Hyperthyroid patients require which specialty consultation even when asymptomatic for that organ system?

Question 1Hyperthyroid patients require which specialty consultation even when asymptomatic for that organ system?

 

Select one:

 

a.Hepatology

 

b.Pulmonary

 

c.Ophthalmology

 

d.Rheumatology

 

Question 2After decades of thyroid supplementation in a patient with TSH at the low end of the range, the patient has increased risk for what?

 

Select one:

 

a.Cataracts

 

b.Osteoporosis

 

c.Cancer

 

d.Dementia

 

Question 3When a patient with hypothyroidism is treated with thyroid replacement, goals would include which of the following?

 

Select one:

 

a.Normal TSH and free T4 levels

 

b.Resolution of fatigue

 

c.Weight loss to baseline

 

d.All of the above

 

Question 4Once a patient who is being treated for hypothyroidism returns to euthyroid with normal TSH levels, how often should he or she be monitored for TSH and free T4 levels?

 

Select one:

 

a.Every two weeks

 

b.Every four weeks

 

c.Every two months

 

d.Every six months

 

Question 5Why are some patients unable to achieve stability on generic forms of Synthroid?

 

Select one:

 

 

 

a.The U.S. Food and Drug Administration (FDA)–allowed tolerance of 20% variance per tablet is a potential issue even with very small dosage changes in this drug family.

 

b.Thyroid patients are sensitive to the food coloration used in the tablets.

 

c.It is a psychosomatic belief that emphasizes the true power of the hypothalamic pituitary adrenal (HPA) axis.

 

d.This only occurs during pregnancy.

 

Question 6What does treatment of a patient with hypothyroidism and cardiovascular disease consist of?

 

Select one:

 

a.Levothyroxine

 

b.Liothyronine

 

c.Liotrix

 

d.Methimazole

 

Question 7A patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic and dizzy. She reports taking her medication that morning and having a bagel and coffee for breakfast. Blood pressure (BP) is 110/70 and random finger-stick glucose is 64. How should this patient be treated?

 

Select one:

 

a.12 oz apple juice with 1 tsp sugar

 

b.10 oz diet soda

 

c.8 oz milk or 4 oz orange juice

 

d.4 cookies and 8 oz chocolate milk

 

Question 8What is effective treatment for pinworms in children?

 

Select one:

 

a.Over-the-counter (OTC) pyrantel pamoate

 

b.Ivermectin

 

c.Itraconazole

 

d.Metronidazole

 

Question 9An 82-year-old patient has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir what will you need to make an assessment of?

 

Select one:

 

a.Complete blood count to rule out anemia

 

b.Liver function

 

c.Renal function

 

d.Immunocompetence

 

Question 10An adult patient presents to the clinic with symptoms of allergic conjunctivitis and is prescribed cromolyn sodium (Opticrom) eye drops. What should the education regarding cromolyn eye drops include?

 

Select one:

 

a.They should not wear soft contacts while using the cromolyn eye drops.

 

b.Cromolyn drops are instilled once a day to prevent allergy symptoms.

 

c.Long-term use may cause glaucoma.

 

d.They may experience bradycardia as an adverse effect.

 

Question 11Which of the following is a common adverse drug reaction of ocular antihistamines (H1 blockers)?  Select one.

 

Select one:

 

a.Dry eyes

 

b.Red eyes

 

c.Increased ocular pressure in the left eye

 

d.Blurred vision

 

Question 12A patient presents to the clinic with hard earwax in both ear canals. What will instructions regarding home removal of hard cerumen include?

 

Select one:

 

a.Moisten a cotton swab (Q-tip) and swab the ear canal twice daily.

 

b.Instill tap water in both ears while bathing.

 

c.Squirt hydrogen peroxide into ears with each bath.

 

d.Instill carbamide peroxide (Debrox) twice daily until canals are clear.

 

Question 13A young adult patient comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, what should the plan of care be?

 

Select one:

 

a.None, wait for the culture results to determine the course of treatment

 

b.Ciprofloxacin (Ciloxan) ophthalmic drops

 

c.Intramuscular (IM) ceftriaxone

 

d.High-dose oral amoxicillin

 

Question 14What does the first-line treatment consideration for managing acute alcohol withdrawal delirium include?

 

Select one:

 

a.Intubation

 

b.Benzodiazepines

 

c.Physical restraints to decrease agitation

 

d.Antipsychotic medications

 

Question 15Serotonin 5 HT receptor agonists should be avoided in which of the following patient populations? Select one.

 

Select one:

 

a.Pregnant patients

 

b.Heart failure patients

 

c.Dialysis patients

 

d.Diabetic patients

 

Question 16Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

 

Select one:

 

a.Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.

 

b.Additive antimuscarinic effects may occur with antihistamines.

 

c.Cholinergic blockers may decrease the sedative effects of hypnotics.

 

d.Cholinergic blockers are contraindicated with antipsychotics.

 

Question 17

 

What may migraines in pregnancy be safely treated with?

 

Select one:

 

a.Acetaminophen

 

b.Sumatriptan (Imitrex)

 

c.Ergotamine tablets (Ergostat)

 

d.Dihydroergotamine (DHE)

 

Question 18When are migraines considered cured?

 

Select one:

 

a.Refills sumatriptan (Imitrex) less than twice per year

 

b.Prophylactic treatment is no longer used.

 

c.Fewer than two migraines per month

 

d.There is no cure for migraines.

 

Question 19When prescribing for migraines, what does patient education include?

 

Select one:

 

a.Triptans are safe to use as often as needed as long as the patient is healthy.

 

b.Use triptan before trying OTC meds such as acetaminophen or naproxen.

 

c.Stress reduction and regular sleep are integral to migraine treatment.

 

d.If migraines worsen, they are to increase their medication.

 

Question 20Which of the following is indicated for the prophylactic treatment of migraine headache?

 

Select one:

 

a.Ibuprofen (Motrin)

 

b.Naproxen sodium (Anaprox)

 

c.Propranolol (Inderal)

 

d.Sumatriptan (Imitrex)

 

Question 21A 16-year-old female who is taking minocycline for acne comes to the clinic complaining of a headache. What would be the appropriate care?

 

Select one:

 

a.Advise acetaminophen or ibuprofen as needed for headaches.

 

b.Prescribe sumatriptan (Imitrex) to be taken at the onset of headache.

 

c.Evaluate her for pseudotumor cerebri.

 

d.Assess her caffeine intake and sleep patterns.

 

Question 22What does nonpharmacologic therapy for tension headaches include?

 

Select one:

 

a.Biofeedback

 

b.Stress management

 

c.Massage therapy

 

d.All of the above

 

Question 23Why are selective estrogen receptor modulators (SERMs) generally not ordered for women early into menopause?

 

Select one:

 

a.The rapid onset of severe hot flashes can be unbearable.

 

b.The bone remodeling effect results in osteoporosis.

 

c.They tend to induce intermittent spotting.

 

d.The increased risk of breast cancer isn’t worth the benefits of a SERM.

 

Question 24When is “menopause” diagnosed?

 

Select one:

 

a.The patient has no menses for 12 months.

 

b.The patient has onset of vasomotor symptoms with irregular menses.

 

c.The patient has no bleeding cycle for six months.

 

d.Precise laboratory values are documented.

 

Question 25Re-examination of the women’s health study has modified guidelines for the use of estrogen in menopause. Which of the following is true?

 

Select one:

 

a.Supplementation for the first five years is considered to have a reasonable risk/benefit profile for selected groups of women.

 

b.Estrogen can once again be given solely for its bone health benefits.

 

c.The risk of deep vein thrombosis (DVT) is not as high as previously thought.

 

d.Supplementation has a great CV benefit if started after the first five years of menopause.

 

Question 26The goals of therapy when prescribing hormone replacement therapy (HRT) include reducing which of the following?

 

Select one:

 

a.Cardiovascular risk

 

b.Risk of stroke or other thromboembolic event

 

c.Risk of breast cancer

 

d.Vasomotor symptoms

 

Question 27Which of the following is not an indication for starting hormone replacement therapy (HRT)?

 

Select one:

 

a.Symptomatic hot flashes

 

b.Treatment or prevention of vaginal atrophy

 

c.Prevention of osteoporosis

 

d.Early surgical menopause

 

Question 28What should postmenopausal women with an intact uterus not be prescribed?

 

Select one:

 

a.An estrogen/progesterone combination

 

b.progesterone alone

 

c.Estrogen alone

 

d.Androgens

 

Question 29An adolescent who admits to a high amount of sexual behavior and is prescribed tenofovir and emtricitabine (Truvada®) pre-exposure prophylaxis (PrEP) should be educated regarding which of the following?

 

Select one:

 

a.A high risk of developing hypertension, requiring a blood pressure check every three months

 

b.The unique dosing schedule of taking the medication just before high-risk activity

 

c.The need for annual HIV and hepatitis B testing

 

d.The possibility of developing kidney problems, requiring monitoring of renal function every six months

 

Question 30An adult female has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. What should education include?

 

Select one:

 

a.Use a back-up method of birth control (condom) until her next menses.

 

b.Doxycycline may cause tendonitis and she should report any joint pain.

 

c.Her partner will need treatment if her infection doesn’t clear with the doxycycline.

 

d.Doxycycline is used for one-dose treatment of sexually transmitted infections (STIs); take the whole prescription at once.

 

Question 31Besides being prescribed antimicrobial therapy, patients with bacterial vaginosis require education regarding which of the following?

 

Select one:

 

a.The most recent partners in the past 60 days should also be treated.

 

b.Alcohol should not be consumed during and for 72 hours after metronidazole therapy.

 

c.Condoms should be used during intercourse if intravaginal clindamycin cream is used.

 

d.Cotreatment for chlamydia is necessary.

 

Question 32Genital yeast infections are increased with which of the following?

 

Select one:

 

a.GLP-1 therapies

 

b.SGLT-2 therapies

 

c.Amylin-based treatment

 

d.Weekly noninsulin-based therapies

 

Question 33The goals of treatment when prescribing for sexually transmitted infections include which of the following?

 

Select one:

 

a.Treatment of infection

 

b.Prevention of disease spread

 

c.Prevention of long-term sequelae from the infection

 

d.All of the above

 

Question 34When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include which of the following?

 

Select one:

 

a.Metronidazole is safe in the first trimester of pregnancy.

 

b.Consuming alcohol in any form may cause a severe reaction.

 

c.Sexual partners need concurrent therapy.

 

d.Headaches are a sign of a serious adverse reaction and need immediate evaluation.

 

Question 35A 14-year-old female who is sexually active is brought in by her mother for an immunization update. According to the mother, her daughter had one dose of hepatitis B vaccine. Which of the following vaccines would you administer at this visit?

 

Select one:

 

a.Tetanus & Diphtheria (TD) and hepatitis B

 

b.DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B

 

c.Hepatitis B only

 

d.MMR (measles, mumps, rubella) and TD

 

Question 36A 24-year-old female patient is 32 weeks pregnant and has tested positive for syphilis. The best treatment for her would be which of the following?

 

Select one:

 

a.IM ceftriaxone

 

b.IM benzathine penicillin G

 

c.Oral azithromycin

 

d.Any of the above

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