Respiratory
Which of the following are risk factors of COPD?
A: Smoking 2ppd for 20 years
B: Asthma since childhood
C: Working in a steel mill with high pollutant exposure
D: A and B only
E: All of the Above
E: All of the Above
Which of the following is a potential trigger for PE?
a. A 12 hour flight
b. A 6 mile run
c. A fall caused by orthostatic hypotension
d. An INR of 4.0
a. A 12 hour flight
Name 2 important counseling points for sublingual nitroglycerin
dissolve under tongue
q5min up to 3 doses
if pain does not resolve after first dose, take another and call 911
Do not take within 24 hours of Sildenafil and 48 hours of Tadalafil
When should parenteral BP control be considered in a hypertensive crisis?
When there is evidence of organ damage or decreased organ perfusion
What leads to the increased risk of Wernicke’s encephalopathy, especially when associated with alcohol use disorder?
Thiamine Deficiency
What are the 3 cardinal symptoms of COPD
Increased SOB
Increased sputum production
Purulent sputum
What score can be used to assess a patient’s risk of having heparin-induced thrombocytopenia (HIT)?
4T Score
What scale assesses the need for catheterization for patients experiencing an NSTEMI?
TIMI scale
T/F : Hypertensive urgency involves symptoms like headache and chest pain, and requires IV antihypertensive agents.
False
What's the systemic duration of Lasix?
A. 2 hours
B. 8 hours
C. 6 hours
D. 10 hours
C. 6 hours
Which of the following is recommended for COVID patients who need supplemental oxygen:
a. Paxlovid
d. Dexamethasone
c. Aspirin
d. 0.9% NS
d. Dexamethasone
When diagnosing a PE, which test poses potential concern in patients with renal impairment?
a. D-dimer
b. VQ scan
c. Troponin
d. CTA (Computed Tomography Angiography)
d. CTA (Computed Tomography Angiography) due to contrast dye
What are the “Pillars” of heart failure? (5 drugs - name all)
ARNi
Beta Blockers
Mineralocorticoid Receptors
SGLT2i
Diuretics
What is the target BP in a patient with an intracranial hemorrhage:
a. SBP < 140
b. SBP < 130
c. SBP < 200
d. Target is individualized to the patient based on their condition
a. SBP < 140
A female patient with penicillin allergy (no reaction listed) presents with a UTI. Cultures are positive for E.Coli showing ESLB resistance. Which antibiotic is MOST reasonable?
a. Cephalexin 500mg Q12 hrs x 5 days (possible b-lactam rxn)
b. Linezolid 600mg Q12 hrs x 5 days (doesn’t cover e coli)
c. Cefepime 1g Q24 hrs x 5 days (possible b-lactam rxn)
d. Nitrofurantoin 100mg BID x 5 days
d. Nitrofurantoin 100mg BID x 5 days
RK was admitted for COPD exacerbation and is ready for discharge. The doctor would like to discharge him with Augmentin, but he has an anaphylactic allergy to Penicillin. Which are potential recommendations? (Select all that apply)
A. Doxycycline
B. Cefazolin
C. Azithromycin
D. Moxifloxacin
A. Doxycycline
and
C. Azithromycin
Which of the following are appropriate therapies for a patient with a 4T score of 5?
A. Discontinue Heparin and Initiate Bivalirudin.
B. Discontinue Heparin and Initiate Argatroban.
C. Discontinue Heparin and Initiate Lovenox.
D. A and B
E. All of the above.
D. A and B
Which beta blockers are shown to have benefit in HFrEF? (Name 3)
Carvedilol, bisoprolol, and metoprolol succinate
Which of the following is an appropriate scenario to treat hypertensive crisis with a BP of 182/114 and NO symptoms of organ damage?
A. Treatment is not necessary because there are more lenient BP goals inpatient due to close monitoring.
B. Initiating IV Labetalol 20mg push over 2 minutes followed by 40mg q10 min for 1 hour to drop to BP to < 130/90.
C. Initiating IV Furosemide 80mg to decrease fluid volume.
D. Initiating PO Lisinopril to gradually lower BP to prevent hypotension/shock.
D. Initiating PO Lisinopril to gradually lower BP to prevent hypotension/shock.
When transitioning a patient from an ACE inhibitor to Entresto, what considerations are required to prevent angioedema?
A. Ensure a 36-hour washout period before initiating Entresto.
B. Bridge the ACE inhibitor with Sacubitril for 1 week before initiating Entresto.
C. Administer prophylactic Furosemide 40 mg PO x 1 to prevent edema.
D. Past ACE inhibitor use is a contraindication for initiating Entresto.
A. Ensure a 36-hour washout period before initiating Entresto.
Which of the following is appropriate maintenance therapy for a patient with COPD who was previously on a LAMA + LABA, has Eosinophils of 115, and a recent exacerbation that resulted in hospitalization. Insurance is not a concern.
A. Stiolto Respimat (Tiotropium/Olodaterol) 2.5mcg/2.5mcg 2 inhalations once daily.
B. ProAir HFA (Albuterol) 2.5mg/3mL Solution 1 inhalation BID.
C. Spiriva (Tiotropium) 18mcg inhale 1 capsule daily.
D. Trelegy (Fluticasone furoate 100 mcg/Umeclidinium 62.5 mcg/Vilanterol 25 mcg) 1 inhalation once daily.
D. Trelegy (Fluticasone furoate 100 mcg/Umeclidinium 62.5 mcg/Vilanterol 25 mcg) 1 inhalation once daily.
What treatments can be used for reversal of warfarin overdose? (Name at least 2 types - not brands)
Vitamin K
prothrombin complex concentrate (PCC)
fresh frozen plasma
Which of the following is an appropriate antiplatelet regimen for a patient getting discharged post NSTEMI?
A. Aspirin 81mg PO daily for 12 mo
B. Aspirin 81mg PO daily for life + Ticagrelor 90mg PO BID for 12 mo
C. Aspirin 81mg PO daily for life + Clopidogrel 75mg PO daily for life
D. Aspirin 81mg PO daily for life
B. Aspirin 81mg PO daily for life + Ticagrelor 90mg PO BID for 12 mo
ML is an 86 yo female presenting with intracranial hemorrhage. Upon CT, there is no midline shift. She was previously taking Warfarin for A. fib and her INR two days ago was 4.9. Her current blood pressure is 176/102. Which of the following are appropriate actions to treat this patient?
A. Administer Alteplase 0.09 mg/kg IV bolus + 0.81 mg/kg IV infusion over 1 hour.
B. Administer KCentra 2000 units IV x 1.
C. Administer Nicardipine IV 5mg/hr continuous infusion.
D. A and C
E. B and C
F. All of the above.
E. B and C
Which of the following is NOT a monitoring parameter for Ertapenem?
A. Magnesium
B. Albumin
C. Seizure Risk
D. N/V/D
A. Magnesium