Untitled Quiz

ACE inhibitors cause a cough due to the accumulation of bradykinin, a peptide normally broken down by the angiotensin-converting enzyme. Elevated bradykinin levels stimulate sensory nerves in the respiratory tract and promote mild airway inflammation, leading to a persistent dry cough in some patients. Switching to angiotensin receptor blockers (ARBs), which do not affect bradykinin, may alleviate this side effect.

<p>Spironolactone blocks receptors of aldosterone. It retains potassium while excreting Na and water. It causes a smaller degree of diuresis, resulting in modest hypotensive effects.</p> Signup and view all the answers

<p>X-waiver was a special authorization required for healthcare providers to prescribe buprenorphine to treat opioid use disorder (OUD). This waiver, mandated by the Drug Addiction Treatment Act of 2000 (DATA 2000), necessitated additional training and certification. Section 1262 of the Consolidated Appropriations Act of 2023 removed the federal requirement for practitioners to have x-waiver to prescribe medications.</p> Signup and view all the answers

<p>All of the above (E)</p> Signup and view all the answers

<p>All of the above (F)</p> Signup and view all the answers

<p>104 NP (A), 103 NP (B)</p> Signup and view all the answers

<p>The California Prescription Drug Utilization Review and Evaluation System (CURES) is a program that helps to prevent prescription drug abuse. Healthcare providers are required to consult CURES before prescribing Schedule II–IV drugs for the first time and every 4 months for ongoing treatment.</p> Signup and view all the answers

<p>Opioids: Dilaudid, morphine, oxycodone, hydrocodone, fentanyl (A), Stimulants: Adderall, Ritalin, methamphetamine (B)</p> Signup and view all the answers

<p>CNS: sedation, drowsiness (A), GI: Nausea, constipation (B), Dermatological: pruritic, sweating (C), GU: urinary retention (D), Cardiovascular: hypotension (E), Respiratory: respiratory depression (F)</p> Signup and view all the answers

<p>LDL cholesterol: only 50% is absorbed by liver, rest goes to peripheral cells (A), HDL cholesterol: produced in liver and intestine with function to remove LDL cholesterol from peripheral cells (B)</p> Signup and view all the answers

<p>At-risk children and adolescents: between 2 and 8 years (A), All children between ages 9 and 11 and another screening ages 18 and 21 years (B)</p> Signup and view all the answers

<p>Statins block the enzyme HMG-CoA reductase, reducing cholesterol production in the liver. (A), Decreases intracellular cholesterol levels, leading to increased uptake of LDL from the bloodstream. (B), Reduces triglycerides and slightly increases HDL levels. (C)</p> Signup and view all the answers

<p>Hepatotoxicity (A), GI disturbances (B), Headaches (C), Myalgia, possibly myopathy (D)</p> Signup and view all the answers

<p>Statins (A)</p> Signup and view all the answers

<p>Dilates peripheral arteries, veins, and coronary arteries. (A), Veins return less blood to heart, reducing preload which results in reduced cardiac workload. (B), Coronary arterial dilation increases blood flow and oxygen supply to myocardium. (C)</p> Signup and view all the answers

<p>BNP (B-Type Naturiuretic Peptide) is a polypeptide secreted by the heart's ventricles in response to excessive stretching or wall tension, often due to worsening heart failure. It provides an objective measure of cardiac function and is a strong predictor of risk for death and cardiovascular events in heart failure patients. The normal range is &lt;100 pg/mL.</p> Signup and view all the answers

<p>ARB, beta blocker, aldosterone agonist, diuretic, and digoxin (A), ACE-I or ARB or ARNI with or without a diuretic (depends on fluid retention) (B), ACE-I or ARB or ARNI and beta blocker with a diuretic (C)</p> Signup and view all the answers

<p>Carvedilol (coreg) (A), Metoprolol succinate (Toprol XL) (B), Bisoprolol (Zebeta) (C)</p> Signup and view all the answers

<p>INR &gt; 10 (A), INR 4.5 – 10 (B), INR &lt; 4.5 (C)</p> Signup and view all the answers

<p>Renal Function: Creatinine, eGFR (dose adjustments needed for renal impairment). Hepatic Function: ALT, AST, bilirubin (important for rivaroxaban and apixaban). CBC: Monitor for anemia or thrombocytopenia.</p> Signup and view all the answers

<p>aPTT (A)</p> Signup and view all the answers

<p>Pulmonary Embolism (PE) / Deep Vein Thrombosis (DVT): Heparin (followed by oral anticoagulants like warfarin or DOACs for long-term management) (A), Transient Ischemic Attack (TIA): Aspirin (antiplatelet therapy is preferred for TIA) (B), Atrial Fibrillation (A-fib) (to prevent stroke): Warfarin or Apixaban (or other DOACs for A-fib stroke prevention) (C), Myocardial Infarction (MI): Aspirin and Clopidogrel (antiplatelet therapy is first-line for MI) (D)</p> Signup and view all the answers

<p>Classic signs: fatigue, weakness, pallor, shortness of breath (A), Blood smear findings: microcytic, hypochromia, target cell and acanthocytes (cell with irregularly spaced bulbous projections) (B)</p> Signup and view all the answers

<p>Gastric mucosal atrophy, neurologic changes (paranoia, dementia, confusion, delirium), yellow-blue color blindness, fatigue, weakness. (A)</p> Signup and view all the answers

<p>Inotropic Medications: Affect cardiac contractility (A), Chronotropic Medications: Affect heart rate (B)</p> Signup and view all the answers

<p>Blue-gray skin discoloration (A)</p> Signup and view all the answers

<p>Phase 0: Rapid depolarization from sodium influx (A), Phase 1: initial repolarization caused by transient potassium efflux. (B), Phase 4: Resting phase where the membrane potential is maintained by the sodium-potassium pump (C), Phase 2: Plateau phase where calcium influx balances potassium efflux, sustaining contraction. (D), Phase 3: Repolarization caused by potassium efflux (E)</p> Signup and view all the answers

<p>Nitrates are converted to nitric oxide, which causes vasodilation. This reduces preload (venous return to the heart) and afterload (arterial resistance), lowering cardiac workload and oxygen demand. This mechanism helps relieve angina symptoms. (A)</p> Signup and view all the answers

<p>Modifiable Risk Factors: Include lifestyle factors such as poor diet, physical inactivity, obesity, and smoking, which can be changed to manage hyperlipidemia. (A), Non-modifiable Risk Factors: Include age, race, gender, and family history of hyperlipidemia or early cardiovascular disease, which cannot be altered (B)</p> Signup and view all the answers

<p>GI disturbances, gallstones, myopathy (A)</p> Signup and view all the answers

<p>The 10-year ASCVD Risk Score uses factors such as age, gender, race, total cholesterol, HDL cholesterol, blood pressure (treated or untreated), diabetes status, and smoking status to estimate the likelihood of a cardiovascular event in the next 10 years. (A)</p> Signup and view all the answers

<p>Digoxin inhibits the sodium-potassium ATPase pump. Indirectly leads to accumulation of intracellular calcium, causing increased myocardial contractility. (A)</p> Signup and view all the answers

<p>Aspirin inhibits platelet activation through irreversible enzyme antagonism to block prostaglandin synthesis. (A)</p> Signup and view all the answers

<p>Aplastic anemia treatments: Mild cases treated with supportive care. RBC transfusions and platelets given as necessary. (A), Aplastic anemia is caused by bone marrow failure, often due to autoimmune mechanisms, chemo/radiation, infections, or medications. It presents with fatigue, infections, bleeding, and pancytopenia (on CBC). (B)</p> Signup and view all the answers

<p>Thermal Nociceptors: (A), Chemical Nociceptors: (B), Mechanical Nociceptors: (C)</p> Signup and view all the answers

<p>Schedule IV: Low abuse potential, accepted medical use (e.g., benzodiazepines) (A), Schedule I: No accepted medical use, high abuse potential (e.g., heroin, LSD) (B), Schedule III: Moderate abuse potential, accepted medical use (e.g., codeine combinations) (C), Schedule V: Lowest abuse potential, accepted medical use (e.g., cough preparations with codeine) (D), Schedule II: High abuse potential, restricted medical use (e.g., oxycodone, morphine) (E)</p> Signup and view all the answers

<p>When activated, nociceptors generate electrical signals (action potentials). These signals travel along sensory nerve fibers (Ad fibers for sharp, acute pain; C fibers for dull, throbbing pain) to the spinal cord and brain. The brain processes these signals, resulting in the perception of pain and initiating protective responses. (A)</p> Signup and view all the answers

<p>Miosis (A), CNS depression (B), Altered mental status, stupor, or coma (C), Managed by correction of immediate life-threatening complications (airway assessment and intubation); Narcan. (D), Hypoventilation – severe respiratory depression (E)</p> Signup and view all the answers

<p>This hyperpolarizes the neuron, making it less likely to fire and leading to CNS depression. (A), Barbiturates enhance the effect of GABA, the primary inhibitory neurotransmitter in the central nervous system (CNS) (B), They bind to the GABA-A receptor at a distinct site from GABA, increasing the duration that the chloride ion channel remains open. (C)</p> Signup and view all the answers

<p>Excessive sodium and low potassium intake (A), Family History (B), Race/Ethnicity (C), Smoking (D), DM and HLD (E), Alcohol (F), Physical inactivity (G), Obesity (BMI &gt;30) (H), Age (I)</p> Signup and view all the answers

A persistent, dry cough due to bradykinin buildup.

Reflex tachycardia, fluid retention, headache, dizziness, weakness, and fatigue due to rapid blood pressure drop.

Blocks aldosterone receptors, retaining potassium and excreting sodium and water, causing modest blood pressure decrease.

Authorization to prescribe buprenorphine for opioid use disorder, previously required under DATA 2000.

No longer requires an x-waiver for prescribing medications in California, per the Consolidated Appropriations Act of 2023

Requires accredited pharmacology course, active furnishing number, DEA registration, and adherence to standardized procedures/protocols

Includes patient and prescriber information, drug details, date, signature, and refill limitations (schedule-specific).

California's prescription drug monitoring program, crucial for combating opioid abuse by tracking controlled substance prescriptions.

Opioids (e.g., Dilaudid, morphine) and stimulants (e.g., Adderall, Ritalin).

CNS (sedation, drowsiness), GI (nausea, constipation), respiratory (depression), cardiovascular (hypotension), dermatological (pruritus, sweating), and GU (urinary retention).

HDL removes LDL from cells; LDL delivers cholesterol to cells.

At-risk children/adolescents (2-8 yrs) - family history, obesity; All children (9-11, 18-21).

Blocks HMG-CoA reductase, decreasing cholesterol production and increasing LDL uptake.

GI issues, headaches, myalgia/myopathy, and hepatotoxicity.

Contraindicated due to their role in fetal cholesterol synthesis.

Dilates blood vessels, reducing preload and afterload, improving blood flow to the heart.

A peptide secreted by heart ventricles in response to pressure; a measure of worsening heart failure.

Bleeding, hypersensitivity, thrombocytopenia, others.

Monitored via aPTT (activated partial thromboplastin time).

Heparin, followed by warfarin or DOACs.

Aspirin (antiplatelet therapy).

Warfarin or DOACs.

Aspirin and Clopidogrel (antiplatelet therapy).

Slows heart rate and decreases heart contraction strength, reducing myocardial oxygen demand.

Blocks angiotensin II receptors, decreasing blood vessel resistance and heart workload.