How can I breathe with no air!
Tearing up my heart
You drive me crazy!
Killing me softly
I'll take you to the candy shop..
100
32 y.o female who has not seen a doctor in 10 years comes in for albuterol refills for her asthma. She uses it 1-2 times a month. What do you do next?
Switch her to ICS/LABA prn
100
Name another song by this artist/band
It's gonna be me..
Bye Bye Bye
I want you back
This I promise you
100
What should you rule out when you see a CC of dementia/cognitive impairment?
Depression; Anemia; Thyroid Disease; Syphillis
100
What is the appropriate time frame to responding to URGENT TEs?
24 hrs
100
According to the ADA and AACE, what is the LDL goal for diabetics
<70
200
The FEV1/FVC ratio for COPD
<70%
200
60 y.o M with afib on warfarin 5 mg daily comes in with an INR of 3.2. What do you do next? When do they come back?
Decrease weekly dose by 5-10% and return in 1 week
200
What is the most common SE reported from SSRIs?
Sexual Dysfunction
200
What would you eRx if you are starting a patient on Ozempic 0.25 mg and you will titrate up after 4 weeks but your patient wants a 90 day supply?
Three 2mg/3ml pens (you will have 1 mg extra)
200
70 y.o male patient with a h/o Hashimoto's on Synthroid 88 mcg presents for routine follow up with no acute concerns. Pertinent labs include a TSH of 5.5 (N 0.465 - 4.68). What do you do next?
Continue current medication
300
What does SMART stand for?
Single Maintenance and Reliever Therapy for asthma
300
65 y.o male with h/o CAD s/p 2 PCIs and HFpEF and T2DM with an A1c of 7.2% should be on which medications? Name 4
ASA
Bblocker
Statin
SGLT2i
300
Which SSRI needs a washout at higher doses?
Fluoxetine
300
What is the correct order to diagnose Syphillis in our system?
RPR rflx to Qnt RPR/TP-PA
300
62 y.o F with HTN, CAD, Medullary Thyroid Cancer s/p resection, HFpEF, T2DM w/ A1c of 8.5% currently on metformin and a BMI of 42. What medication do you add next?
SGLT2i
400
Per new 2023 GOLD guidelines, a patient with COPD who has 1 exacerbation per year and gets dyspnea with strenuous exercise should be on what class of medication?
A bronchodilator
400
2nd degree Mobitz type 1
- Progressive prolongation of PR interval, with a subsequent non-conducted P wave
- Repeating 5:4 conduction ratio of P waves to QRS complexes
- Relatively constant P-P interval despite irregularity of QRS complexes
400
How do you taper down Cholinesterase inhibitors?
Tapering dose every 4 weeks and close cognitive monitoring. If changes including agitation, aggression, hallucinations occur 1 week after tapering – restart initial dosing and then once stable taper even more gradually. If changes occur about 2 to 6 weeks later – it might have been providing benefit.
400
What is the appropriate hormonal birth control for migraines with aura?
IUD, nexplanon, norethindrone, or Slynd
400
Per AACE Guidelines, which medication beside GLP1-RA should be considered for patients with a history of stroke or TIA.
Pioglitazone
500
Per GOLD Guidelines, what combination therapy is recommended for escalation from LABA + LAMA therapy in non-smokers if eos < 100, FEV1 < 50%, and chronic bronchitis.?
Roflumilast
500
This pressor has more beta activity and very little alpha activity
Dobutamine
500
Patient is a 52-year-old female presenting to the ER with confusion, agitation, delirium, tachycardia, and hypertonia. Patient has a past medical history of diabetes, hypothyroidism, hypertension, and bipolar disorder. Current medications include acetaminophen, Ozempic, metformin, levothyroxine, lisinopril/HCTZ, lithium, and divalproex. What drug-drug interaction is likely causing this patient’s presentation?
Lithium-lisinopril/hctz
500
35 year old female with no med hx presents for routine physical. Normal vitals, normal BMI, normal PAP 2 years ago. Family hx of parkinson's and RA. These are the labs you can reasonably expect to be covered as screening by her state BCBS plan
CBC, CMP (lipids is Grade C for her so possibly not covered by a restrictive plan bc she does not have inc risk of CAD)
500
According to the ADA 2023 guidelines, what drug do you use for diabetic CKD with persistent albuminuria despite being on an ACEi/ARB and SGLT2i
Finerenone