HP1
A lung condition characterized by wheezing lung sounds.
Asthma or COPD
Typically used to treat asthma (used through a nebulizer or inhaler)
Albuterol
Bonus 200 points - if you can name Albuterol Brands
What are the "good" and "bad" types of cholesterol?
good - HDL (H want to be HIGH)
bad - LDL (L want to be LOW)
Cellulitis with fluctuance.
Abscess
Normal visual acuity in children ages 5-6 years
20/30 or better
Which statement is correct about CVD treatment?
A. antihypertensive medications are the most effective when taken at bedtime
B. a treat to target approach to statin therapy is superior to a fixed dose strategy in adults with CAD
C. ambulatory blood pressure monitoring is better than office measurements in predicting mortality
D. Vitamin K antagonists have a net clinical benefit than DOACS in older adults with A Fib.
C. ambulatory blood pressure monitoring is better than office measurements in predicting mortality
A 34-year-old patient with a 20-pack-year smoking history reports loss of smell. Which one of the following statements applies to this patient?
A. Even if they quit, their sense of smell will not return to normal.
B. Vascular injury has been identified as the major mechanism of loss of smell in patients who smoke.
C. Some evidence suggests that the patient’s spouse may lose their sense of smell from secondhand smoke.
D. The effects of secondhand smoke on children’s sense of smell have not been studied.
C. Some evidence suggests that the patient’s spouse may lose their sense of smell from secondhand smoke.
After smoking cessation, olfactory function takes 15 years to return to levels consistent with nonsmokers. The mechanisms by which smoking affects olfaction have not been definitively identified. The effect of secondhand smoke exposure on olfactory function is inconsistent; however, a prospective, case-control study comparing olfactory function in adults younger than 65 years found that it was similarly worse in people who smoke and people passively exposed to smoke compared with nonsmokers without passive exposure. A cross-sectional analysis of 201 children six to 11 years of age showed no difference in olfaction among those with or without parents who smoke.
Which one of the following medications is an effective adjunctive therapy to assist with benzodiazepine tapering? (check one)
A. Lithium.
B. Melatonin.
C. Buspirone.
D. Tricyclic antidepressants.
D. Tricyclic antidepressants
A reduction in withdrawal symptoms using the Physician Withdrawal Checklist questionnaire (0 to 60 points) was shown with tricyclic antidepressants, paroxetine, carbamazepine, and pregabalin
A 27-year-old patient (gravida 2, para 1) with a history of polycystic ovary syndrome presents for her initial prenatal visit at nine weeks of gestation. Her first pregnancy was complicated only by pregnancy-induced hypertension diagnosed at 34 weeks of gestation, and a healthy 3,830-g infant was born via cesarean delivery at 38 weeks of gestation. The patient has normal blood pressure and a body mass index of 27 kg per m2. Which one of the following is a risk factor suggesting that early screening for gestational diabetes mellitus (GDM) should be performed in this patient?
A. Delivery of an infant weighing more than 3,800 g.
B. Cesarean delivery.
C. Preterm delivery at 38 weeks.
D. Polycystic ovary syndrome.
D. Polycystic ovary syndrome.
Screening for preexisting and early-onset GDM should be considered at the initiation of pregnancy care in patients who are overweight or obese and have one additional diabetes risk factor. Risk factors include polycystic ovary syndrome, history of delivering a macrosomic infant weighing more than 4,000 g, hypertension, morbid obesity, and past GDM.
A well-appearing, full-term newborn is noted to have scattered, small, pustular lesions on the face, trunk, and extremities at the third day of life. The lesions have a red base and do not appear in groups or on the palms and soles. Which one of the following is the most likely diagnosis?
A. Congenital syphilis.
B. Erythema toxicum neonatorum (ETN)
C. Herpes simplex virus infection.
D. Transient neonatal pustular melanosis.
B. Erythema toxicum neonatorum (ETN)
A rash with scattered, small pustules that do not appear in groups is most likely erythema toxicum neonatorum. It affects approximately one-half of newborns. The lesions can increase concern for herpes simplex virus infection or congenital syphilis, but the well-appearing newborn and the characteristics of the rash distinguish erythema toxicum neonatorum from herpes simplex. The sparing of the palms and soles distinguishes the rash from syphilis. Transient neonatal pustular melanosis also features pustules but can affect the palms and soles and often presents with pigmented macules from ruptured pustules.
A 33-year-old pregnant patient has a blood pressure of 153/90 mm Hg during a routine appointment at 32 weeks’ gestation. She has not had elevated blood pressure at any previous appointments. The patient does not have a headache, vision changes, or right upper quadrant pain, and laboratory test results are within normal limits. Which one of the following medications is most appropriate for this patient?
A. Hydrochlorothiazide.
B. Labetalol.
C. Nifedipine.
D. No medication.
D. No medication
An initial blood pressure greater than 140/90 mm Hg and less than 160/110 mm Hg at 32 weeks’ gestation indicates that this patient has gestational hypertension or preeclampsia. Because she has no symptoms and test results are normal, she is diagnosed with gestational hypertension, which does not require treatment. If the patient’s blood pressure had been 160/110 mm Hg or greater, preeclampsia with severe features would be the diagnosis; in that case, it would be treated with nifedipine or labetalol. Hydrochlorothiazide would be an appropriate second-line treatment for chronic hypertension during pregnancy, especially if the patient had been taking it before pregnancy.
Which one of the following statements about endometriosis is correct?
A. Fatigue is the most commonly reported symptom.
B. A menstrual cycle of less than 24 days is a risk factor for endometriosis.
C. Endometriosis has little effect on home or work productivity and absenteeism.
D. Endometriosis is associated with a lower risk of ovarian cancer.
B. A menstrual cycle of less than 24 days is a risk factor for endometriosis.
The most commonly reported symptoms of endometriosis are painful periods (62%), heavy/irregular bleeding (51%), and pelvic pain (37%). Endometriosis is more common in people with onset of menarche before 12 years of age, menstrual cycles of less than 24 days, lower parity, and lower lean body weight. The effect of endometriosis on home or work productivity and absenteeism can be substantial, with the average patient losing more than 10 hours of weekly productivity. Endometriosis is linked to a higher risk of ovarian cancer.
A. Azithromycin for 3 weeks
B. Doxycyline for 3 weeks
C. Ciprofloxacin for 4 weeks
D. Bactrim for 4 weeks.
C. Ciprofloxacin for 4 weeks
fluoroquinolones are first line in chronic bacterial prostatitis
bactrim/doxy can be used but would need 6 weeks therapy
A 61-year-old healthy patient with no active medical diagnoses is admitted to the hospital with persistent hematochezia. The patient’s blood pressure is stable at 125/85 mm Hg, with a heart rate of 90 beats per minute. According to the American College of Gastroenterology, which one of the following evaluation plans is most appropriate for this patient?
A. Immediate computed tomography (CT) angiography.
B. CT angiography, with colonoscopy in 24 hours.
C. Colonoscopy in 14 days.
D. Colonoscopy or CT is not needed if the patient has had a colonoscopy in the past five years.
C. Colonoscopy in 14 days.
Emergent CT angiography is recommended as first line in patients with hemodynamically significant bleeding. This patient is hemodynamically stable, and colonoscopy is recommended. Routinely performing CT angiography before colonoscopy does not improve mortality. Completing the colonoscopy in the first 14 days has similar outcomes to performing in the first 24 hours. Patients who have had a colonoscopy in the past 12 months may not need repeat testing if bleeding has subsided and a suspected bleeding source, such as diverticulosis, was identified on the prior examination.
According to the American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines, which one of the following statements about the management of abnormal cervical cancer screenings is correct?
A. Colposcopy is recommended following any abnormal cervical cancer screening.
B. Repeat testing with human papillomavirus (HPV) and cervical cytology is recommended following any abnormal cervical cytology.
C. Recommendations for colposcopy and treatment are based on a patient’s immediate risk of cervical intraepithelial neoplasia grade 3 or higher (CIN3+).
D. Long-term surveillance is based on a patient’s immediate risk of CIN3+.
C. Recommendations for colposcopy and treatment are based on a patient’s immediate risk of cervical intraepithelial neoplasia grade 3 or higher (CIN3+).
The ASCCP guidelines recommend starting with an assessment to determine the immediate risk of developing CIN3+ to determine the appropriate management strategy. Those with a risk of 4% or greater immediate risk are triaged to colposcopy or expedited treatment depending on their level of risk, whereas patients with a risk of less than 4% are triaged to follow-up HPV-based testing at one, three, or five years depending on their five-year risk of developing CIN3+.
A 47-year-old man has had low back pain for the past 13 weeks. He reports that it feels much better when he is lying down. History reveals no red flags, and physical examination, including checking for neuromuscular deficits, identifies no abnormalities. Which one of the following would be an appropriate first step in the management of this patient’s low back pain?
A. Obtain plain film radiography of the lumbar spine.
B. Begin a trial of ibuprofen.
C. Recommend intermittent periods of bed rest.
D. Recommend a home exercise program and physical therapy.
D. Recommend a home exercise program and physical therapy.
Nonpharmacologic treatments are the first-line management choice for chronic low back pain. Exercise therapy is beneficial in the primary prevention of chronic low back pain and improves symptoms. Routine imaging is not recommended without clinical indications. Bed rest should be avoided. Medications should be considered second-line therapy for chronic low back pain.
Which of the following statements of treating Carpal Tunnel Syndrome is true?
A. Splints are most effective when worn 24 hours a day
B. Symptom relief from splints typically occurs within 1 week
C. NSAIDS can be helpful for short term pain relief
D. Local corticosteroid injections provide relief and decrease the need for surgery 1 year after injection.
D. Local corticosteroid injections provide relief and decrease the need for surgery 1 year after injection.
Which of the following is correct statement regarding infections?
A. Paxlovid reduced hospitalizations and deaths from COVID19 in the Omicron phase of the pandemic.
B. A lower leukocyte cutoff should be used to define pyuria in older women
C. A 4-week course of Terbinafine is the best treatment for toenail fungus?
D. Antitussives, honey and anticholinergics all reduce cough more than placebo in patient with acute cough
A. Paxlovid reduced hospitalizations and deaths from COVID19 in the Omicron phase of the pandemic.
Which one of the following tongue conditions is potentially malignant?
A. black hairy tongue
B. geographic tongue
C. median rhomboid glossitis
D. erythroplakia
D. erythroplakia
Black hairy tongue, geographic tongue, and median rhomboid glossitis are benign lesions; erythroplakia may progress to oral cancer and should be biopsied.
Which one of the following statements about diabetic peripheral neuropathy is correct? (check one)
A. Glycemic control does not influence the risk of diabetic peripheral neuropathy in patients with type 1 diabetes mellitus.
B. Patients taking metformin should be checked for vitamin B12 deficiency.
C. Monofilament testing is more than 95% sensitive for diabetic peripheral neuropathy.
D. After diabetic peripheral neuropathy begins, tobacco cessation has no effect on the clinical course.
B. Patients taking metformin should be checked for vitamin B12 deficiency.
Individuals with absorption issues, autoimmune disease, or strict vegetarian diets or those taking metformin should have B12 levels measured when symptoms of neuropathy develop to rule out a vitamin deficiency, which can lead to symptoms and a possible misdiagnosis of diabetic peripheral neuropathy. In patients with type 1 diabetes, intensive glycemic control with an A1C goal of approximately 7% reduces the risk of symptomatic neuropathy by up to 60%. The American Diabetes Association Diabetes Standard of Care Guidelines recommend diabetic peripheral neuropathy screening with monofilament testing, but this practice has poor sensitivity for detecting peripheral neuropathy. Tobacco cessation should be a priority to slow the progression of neuropathy and to reduce other complications of diabetes.
Which one of the following treatments is potentially useful in all stages of pancreatic cancer?
A. Systemic chemotherapy.
B. Surgical resection.
C. Radiation therapy.
D. Antioxidants, such as vitamin E.
A. Systemic chemotherapy.
Treatment depends on the stage of pancreatic cancer at the time of diagnosis, which identifies patients for whom surgery and curative intent are possible. Systemic chemotherapy is used in all stages of pancreatic cancer and can be given before or after surgery. Trials of radiation therapy demonstrated no survival benefit, although there is a role for radiation in palliation. There is no evidence that antioxidants are effective, and they may be harmful.
Your patient presents with symptoms of periodic bloating, heartburn, and stomach pain; you diagnose them with functional dyspepsia. Which one of the following statements about functional dyspepsia is correct?
A. STW 5 (Iberogast), peppermint plus caraway oil, and turmeric (Curcuma longa) may be effective in improving symptoms of functional dyspepsia.
B. Herbal medicines such as STW 5, peppermint plus caraway oil, and turmeric are not associated with an increase in adverse events.
C. The American College of Gastroenterology clinical guideline suggests considering the use of herbal medicine for treatment of functional dyspepsia.
D. All of the above.
D. All of the above.
Functional dyspepsia is characterized by one or more of the following Rome IV criteria: postprandial fullness, early satiety, epigastric pain, and epigastric burning. Functional dyspepsia can be treated with antacids, antidepressants, and other prescription products. Several herbal products, to include STW 5, peppermint plus caraway oil, and turmeric, have been shown to improve symptoms without significant adverse effects. The current American College of Gastroenterology guideline states that herbal medicines may be effective and their use can be suggested.
Puss-like.
purulence!
a 30-year old comes in for severe atopic dermatitis that is in remission currently. Which one of the following is recommended by the American Academy/College of Allergy/Asthma/Immunology for this patient?
A. Eucrisa (Crisaborole) 2% ointment - a topical phosphodiesterase
B. Tacrolimus 0.1% - a topical calcineurin inhibitor
C. Opzelura (Ruxolitinib) 1.5% - a topical Janus kinase inhibitor
D. Oral prednisone - systemic steroids
B. Tacrolimus 0.1% - a topical calcineurin inhibitor
are effective as continued intermittent treatment and maintenance therapy for uncontrolled atopic dermatitis
Which one of the following statements about the management of DKA in children is correct?
A. In the absence of shock, 1 L of 0.9% normal saline should be administered over 15 minutes.
B. Administer insulin at 0.05 to 0.1 unit/kg per hour if no hypokalemia is present, beginning 1 to 2 hours after fluid initiation.
C. Glucose should not be added to intravenous fluids.
D. Chest radiography and urine and blood cultures should be ordered routinely.
B. Administer insulin at 0.05 to 0.1 unit/kg per hour if no hypokalemia is present, beginning 1 to 2 hours after fluid initiation.
In the absence of shock, 10 mL/kg of 0.9% normal saline should be given over 30 minutes. Insulin replacement should begin 1 to 2 hours after fluid replacement at a rate of 0.05 to 0.1 unit/kg per hour. Glucose should be added when blood glucose drops to less than 250 mg/dL so that insulin therapy can continue to help resolve the underlying diabetic ketoacidosis. Chest radiography and urine and blood cultures are needed only if pneumonia or a urinary infection is suspected clinically.