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A 6-year-old female presents to the clinic for evaluation. She has no significant past medical history. Her brother was recently treated with an over-the-counter medication after his parents found nits in his hair. On physical examination, the patient is found to have nits in her hair, as well. Which of the following is an appropriate treatment regimen?
A 6-year-old female presents to the clinic for evaluation. She has no significant past medical history. Her brother was recently treated with an over-the-counter medication after his parents found nits in his hair. On physical examination, the patient is found to have nits in her hair, as well. Which of the following is an appropriate treatment regimen?
What information should a patient who develops diarrhea as a result of chemotherapy receive regarding this symptom?
What information should a patient who develops diarrhea as a result of chemotherapy receive regarding this symptom?
Coffee can have a laxative effect, so it should be avoided in a patient with diarrhea. Fresh fruits and vegetables and foods rich in fiber will increase the frequency of bowel movements. Foods with extreme temperatures will have no effect.
What are the primary "measurable" goals of therapy for this patient with type 2 diabetes, who is otherwise in good health?
What are the primary "measurable" goals of therapy for this patient with type 2 diabetes, who is otherwise in good health?
What should be administered to a newborn with congenital hepatitis B to provide passive protection against hepatitis B?
What should be administered to a newborn with congenital hepatitis B to provide passive protection against hepatitis B?
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A 44-year-old woman with a medical history of uncontrolled type 2 diabetes mellitus presents to the clinic for a follow-up appointment. At her last visit, the patient was found to have a fatty hump in between her shoulders, a rounded face, and concerns about developing hypertension. She was then prescribed mifepristone. Which of the following complications is most likely to occur in this patient?
A 44-year-old woman with a medical history of uncontrolled type 2 diabetes mellitus presents to the clinic for a follow-up appointment. At her last visit, the patient was found to have a fatty hump in between her shoulders, a rounded face, and concerns about developing hypertension. She was then prescribed mifepristone. Which of the following complications is most likely to occur in this patient?
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A 25-year-old woman presents with occasional stomach aches and difficulty in emptying her bowels. She says she has hardened stools and only has two to three bowel movements per week. She tried a stimulant laxative in the past, but she does not want to use it again because it caused her abdominal cramping. She cannot remember the name of this laxative. An over-the-counter medication that has limited adverse effects and a better-tasting profile is prescribed. What is the mechanism of action of this drug?
A 25-year-old woman presents with occasional stomach aches and difficulty in emptying her bowels. She says she has hardened stools and only has two to three bowel movements per week. She tried a stimulant laxative in the past, but she does not want to use it again because it caused her abdominal cramping. She cannot remember the name of this laxative. An over-the-counter medication that has limited adverse effects and a better-tasting profile is prescribed. What is the mechanism of action of this drug?
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When starting a patient on warfarin, approximately how long does it take for anticoagulation to increase the INR?
When starting a patient on warfarin, approximately how long does it take for anticoagulation to increase the INR?
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A drug prescribed for prophylaxis for the exertional (classical) form of angina, but NOT for variant (vasospastic) angina is:
A drug prescribed for prophylaxis for the exertional (classical) form of angina, but NOT for variant (vasospastic) angina is:
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A 45-year-old woman with a past medical history of hypertension, treated with amlodipine and hydrochlorothiazide, presents for follow-up. She had routine blood work done two days ago, which showed a sodium level of 128 mEq/L. The patient has no complaints and denies any symptoms. Her physical exam is normal, and her blood pressure is at her defined target. What is the next best step in the management of this patient?
A 45-year-old woman with a past medical history of hypertension, treated with amlodipine and hydrochlorothiazide, presents for follow-up. She had routine blood work done two days ago, which showed a sodium level of 128 mEq/L. The patient has no complaints and denies any symptoms. Her physical exam is normal, and her blood pressure is at her defined target. What is the next best step in the management of this patient?
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Which groups of diuretics are often used to treat hypertension and heart failure (more than one answer is possible)?
Which groups of diuretics are often used to treat hypertension and heart failure (more than one answer is possible)?
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A 49-year-old male presents for his routine health visit. The patient has a medical history of hypertension and was diagnosed with type 2 diabetes mellitus 18 months ago. The patient has tried to control his blood sugar with diet and exercise and has been unsuccessful. Eight months ago, metformin was added to the patient's medication regime. The patient does not drink alcohol, smoke cigarettes, or use illicit drugs. The patient's recent hemoglobin A1c (HbA1c) reported 8.7%. The clinician adds a medication that acts on the kidneys' proximal tubules, reduces filtered glucose reabsorption, and further increases urinary glucose excretion. What is a common adverse effect of this agent?
A 49-year-old male presents for his routine health visit. The patient has a medical history of hypertension and was diagnosed with type 2 diabetes mellitus 18 months ago. The patient has tried to control his blood sugar with diet and exercise and has been unsuccessful. Eight months ago, metformin was added to the patient's medication regime. The patient does not drink alcohol, smoke cigarettes, or use illicit drugs. The patient's recent hemoglobin A1c (HbA1c) reported 8.7%. The clinician adds a medication that acts on the kidneys' proximal tubules, reduces filtered glucose reabsorption, and further increases urinary glucose excretion. What is a common adverse effect of this agent?
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After successful treatment for her skin infection with a broad spectrum cephalosporin (cefotaxime), Amy's condition improves for several days, and then suddenly declines. A second set of cell cultures confirmed the presence of a superinfection by a new organism Bacteroides fragilis, a beta-lactamase producing obligate anaerobic gram-negative rod-shaped bacteria. Based upon basic principles of antibiotic action, which of the following would be contraindicated for treating this infection?
After successful treatment for her skin infection with a broad spectrum cephalosporin (cefotaxime), Amy's condition improves for several days, and then suddenly declines. A second set of cell cultures confirmed the presence of a superinfection by a new organism Bacteroides fragilis, a beta-lactamase producing obligate anaerobic gram-negative rod-shaped bacteria. Based upon basic principles of antibiotic action, which of the following would be contraindicated for treating this infection?
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Which statements by a patient with AIDS indicate that he needs further clarification about his illness?
Which statements by a patient with AIDS indicate that he needs further clarification about his illness?
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Which laboratory parameters change when chloroquine is administered (multiple answers are possible)?
Which laboratory parameters change when chloroquine is administered (multiple answers are possible)?
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A patient with diffuse non-Hodgkin's lymphoma begins combination therapy with bleomycin, cyclophosphamide, vincristine, doxorubicin, and prednisone. The cumulative dose of bleomycin should be carefully monitored because it is associated with
A patient with diffuse non-Hodgkin's lymphoma begins combination therapy with bleomycin, cyclophosphamide, vincristine, doxorubicin, and prednisone. The cumulative dose of bleomycin should be carefully monitored because it is associated with
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A 58-year-old postmenopausal woman with a significant past medical history of Type 2 diabetes presents to the clinic with joint pain in both her knees. She says she cannot walk for more than a few minutes before her knees swell up. The patient uses over-the-counter ibuprofen 500 mg to alleviate symptoms, but they only have temporary effects. She also has had associated vasomotor symptoms, such as hot flashes indicative of menopause. On the physical exam, the clinician noticed a decreased lordotic curve of the lumbar region and moderate scoliosis in the upper thoracic region. Vital signs were stable. DEXA imaging showed a BMD T score of -3.0 and low-grade spondylosis at the L5-S1 level. The clinician prescribed a drug combined with conjugated estrogens to decrease bone resorption and vasomotor symptoms. Which one of the following statements best describes this drug?
A 58-year-old postmenopausal woman with a significant past medical history of Type 2 diabetes presents to the clinic with joint pain in both her knees. She says she cannot walk for more than a few minutes before her knees swell up. The patient uses over-the-counter ibuprofen 500 mg to alleviate symptoms, but they only have temporary effects. She also has had associated vasomotor symptoms, such as hot flashes indicative of menopause. On the physical exam, the clinician noticed a decreased lordotic curve of the lumbar region and moderate scoliosis in the upper thoracic region. Vital signs were stable. DEXA imaging showed a BMD T score of -3.0 and low-grade spondylosis at the L5-S1 level. The clinician prescribed a drug combined with conjugated estrogens to decrease bone resorption and vasomotor symptoms. Which one of the following statements best describes this drug?
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A 48-year-old woman who has a history of hyperthyroidism arrives in your clinic exhibiting signs and symptoms of hypothyroidism. She is currently not taking any medications. Which form of therapy was most used in her treatment that could account for her present condition?
A 48-year-old woman who has a history of hyperthyroidism arrives in your clinic exhibiting signs and symptoms of hypothyroidism. She is currently not taking any medications. Which form of therapy was most used in her treatment that could account for her present condition?
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This drug is a small molecule that polymerizes from hydrochloric acid and coats the ulcer, speeding healing and reducing symptoms.
This drug is a small molecule that polymerizes from hydrochloric acid and coats the ulcer, speeding healing and reducing symptoms.
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While in the clinic, you identify a patient who may be a candidate for luspatercept as first-line therapy for treating anemia associated with their LR-MDS. What is the initial recommended dosing strategy for luspatercept?
While in the clinic, you identify a patient who may be a candidate for luspatercept as first-line therapy for treating anemia associated with their LR-MDS. What is the initial recommended dosing strategy for luspatercept?
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An 18-year-old man presents to the clinic for a follow-up of severe hyperlipidemia. The family history is positive for severe hyperlipidemia and premature coronary artery disease. Genetic testing confirms the suspected condition. The clinician is considering treatment with mipomersen. What would be the mechanism of action of this novel therapeutic?
An 18-year-old man presents to the clinic for a follow-up of severe hyperlipidemia. The family history is positive for severe hyperlipidemia and premature coronary artery disease. Genetic testing confirms the suspected condition. The clinician is considering treatment with mipomersen. What would be the mechanism of action of this novel therapeutic?
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CK is a 53 yo woman with a history of chronic pulmonary obstructive disease & heart disease who presents with chest palpitations & dizziness of sudden onset. She has been on theophylline therapy for COPD, along with an quinopril, spironolactone, dihydrochlorothiazide and carvedilol for HF. A12 lead ECG reveals the presence of a tachycardia with narrow QRS complexes & inverted P waves buried at the end of the QRS complex. A tentative diagnosis of paroxysmal supraventricular tachycardia (PSVT), most likely caused by AV node reentry is made. The best drug for acute conversion of CJ's arrhythmia would be:
CK is a 53 yo woman with a history of chronic pulmonary obstructive disease & heart disease who presents with chest palpitations & dizziness of sudden onset. She has been on theophylline therapy for COPD, along with an quinopril, spironolactone, dihydrochlorothiazide and carvedilol for HF. A12 lead ECG reveals the presence of a tachycardia with narrow QRS complexes & inverted P waves buried at the end of the QRS complex. A tentative diagnosis of paroxysmal supraventricular tachycardia (PSVT), most likely caused by AV node reentry is made. The best drug for acute conversion of CJ's arrhythmia would be:
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Which of the following are included in the treatment of both hypertension and heart failure? (Select all that apply)
Which of the following are included in the treatment of both hypertension and heart failure? (Select all that apply)
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Study Notes
Patient Evaluation
- A 6-year-old female presents to the clinic for evaluation.
- She has no significant past medical history.
- Her brother was previously treated for head lice.
- The patient has head lice.
- Appropriate treatment regimen for head lice is 1% permethrin shampoo applied to dampened hair, washed off after 10 minutes, and repeated 7 days later.
- 5% permethrin cream is used for scabies treatment.
Pediculosis Capitis Treatment
- Permethrin is effective in treating head lice (pediculosis capitis).
- Apply 1% permethrin shampoo to dampened hair, washing off after 10 minutes.
- Repeat treatment 7 days later.
Chemotherapy-Induced Diarrhea
- A patient may experience diarrhea due to chemotherapy.
- Advise the patient to eat fresh vegetables and fruits, and foods high in fiber.
- Avoid very hot or very cold foods.
- Limit coffee.
Type 2 Diabetes Treatment Goals
- HbA1c <7% (A1C should be less than 7%)
- FBG <130 mg/dL. (Fasting blood glucose should be less than 130mg/dL)
Hepatitis B in Newborns
- If the mother is hepatitis B-positive, administer hepatitis B immune globulin (HBIG) to the newborn.
- Administer the first dose of recombinant hepatitis B vaccine injection at a separate site from HBIG.
Mifepristone Complications
- Mifepristone, at high doses, acts as a glucocorticoid receptor antagonist.
- Adrenal insufficiency is a possible complication.
- Hypoglycemia has not been reported.
Polyethylene Glycol (PEG)
- PEG is a preferred osmotic laxative for chronic constipation and impaction.
- It remains in the intestinal lumen, causing water retention and softer stools.
Warfarin Anticoagulation
- Warfarin takes 2-3 days to increase the INR (international normalized ratio).
- Patients may require a bridging anticoagulant during this time.
- The typical bridging anticoagulant is low-molecular-weight heparin
Angina Prophylaxis
- Nifedipine is a drug for use in prophylaxis for exertional (classic) angina, but not variant (vasospastic) angina.
Hyponatremia in a Patient on Thiazide Diuretics
- Thiazide diuretics can cause hyponatremia.
- Stop the thiazide diuretic.
- Consider alternative therapy if blood pressure rebounds. (e.g. ACE inhibitor).
Hyperthyroidism Treatment
- Radioactive iodine is used in treatment of hyperthyroidism.
- Overuse can result in hypothyroidism.
Drug for Peptic Ulcer
- Sucralfate is a drug that polymerizes when in contact with stomach acid.
- It coats the ulcer, protecting it and aiding in healing.
- This facilitates healing and reduces symptoms.
Luspatercept Dosage
- Luspatercept should be started at a dose of 1 mg/kg subcutaneously every 2 weeks.
Mipomersen Mechanism of Action
- Mipomersen is an antisense oligonucleotide that inhibits apolipoprotein B-100 messenger RNA.
- This decreases levels of apo B-100 associated with VLDL in the liver.
Antibiotic Treatment for Superinfection
- A carbapenem, such as Meropenem should not be used in this scenario.
- Macrolides, such as clarithromycin, should not be used in this scenario.
- Tetracycline derivatives, such as tigecycline, should not be used in this scenario.
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Description
This quiz covers key aspects of pediatric health evaluations, focusing on the treatment of head lice, chemotherapy-induced diarrhea, and type 2 diabetes management. It is designed for healthcare professionals to enhance their understanding of proper treatment regimens and guidelines in pediatric care.
