, but her eye feels a little itchy. Her vital signs reveal blood pressure 122/80 mmHg, pulse 90/min, respiratory rate 14/min, and temperature 99.5°F (37,5°C). She has a past medical history significant for cystic fibrosis, type 2 diabetes mellitus, and IgA nephropathy. Tobramycin ophthalmic solution is considered for her eye infection. Which of the following is most appropriate to be checked before prescribing this medication?
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After 3 days of Gentamicin therapy, the supervising nurse leaves you voice mail indicating that the patient you just began treating has begun to exhibit signs of drug toxicity. As you return to the hospital, you reflect on the drugs side effect profile. Which of the following would your patient most likely be experiencing?
After 3 days of Gentamicin therapy, the supervising nurse leaves you voice mail indicating that the patient you just began treating has begun to exhibit signs of drug toxicity. As you return to the hospital, you reflect on the drugs side effect profile. Which of the following would your patient most likely be experiencing?
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Don is a 84 year old man diagnosed with having acute onset community-acquired pneumonia. A sputum culture tests positive for S. pneumoniae. He has a history of atrial fibrillation which has been under control by drug therapy with the Class III antiarrhythmic sotalol for the past 10 years. Which of the following is the best choice for treatment of Don's infection?
Don is a 84 year old man diagnosed with having acute onset community-acquired pneumonia. A sputum culture tests positive for S. pneumoniae. He has a history of atrial fibrillation which has been under control by drug therapy with the Class III antiarrhythmic sotalol for the past 10 years. Which of the following is the best choice for treatment of Don's infection?
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Side effects of zidovudine are (more than one possible)
Side effects of zidovudine are (more than one possible)
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A 55-year-old man presents with oral white plaques and dysphagia for two weeks. Endoscopy confirms oral and esophageal thrush, and HIV testing is positive. An antifungal for thrush and lamivudine monotherapy for HIV are prescribed. The patient initially shows improvement, but six months later, bloodwork shows an HIV-1 RNA level of 10000 copies/mL. What is the most likely cause for the increase in HIV-1 RNA in this patient?
A 55-year-old man presents with oral white plaques and dysphagia for two weeks. Endoscopy confirms oral and esophageal thrush, and HIV testing is positive. An antifungal for thrush and lamivudine monotherapy for HIV are prescribed. The patient initially shows improvement, but six months later, bloodwork shows an HIV-1 RNA level of 10000 copies/mL. What is the most likely cause for the increase in HIV-1 RNA in this patient?
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A 10-year-old girl is admitted to the Emergency Department with fever, chills, lethargy, and splenomegaly. She recently returned from Nigeria, where she spent three weeks with her grandparents. She had previously received all the standard immunizations for her age, but no pre-travel prophylaxis as her parents had returned from Nigeria some time ago with no medical problems. Laboratory examination shows low hematocrit and platelets and elevated creatinine. A blood smear showed parasites in the erythrocytes and a diagnosis of falciparum malaria was made. Prophylaxis with what should have been done in this patient
A 10-year-old girl is admitted to the Emergency Department with fever, chills, lethargy, and splenomegaly. She recently returned from Nigeria, where she spent three weeks with her grandparents. She had previously received all the standard immunizations for her age, but no pre-travel prophylaxis as her parents had returned from Nigeria some time ago with no medical problems. Laboratory examination shows low hematocrit and platelets and elevated creatinine. A blood smear showed parasites in the erythrocytes and a diagnosis of falciparum malaria was made. Prophylaxis with what should have been done in this patient
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Which antibodies are a type of monoclonal antibody (more than one response) that can be used in tumor diseases
Which antibodies are a type of monoclonal antibody (more than one response) that can be used in tumor diseases
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A 65-year-old female is following up with her primary care provider for osteoporosis treatment. She is at high risk of developing bone fractures due to osteoporosis. The patient has not responded adequately to bisphosphonate agents. She is prescribed an anabolic agent, a human parathyroid hormone-related protein (PTHrP) analog, to decrease her chance of having a fracture due to osteoporosis. Which of the following is the black box warning associated with the drug?
A 65-year-old female is following up with her primary care provider for osteoporosis treatment. She is at high risk of developing bone fractures due to osteoporosis. The patient has not responded adequately to bisphosphonate agents. She is prescribed an anabolic agent, a human parathyroid hormone-related protein (PTHrP) analog, to decrease her chance of having a fracture due to osteoporosis. Which of the following is the black box warning associated with the drug?
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An 80-year-old woman presents via EMS after being found unresponsive. EMTs reported a fingerstick glucose of 46 mg/dL (2.55 mmol/l) at the scene. She has a medical history of type 2 diabetes mellitus and uses an insulin pump. She received a dose of D50 (50% dextrose) in the ambulance. The patient is responsive by the time she is seen in the ED and can provide a history. She reports her hemoglobin A1c was 8.0% 1 week ago. Her physical examination demonstrates an intact infusion site without evidence of inflammation. The patient says she changed the infusion site this morning and administered her insulin, but she missed her breakfast because she got distracted. She asks the clinician what she should do. What is the most appropriate response?
An 80-year-old woman presents via EMS after being found unresponsive. EMTs reported a fingerstick glucose of 46 mg/dL (2.55 mmol/l) at the scene. She has a medical history of type 2 diabetes mellitus and uses an insulin pump. She received a dose of D50 (50% dextrose) in the ambulance. The patient is responsive by the time she is seen in the ED and can provide a history. She reports her hemoglobin A1c was 8.0% 1 week ago. Her physical examination demonstrates an intact infusion site without evidence of inflammation. The patient says she changed the infusion site this morning and administered her insulin, but she missed her breakfast because she got distracted. She asks the clinician what she should do. What is the most appropriate response?
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What drugs are most commonly used to affect perineal pain in episiothymia and lacerations (more than one response)
What drugs are most commonly used to affect perineal pain in episiothymia and lacerations (more than one response)
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A 30-year-old woman presents with a history of unprotected intercourse multiple times during her vacation to Vegas. She was taking combined oral contraceptive pills (COC) and took her last pill 5 days ago and has forgotten to pack her pills for the trip. She plans to marry her partner soon and does not want to have children for a few years. She wants to avoid pregnancy. Which of the following is the best contraceptive in her situation?
A 30-year-old woman presents with a history of unprotected intercourse multiple times during her vacation to Vegas. She was taking combined oral contraceptive pills (COC) and took her last pill 5 days ago and has forgotten to pack her pills for the trip. She plans to marry her partner soon and does not want to have children for a few years. She wants to avoid pregnancy. Which of the following is the best contraceptive in her situation?
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