Podcast
Questions and Answers
A 46-year-old man consults you regarding sexual complaints. A drug that is used for erectile dysfunction and inhibits phosphodiesterase is:
A 46-year-old man consults you regarding sexual complaints. A drug that is used for erectile dysfunction and inhibits phosphodiesterase is:
When considering patient characteristics, which patient population has comparatively lower intakes of omega-3 fatty acids?
When considering patient characteristics, which patient population has comparatively lower intakes of omega-3 fatty acids?
A patient has been prescribed aliskiren, and lab results show that the patient is hypovolemic. What should be done?
A patient has been prescribed aliskiren, and lab results show that the patient is hypovolemic. What should be done?
A drug was tested in the electrophysiology laboratory to determine its effect on the action potential of a normal cardiomyocyte and the result is shown in the diagram.
A drug was tested in the electrophysiology laboratory to determine its effect on the action potential of a normal cardiomyocyte and the result is shown in the diagram.
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Which of the following drugs is most effective when others are ineffective in treating ventricular fibrillation?
Which of the following drugs is most effective when others are ineffective in treating ventricular fibrillation?
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A 50-year-old man with a history of frequent episodes of renal colic with calcium-containing stones, after a thorough examination and examination, was found to have a defect in the reabsorption of calcium in the proximal tubules, which is the cause of high concentrations of calcium salts in the tubular urine. The most useful diuretic for the treatment of recurrent calcium stones is:
A 50-year-old man with a history of frequent episodes of renal colic with calcium-containing stones, after a thorough examination and examination, was found to have a defect in the reabsorption of calcium in the proximal tubules, which is the cause of high concentrations of calcium salts in the tubular urine. The most useful diuretic for the treatment of recurrent calcium stones is:
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A nurse notices that the urine output of a patient who is being treated with vancomycin drops to 500 mL daily. What should he do?
A nurse notices that the urine output of a patient who is being treated with vancomycin drops to 500 mL daily. What should he do?
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A 72-kg patient with a creatinine clearance of 80 ml/min has a Gram-negative infection. Amikacin was administered intramuscularly at a dose of 5 mg/kg every 8 hours and the patient began to improve. After two days, creatinine clearance drops to 40 ml/min. Assuming no information is available regarding plasma levels of amikacin, what would be the most reasonable approach in treating this patient?
A 72-kg patient with a creatinine clearance of 80 ml/min has a Gram-negative infection. Amikacin was administered intramuscularly at a dose of 5 mg/kg every 8 hours and the patient began to improve. After two days, creatinine clearance drops to 40 ml/min. Assuming no information is available regarding plasma levels of amikacin, what would be the most reasonable approach in treating this patient?
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A soldier who recently returned to the US on military leave from Afghanistan is diagnosed with a bloodstream infection due to Acinetobacter baumannii. Which of the following drugs is known to be effective against most strains of this pathogen?
A soldier who recently returned to the US on military leave from Afghanistan is diagnosed with a bloodstream infection due to Acinetobacter baumannii. Which of the following drugs is known to be effective against most strains of this pathogen?
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What is the standard prophylactic treatment for a pregnant patient with HIV who is asymptomatic?
What is the standard prophylactic treatment for a pregnant patient with HIV who is asymptomatic?
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Resistance to acyclovir most often develops as a result of a mutation in the viral gene that codes for the protein that:
Resistance to acyclovir most often develops as a result of a mutation in the viral gene that codes for the protein that:
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A 42 year hospitalized patient with an indwelling central venous catheter develops a life-threatening infection by a drug-resistant form of Candida albicans. A decision is made to treat the patient with a liposomal infusion containing an antifungal drug that acts by binding to ergosterol, creating large pores in the fungal cell membrane that cause leakage of cellular components, resulting in cell death. Which antifungal drug was used to treat this patient's resistant infection?
A 42 year hospitalized patient with an indwelling central venous catheter develops a life-threatening infection by a drug-resistant form of Candida albicans. A decision is made to treat the patient with a liposomal infusion containing an antifungal drug that acts by binding to ergosterol, creating large pores in the fungal cell membrane that cause leakage of cellular components, resulting in cell death. Which antifungal drug was used to treat this patient's resistant infection?
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A 54-year-old woman with a history of hypertension, type 2 diabetes, HIV, alcohol use disorder, and end-stage renal disease presents to the clinic with a complaint of vaginal discharge for 14 days. She describes the discharge as similar to cottage cheese. The patient is nonadherent to her antiviral medications. She was initially prescribed fluconazole but was discontinued due to no improvement to her symptoms. A new antifungal medication is being considered, which is an antimetabolite that takes its active form once introduced to fungal cells. Which of the following conditions is the strongest contraindication for the use of this medication in this patient?
A 54-year-old woman with a history of hypertension, type 2 diabetes, HIV, alcohol use disorder, and end-stage renal disease presents to the clinic with a complaint of vaginal discharge for 14 days. She describes the discharge as similar to cottage cheese. The patient is nonadherent to her antiviral medications. She was initially prescribed fluconazole but was discontinued due to no improvement to her symptoms. A new antifungal medication is being considered, which is an antimetabolite that takes its active form once introduced to fungal cells. Which of the following conditions is the strongest contraindication for the use of this medication in this patient?
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A 55-year-old woman was treated with dexamethasone after liver transplantation. X-ray shows osteoporosis. Which of the following is the agent of choice for osteoporosis in this case?
A 55-year-old woman was treated with dexamethasone after liver transplantation. X-ray shows osteoporosis. Which of the following is the agent of choice for osteoporosis in this case?
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Having completed the final (GI) block before the Winter break, you decide to fly down to Cozumel to drink margaritas at Carlos'n' Charlie's in order to just forget about Med School for awhile. Returning to your hotel at 4 AM, you momentarily forget you are in Mexico and brush your teeth using tap water. The next afternoon you develop a bad case of Montezuma's revenge, and decide to cancel your planned Fury catamaran snorkeling trip. You call the front desk and ask them (in broken high school Spanish) if the gift shop carries an opioid anti-diarrheal medication that is sold over-the-counter, and has no significant addictive properties. What medication is this?
Having completed the final (GI) block before the Winter break, you decide to fly down to Cozumel to drink margaritas at Carlos'n' Charlie's in order to just forget about Med School for awhile. Returning to your hotel at 4 AM, you momentarily forget you are in Mexico and brush your teeth using tap water. The next afternoon you develop a bad case of Montezuma's revenge, and decide to cancel your planned Fury catamaran snorkeling trip. You call the front desk and ask them (in broken high school Spanish) if the gift shop carries an opioid anti-diarrheal medication that is sold over-the-counter, and has no significant addictive properties. What medication is this?
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A 78-year-old female with hypertension and diabetes mellitus is new to the practice. She is on lisinopril 40 mg a day and metformin extended-release 1 gram a day. Her blood pressure is well controlled, and the exam is unremarkable. Laboratories show a glucose of 190 mg/dL, hemoglobin A1c 6.5%, potassium 4.6 mEq/L, creatinine 1.8 mg/dL, and 1+ protein in the urine. The estimated glomerular filtration rate is 28. A review of her records shows an increase in her creatinine compared to a year ago. What is the appropriate management?
A 78-year-old female with hypertension and diabetes mellitus is new to the practice. She is on lisinopril 40 mg a day and metformin extended-release 1 gram a day. Her blood pressure is well controlled, and the exam is unremarkable. Laboratories show a glucose of 190 mg/dL, hemoglobin A1c 6.5%, potassium 4.6 mEq/L, creatinine 1.8 mg/dL, and 1+ protein in the urine. The estimated glomerular filtration rate is 28. A review of her records shows an increase in her creatinine compared to a year ago. What is the appropriate management?
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MT is a 57-year-old man being treated for a B-cell lymphoma with a novel form of therapy that facilitates the interaction of T cells with malignant cells expressing tumor-specific surface antigens. This increased interaction between T cells and cancer cells triggers T cells to release large amounts of cytotoxic cytokines that kill cancer cells, while limiting damage to non-cancerous cells. Which of the following agents has this mechanism of action?
MT is a 57-year-old man being treated for a B-cell lymphoma with a novel form of therapy that facilitates the interaction of T cells with malignant cells expressing tumor-specific surface antigens. This increased interaction between T cells and cancer cells triggers T cells to release large amounts of cytotoxic cytokines that kill cancer cells, while limiting damage to non-cancerous cells. Which of the following agents has this mechanism of action?
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JC begins a rigorous treatment regimen for type 1 diabetes that includes a nightly dose of insulin glargine, and doses of rapid-acting insulin aspart with each meal. Nine months later his HbA1c has fallen from 13% to 6-7%. During a family vacation his parents note that JC is sweating on a temporate day, and he seems both irritable and confused, as well as slow to respond to questions. JC also complains of being warm and having chest palpitations. What would be best treatment for JC's condition?
JC begins a rigorous treatment regimen for type 1 diabetes that includes a nightly dose of insulin glargine, and doses of rapid-acting insulin aspart with each meal. Nine months later his HbA1c has fallen from 13% to 6-7%. During a family vacation his parents note that JC is sweating on a temporate day, and he seems both irritable and confused, as well as slow to respond to questions. JC also complains of being warm and having chest palpitations. What would be best treatment for JC's condition?
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A patient using an etonorgestrel/ethynyl estradiol vaginal ring for contraception calls the doctor and says the ring has fallen out. What should be answered to her?
A patient using an etonorgestrel/ethynyl estradiol vaginal ring for contraception calls the doctor and says the ring has fallen out. What should be answered to her?
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What should be the priority in the management of a patient being treated with prednisone (multiple answers possible)?
What should be the priority in the management of a patient being treated with prednisone (multiple answers possible)?
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Study Notes
Patient Complaints and Medications
- A 46-year-old male consults a physician regarding sexual complaints.
- Finasteride, Fluoxetine, Mifepristone, Sildenafil, and Timolol are mentioned as potential medications, but Sildenafil is the one used for erectile dysfunction, inhibiting phosphodiesterase-5.
- Phosphodiesterase-5 inhibitors improve erections by increasing cGMP in vascular smooth muscle and potentiating the hypotensive effect of nitrates.
Omega-3 Fatty Acid Intake
- Younger individuals (toddlers, children, and adolescents) have lower omega-3 fatty acid intake compared to adults and seniors.
- Females show lower intake compared to males across all age groups.
Hypovolemia and Aliskiren Therapy
- A patient prescribed aliskiren and exhibiting hypovolemia should have the hypovolemia corrected before initiating therapy.
- Patients taking diuretics concurrently with aliskiren require close monitoring of volume status.
- Diuretics are inappropriate for patients with hypovolemia.
Drug Testing and Effect on Action Potential
- A drug was tested in an electrophysiology laboratory.
- The drug decreased the height of the action potential without affecting its duration.
Treatment of Ventricular Fibrillation
- Amiodarone is a highly effective drug for treating ventricular fibrillation when other antiarrhythmics fail.
Treatment of Calcium Stones
- In a 50-year-old male patient with calcium stones, the most beneficial diuretic is chlorthalidone.
- Thiazide diuretics prevent calcium stones by decreasing calcium concentration in tubules potentially through increased passive transport in proximal tubules and reabsorption of calcium in distal convoluted tubules.
Vancomycin and Creatinine Clearance
- A 72-kg patient with a gram-negative infection receiving amikacin and experiencing a decrease in creatinine clearance should have their daily dose reduced to 180 mg every 8 hours.
Acinetobacter Baumannii Infection and Effective Drugs
- Colistin is one of the few medications effective against most Acinetobacter baumannii strains, a last resort antibiotic for multidrug resistant bacteria.
HIV-Positive Pregnant Women and Prophylaxis
- Combination drug therapy is the standard prophylaxis for HIV-positive pregnant women to reduce the risk of transmission to the fetus.
- Intrapartum intravenous zidovudine is required if the viral load is greater than or equal to 400 copies/ml.
Flucytosine Prophylaxis
- Flucytosine's effectiveness is dependent on kidney function and eliminated in the urine without significant changes.
B-Cell Lymphoma Treatments
- MT, a 57-year-old male patient, is being treated for B-cell lymphoma with a novel form of CAR-T cell therapy.
Treatment for Type 1 Diabetes
- Symptoms consistent with hypoglycemia (e.g., sweating, irritability, confusion, palpitations) in a patient with type 1 diabetes should be treated with a rapid carbohydrate source (e.g., 1/2 cup of orange juice, non-diet soda, 5-6 lifesavers).
Renal Insufficiency in Patient with Diabetes and Hypertension
- Metformin should be discontinued in patients with renal insufficiency due to the risk of lactic acidosis.
- ACE inhibitors like lisinopril are the optimal treatment for diabetic nephropathy, and should continue to be monitored for appropriate control of blood pressure.
Contraception and Ejected Vaginal Ring
- If a vaginal ring containing etonorgestrel/ethinyl estradiol is ejected, it should be rinsed and reinserted within three hours.
- If not, an alternative contraception method is recommended for the next seven days.
Prednisone Treatment Considerations
- In patients treated with prednisone, monitoring vital signs, weight, and a full medication history is important because of potential drug interactions and risk of hypernatremia, not hyponatremia.
Osteoporosis Treatment
- Alendronate is a drug of choice for osteoporosis.
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Description
This quiz covers various patient complaints and associated medications, focusing on pharmacological treatments like Sildenafil and Aliskiren. Additionally, it explores dietary considerations such as omega-3 fatty acid intake among different age groups. Test your knowledge of how these factors influence patient care.
