Cardiology
In patients who desire nicotine patch for tobacco cessation, in patients who smoke less than ___ cigarettes, give the 14mg dose, if greater then give the 21mg dose.
10. Also ask how soon they need a cigarette in AM to dose nicotine patch. Within 30 minutes need 21mg, if after 30 mins then 14mg
12% of chronic GERD will develop _________. Risk factors are nocturnal GERD, super chronic 5-10 years, weekly symptoms, male, Caucasian, tobacco use, obesity, smoking.
Barrett's esophagus
Name one of the not-uncommon potentially fatal adverse effects of Megace/Megestrol
adrenal insufficiency or DVT/VTE
What specific type of exercises reduces the risk of osteoporotic fractures?
Weight-bearing exercises
Name the first line medication classes for hypertension treatment
CCB's, ACE/ARB's, thiazide diuretics
What statin does the FDA recommend dosage reduction in the Asian population?
Rosuvastatin (Crestor)
PPI's are classically associated with which electrolyte derangement?
Magnesium (the hypomagnesemia may exacerbate hypocalcemia in patients at risk and may also lead to hypokalemia)
Colon cancer surveillance with colonoscopy every_______ is appropriate for patients with one or two sessile serrated polyps less than 10 mm without dysplasia.
5 to 10 years
Before starting patient on a GLP-1 agonist, what 2 questions should you ask the patient before?
History of pancreatitis and family history of medullary thyroid cancer
This landmark trial in 2015 showed that in patients at high risk for CVD but who do not have history of stroke or diabetes, intensive BP control (target SBP <120) improved CV outcomes and overall survival compared to standard therapy (target SBP 135-139), while modestly increasing the risk of some serious adverse events.
Sprint
Not fasting before obtaining a lipid panel can cause falsely elevated _________.
Triglycerides. Very high TG's can disturb the LDL. Therefore, if you are following for TG, then do fasting. If the TG >400, this may cause abnormal read of LDL. Otherwise can do no-fasting lipid panels
If doing a urea breath test to check for H.pylori eradication after completion of antibiotics, make sure the patient is off of PPI for at least how long?
2 weeks
Treatment of coronary artery vasospasm with_________________ can rapidly reverse coronary vasoconstriction, with improvement in myocardial perfusion, symptoms, ECG abnormalities, and hemodynamics.
calcium channel blockade and/or nitrates
Which biomarker is specific for Neuromyelitis optica?
Aquaporin-4 antibody
Which blood pressure medication has another effect of decreasing uric acid?
Losartan
In patients with this type of amiodarone-induced thyrotoxicosis, thyroid ultrasound doppler shows no flow. What is the treatment?
(Need both type and treatment)
Type 2. Treat with prednisone. Type 2 more like destruction and very tender. Type 1 is increased production with painless thyroid and treat with PTU/methimazole
In patients with Hepatitis C, name 2 scores that can be used to determine the likelihood of hepatic fibrosis and cirrhosis, as well as to estimate the liver scarring to assess for the need for biopsy?
APRI score (based on AST and platelet count, lower <0.5 is better)
FIB-4 Index – noninvasive estimate of liver scarring in HCV and HBV patients to assess need for biopsy (based on age, AST, ALT, platelet count)
To diagnose antiphospholipid syndrome after thrombotic events or adverse pregnancy outcome, it requires confirmatory antibody testing at least how many weeks after?
12 weeks after
Pharmacological therapy is recommended for FRAX scores with 10-year risk of major osteoporotic fracture greater than or equal to __% and hip fracture greater than __%
20% for major osteoporotic fracture, 3% for hip fracture
Which ARB is associated with a protein-losing enteropathy?
Olmesartan
This 2020 trial showed that early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions.
EAST-AFNET 4
Name one of the treatments for Hepatitis C AND duration of treatment.
Glecaprevir/pibrentasvir (Mavyret) for 8 weeks or Sofosbuvir/velpatasvir (Epclusa) for 12 weeks
Recheck sustained virologic response after 12 weeks after completion of treatment
What is the first line treatment for mild to moderate rosacea?
topical metronidazole, azelaic acid, or topical ivermectin. The lower cost of metronidazole 0.75% gel favors the initial use of metronidazole
__________ is a selective non-steroidal mineralocorticoid receptor antagonist that slows the progression of diabetic kidney disease with microalbuminemia.
Finerenone
In the 2002 ALLHAT Trial, which medication arm was stopped due to worsening HF exacerbation episodes in patients with heart failure compared to the other therapies?
Doxazosin