Headaches
Final jeopardy
Nicotine /abuse
Fibromyalgia
Potpourri
100

Which of the following oral agents has the most rapid analgesic onset?

A. naproxen

B. liquid ibuprofen

C. Immediate release diclofenac (voltaren)

D. Enteric coated naproxen 

B. liquid ibuprofen

100

The FDA approved pharmacological intervention for tobacco use

A. makes little difference in smoking rates

B. reliably increases long-term smoking abstinence rates

C. is helpful but not tolerated

D. poses a greater risk to health then continued tobacco

reliably increases long-term smoking abstinence rates

100

Fibromyalgia is caused by

A. increased production of serotonin

B. an autoimmune reaction following an infection

C. a genetic autoimmune disorder targeting neuronal axons

D. biochemical changes in the CNS

D. biochemical changes in the CNS

100

Limitations with the use of batalbital with acetaminophen and caffeine (Fiorecet) include

A. energizing effect

B. GI upset

C. high rate of rebound headache if used frequently

D. low clinical efficacy 

C. high rate of rebound headache if used frequently

200

Triptans should be used in caution with the concomitant use of

A. high dose SSRI

B. CCB

C. high dose statin

D. fluoroquinolones 

A. high dose SSRI  work as seritonin agonist allowing for increased uptake

200

A 48 yo started Chantix 4 weeks ago for smoking cessation. Which of the following is the most important question to ask during today's visit

A. How many cigarettes a day are you smoking?

B. On a scale of 0-10 how strong is your desire to smoke

C. Have you noticed any changes in your mood?

D. Are you having any trouble sleeping?

C. Have you noticed any changes in your mood?

200

Analgesics approaches used in management of fibromyalgia include all except.

A. acetaminophen

B. NSAIDs

C. fentanyl patch

D. topical capsaicin 

C. fentanyl patch

200

Among the following beta-blockers, which is preferred for preventing migraine headache in a 40 woman with history of tubal ligation and no airway disease.

A. acebutolol

B. carvedilol

C. atenolol

D. propranolol

D. propranolol

300

Which of the following statements about ergotamines is false

A. effectively treats tension type headaches

B. They act as 5-HT 1a and 5-HT 1d receptor agents

C. carries a potential vasoconstrictor effect

D. use should be avoided in presence of CAD

A. effectively treats tension type headaches

300

Administration of naloxone or naltrexone causes immediate withdrawal from opiod toxicity 

True

False

True

300

Each of the following medications is FDA approved for fibromyalgia treatment except

A. duloxetine (Cymbalta)

B. pregabalin (Lyrica)
C. phenytoin (Dilantin)

D. milnacipran (Savella)

C. phenytoin (Dilantin)

300

A 65 yo male has history of acute coronary syndrome and migraine. Which of the following is the best choice for abortive therapy. 

A. verapamil

B. ergotamine

C. acetaminophen

D. sumatriptan


C. acetaminophen

400

With appropriate prophylactic headache therapy, the patient should be informed to expect

A. virtual resolution of headaches

B. no fewer but less severe headache

C. approx 50% reduction in the # of headaches

D. that lifelong therapy is advised

C. approx 50% reduction in the # of headaches

400

You have to be a medical provider to carry naloxone

True

False

False

400

Tricyclic antidepressants, antiepileptics and SSRI's are all drug classes used to treat symptoms associated with fibromyalgia

True or False

True

400

When considering the use of muscle relaxants for treatment of low back pain in a 46 yo construction worker, the NP advises all except

A. these agents have abuse potential

B. have to be used for at least 2 weeks for peak effect

C. use at night can improve sleep\

D. caution with operating heavy machinery 

B. have to be used for at least 2 weeks for peak effect

500

A first line prophylactic treatment option for the prevention of tension type headache is

A. nortriptyline

B. verapamil

C. carbamazepine

D. valproate

A. nortriptyline

500

I found this activity to be ( no wrong answer)

helpful

not so helpful 

would have rather had a lecture 

Whatever they said! 

500

The use of Opioids during pregnancy can cause this effect to the fetus

A. SIDS

B. neurobehavioral disorders

C. neonatal abstinence syndrome

D. abnormal facial features 

C. neonatal abstinence syndrome

Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone.

  • Fussiness, excessive crying or having a high-pitched cry.
  • Poor feeding or sucking or slow weight gain.
  • Breathing problems, including breathing really fast.
  • Fever, sweating or blotchy skin.
500

Patients with fibromyalgia should be encouraged to do all the following except

A. high-intensity aerobic activities

B. limit caffeine use

C. utilize stress management techniques

D. Light yoga 

A. high-intensity aerobic activities

500

Use the 2mg  nicotine gum/lozenge:

If you smoke your 1st cigarette of the day within 30 minutes of waking

True or False

False 4mg