FNP Board Review Questions And Answers Verified And Updated.

FNP Board Review Questions And Answers Verified And Updated. A m24-year mold, motherwise mhealthy mcollege mstudent mpresents mwith mc/o mcough mx m6 mweeks. mShe mhas mtried mseveral mOTC mcough mmeds mwith mno mimprovement. mWhat mis mthe mmost mimportant minformation mto mconsider mwhen mbuilding myour mdifferential mdiagnoses? A) mHer mage B) mFamily mhx C) mIneffectiveness mof mOTC mcough mmedicines D) mLength mof mtime mshe mhas mbeen mcoughing m- m m m mcorrect manswer.D) mLength mof mtime mshe mhas mbeen mcoughing Why? mThis minformation mhelps myou mbuild myour mddx m Acute mcough m m3 mweeks: mbronchitis, msinusitis, mPND, mexacerbation mof mCOPD/asthma, mpneumonia, mpulmonary membolism Chronic mcough m(8 mweeks) mGERD mand mAsthma mare mmost mcommon mcauses, malso mconsider minfection m(e.g. mpertussis, matypical mpneumonia), mACE minhibitors, mchronic mbronchitis, mbronchiectasis, mlung mca) According mto mthe mCDC, mwhat mdrug mclass mis mconsidered mfirst-line mtreatment mfor mpertussis? A) mSulfonamide B) mTetracycline C) mMacrolide D) mBeta-lactam m- m m m mcorrect manswer.C) mMacrolide mantiobitic m(e.g. mAzithromycin, mclarithromycin Sulfonamides mare msecond-line Match mthe mantibiotics mwith mthe mcorrect mdrug mclass: 1. mSulfonamide 2. mTetracycline 3. mMacrolide 4. mBeta-lactam A. mDoxycyline B. mAzithromycin C. mPenicillins D.Trimethoprim-Sulfamethoxazole E. mCephalosporin F. mClarithromycin m- m m m mcorrect manswer.1. mSulfonamide m- mD.Trimethoprim-Sulfamethoxazole m(Bactrim) 2. mTetracycline m- mA. mDoxycycline 3. mMacrolide m- mB m& mF, mAzithromycin mand mClarithromycin 4. mBeta-lactam m- mC m& mE, mPCN mand mcephalosporins What mare mthe mthree mmost mcommon mbugs min mcommunity-acquired mpneumonia? m- m m m mcorrect manswer.Streptococcus mpneumoniae Mycoplasma mpneuomiae m(atypical mpathogen) Chlamydophila mpneumoniae m(atypical mpathogen) What mis mthe mtreatment mfor mCAP mcaused mby mStrep mpneumo? m- m m m mcorrect manswer.Respiratory mquinolone m(e.g. mLevofloxacin, mmoxifloxacin, mgemifloxacin) mOR mhigh-dose mamoxicillin mOR mamoxicillin mwith mclavulanate What mantibiotics mare mavoided min mCAP mcaused mby mStrep mpneumo mdue mto mhigh mrates mof mresistance? m- m m m mcorrect manswer.Macrolides What mis mthe mtreatment mfor mCAP mcaused mby mMycoplasma mpneumoniae? m- m m m mcorrect manswer.Macrolide mOR mdoxycycline What mantibiotics mare mavoided min mCAP mcaused mby matypical mpathogens? m- m m m mcorrect manswer.Beta-lactams m(ineffective) A m38-year mold mmother mof mtwo mteenagers mrecently mrecovered mfrom mMycoplasma mpneumonia ma mcouple mof mweeks mago. mShe masks mif mshe mshould mget mthe m"pneumonia mshot." mShe mtakes mlevothyroxine m88 mmcg mdaily mfor mhypothyroidism, mbut mis motherwise mhealthy. mHow mdo myou mrespond? A) mNo, mit's mtoo msoon mafter myour minfection B) mNo, mit's mnot mindicated C) mYes, myou mcan mget mit min mabout ma mmonth D) mYes myou mcan mget mit mtoday m- m m m mcorrect manswer.B) mNo, mit's mnot mindicated m An motherwise mhealthy madult mwithout mimmunocompromise mor mmultiple mcomorbid mconditions mis mnot ma m"vulnerable mpopulation" m The mpneumonia mvaccine mdoes mnot mprevent mmycoplasma mpneumonia According mto mGOLD, mwhat mis mrequired mto mestablish mthe mdiagnosis mof mCOPD? m- m m m mcorrect manswer.Spirometry m(FEV1/FVC mratio m m70%) A m70-year mold mhouse mpainter mreports ma m4-week mhistory mof mexertional mdyspnea, mchest mtightness, mand mcough mfor mthe mpast m3 mmonths. mHe mhas mnever msmoked. mWhat mdiagnoses mare mincluded min myour mdifferential? mSelect m4. A) mAsthma B) mAngina C) mCOPD D) mGERD E) mPneumonia F) mTuberculosis G) mHeart mFailure m- m m m mcorrect manswer.B) mAngina C) mCOPD F) mTuberculosis G) mHeart mfailure How mdo minhaled manticholinergics mwork mto mtreat mshortness mof mbreath min mCOPD? A) mThey mcause mbronchodilation min mthe mlungs B) mThey mblock mthe maction mof macetylcholine mand mprevent mbronchoconstriction m- m m m mcorrect manswer.B) mThey mblock mthe maction mof macetylcholine mand mprevent mbronchconstriction Name ma mshort-acting minhaled manticholinergic: m- m m m mcorrect manswer.Ipratropium m(Atrovent) Name ma mlong-acting minhaled manticholinergic: m- m m m mcorrect manswer.Tiotropium m(Spiriva) How mdo minhaled mbetá-agonists mwork mto mtreat mshortness mof mbreath min mCOPD? A) mThey mcause mbronchodilation min mthe mlungs B) mThey mblock mthe maction mof macetylcholine mand mprevent mbronchoconstriction m- m m m mcorrect manswer.A) mThey mcause mbronchodilation min mthe mlungs What mare mthe monly m2 minhaled mshort-acting mbeta magonists m(SABAs): m- m m m mcorrect manswer.Albuterol mand mlevalbuterol Name man minhaled mlong-acting mbeta magonists m(LABAs): m- m m m mcorrect manswer.Salmeterol m(Serevent) What mare mthe mside meffects massociated mwith manticholinergic mmedications? m- m m m mcorrect manswer.Cognitive mimpairment, mconfusion, mhallucinations, mdry mmouth, mblurry mvision, murinary mretention, mconstipation, mtachycardia, macute mangle mglaucoma "Can't msee, mcan't mpee, mcan't mspit, mcan't mshit." Name ma minhaled mcombined mshort-acting manticholinergic/short-acting mbeta magonist: m- m m m mcorrect manswer.Ipratropium/albuterol m(Combivent) Name ma minhaled mcombined mlong-acting mbeta-agonist/corticosteroid m- m m m mcorrect manswer.Fluticasone/salmeterol m(Advair) Fluticasone/vilanterol m(Breo) Budesonide/formoterol m(Symbicort) Mometasone/frmoterol m(Dulera) Name man minhaled msteroid: m- m m m mcorrect manswer.Fluticasone m(Flovent) Budesonide m(Pulmicort) Mometasone m(Asmanex) Put mthe mfollowing min mthe mcorrect morder mfor mCOPD mprescribing mstrategy: A) mLong-acting manticholinergic mor mLABA, mplus mrescue mmed B) mInhaled mcorticosteroid m+LABA mor mLA manticholinergic, mplus mrescue mmed C) mShort-acting manticholinergic mor mSABA mPRN D) mInhaled mcorticosteroid m+LABA mand/or mLA manticholinergic, mplus mrescue mmed m- m m m mcorrect manswer.C, mA, mB, mD 1. mShort-acting manticholinergic mor mSABA mPRN THEN 2. mLong-acting manticholinergic mor mLABA, mplus mrescue mmed THEN 3. mInhaled mcorticosteroid m+LABA mor mLA manticholinergic, mplus mrescue mmed THEN 4. mInhaled mcorticosteroid m+LABA mand/or mLA manticholinergic, mplus mrescue mmed There mis mgood mevidence min msupport mof moral msteroids mfor mCOPD mexacerbations mto mshorten mrecovery mtime mand mimprove mlung mfunction. mWhat mis mthe mcorrect mrecommended mdose? A) mMedrol mdose-pack B) m10-day mcourse mof mPrednisone m20 mmg, mfollowed mby ma mtaper C) m5-day mcourse mof mPrednisone m40 mmg m- m m m mcorrect manswer.C) m5-day mcourse mof mPrednisone m40 mmg Chronic muse mshould mbe mavoided m- massociated mwith man munfavorable mrisk-to-benefit mratio A mpatient mwith masthma msymptoms mdaily mwith moccasional mnighttime mawakenings mhas A) mIntermittent masthma B) mMild mpersistent masthma C) mModerate mpersistent masthma D) mSevere mpersistent masthma m- m m m mcorrect manswer.C) mModerate mpersistent masthma A mpatient mwith masthma msymptoms mmore mthan mtwice ma mweek, mbut mnot mdaily mwith moccasional mnighttime mawakenings mhas A) mIntermittent masthma B) mMild mpersistent masthma C) mModerate mpersistent masthma D) mSevere mpersistent masthma m- m m m mcorrect manswer.B) mMild mpersistent masthma A mpatient mwith masthma msymptoms mless mthan mtwice ma mweek mhas A) mIntermittent masthma B) mMild mpersistent masthma C) mModerate mpersistent masthma D) mSevere mpersistent masthma m- m m m mcorrect manswer.A) mIntermittent masthma A mpatient mwith masthma msymptoms mmultiple mtimes mthroughout mthe mday mand mnighttime mawakenings mon mmost mnights mof mthe mweek mhas A) mIntermittent masthma B) mMild mpersistent masthma C) mModerate mpersistent masthma D) mSevere mpersistent masthma m- m m m mcorrect manswer.D) mSevere mpersistent masthma What mare mthe mmost mcommon mside meffects mof mlong-term minhaled msteroid muse? A) mOsteoporosis mand mGERD B) mCataracts mand mosteopenia C) mHyperkalemia mand mdiabetes D) mHypertension mand mdiabetes m- m m m mcorrect manswer.B) mCataracts mand mosteopenia What mmedication mcombination mis mconsidered munsafe min ma mpatient mwith masthma? A) mFluticasone mand malbuterol B) mMometasone, mformoterol, malbuterol C) mBudesonide mand mlevalbuterol D) mSalmeterol mand mlevalbuterol Why? m- m m m mcorrect manswer.D) mSalmeterol mand mlevalbuterol Salmeterol mis ma mlong-acting mbeta magonist. mLABAs mMUST mbe mcombined mwith man minhaled mcorticosteroid m(e.g. mAdvair, mBreo, mSymbicort) A m30-year mold mmale mhas mpersistent masthma. mWhat mdaily mmedication mregimen mwould mbe mappropriate? A) mAlbuterol B) mLow-dose mfluticasone, malbuterol C) mMedium-dose mfluticasone D) mBudseonide, msalmeterol, malbuterol m- m m m mcorrect manswer.C) mMedium-dose mfluticasone Albuterol malone mis mused mfor mintermittent masthma mAlbuterol mshould mnot mbe mused mdaily m(if mthe mpatient mis musing mtheir mrescue minhaler mmore mthan mtwice ma mweek m-- mcall mthe mPCM!) Mr. mJones, ma m45-year mold mdrug mand malcohol mcounselor, msmokes m1 mPPD mand mc/o mcough, mlow-grade mfever, mand mnight msweats mfor mthe mlast mweek. mHis mCXR mshow mbilateral mhilar mnodes. mWhat mshould myou mdo mnext? A) mRefer mto mPulmonology B) mOrder ma mchest mCT mwith mcontrast C) mOrder ma mTB mskin mtest D) mRepeat mthe mCXR min m2 mweeks m- m m m mcorrect manswer.C) mOrder ma mTB mskin mtest A mpatient mwho mtakes mfosinopril mfor mHTN mhas mbeen mdiagnosed mwith mACE-inhibitor mcough. mWhich mof mthe mfollowing mstatements mis mtrue? A) mHe mcould mswitch mto mlisinopril B) mThis mcough mis mmore mlikely min mpatients mwith mlower mairway mdisease C) mHis mcough mshould mimprove mover mtime D) mThe mcough mis mrelated mto man minability mto mbreak mdown mbradykinin m- m m m mcorrect manswer.D) mThe mcough mis mrelated mto man minability mto mbreak mdown mbradykinin A m19-year mold mcollege mstudent m(otherwise mhealthy, mnonsmoker) mwas mdiagnosed mwith mcommunity-acquired mpneumonia mby mCXR ma mcouple mdays mago. mShe mhas mbeen mtaking mamoxillin mwith mclavulanate m875 mmg mBID mfor mthe mpast m48 mhours. mShe mreturns mtoday mfor ma mfollow-up mappointment. m Her mvitals m2 mdays mago: mBP m120/72, mHR m96, mT m103F, mRR m24/min, mÓ2 msats m92%. m Her mvitals mtoday: mBP m130/80, mHR m100, mT m102.2, mRR m24/min, mÓ2 msats m94%. How mwould myou mmanager mher mtoday? A) mRepeat mCXR, mCBC, mand mstart mlevofloxacin B) mStart mazithromycin m5-day mpack C) mContinue mwith mamoxicillin-clavulanate mfor manother m24 mhours D) mStop mamoxicillin-clavulanate mand mstart mdoxcycline m100 mmg mBID mx m7 mdays m- m m m mcorrect manswer.D) mStop mamoxicillin-clavulanate mand mstart mdoxycycline m100 mmg mBID mx m7 mdays She mmost mlikely mhas man matypical mpathogen m(mycoplasma mpneumoniae mor mchlamydophila mpneumoniae), mwhich mshould mbe mtreated mwith ma mmacrolide mor mdoxycycline If ma m19-year mold mcollege mfemale mdiagnosed mwith mcommunity macquired mpneumonia mwas mpregnant min mher mfirst mtrimester, mhow mcould mshe mbe mmanaged? A) mLevofloxacin m750 mmg mPO mdaily mx m5 mdays B) mAzithromycin m500 mmg mon mday m1, mthen m250 mmg mdaily mon mdays m2-5, mplus mamoxicillin m1000 mmg mBID C) mCephalexin m500 mmg mPO mBID mx m5 mdays D) mDoxycyline m100 mmg mPO mBID mx m5 mdays m- m m m mcorrect manswer.B) mAzithromycin m500 mmg mon mday m1, mthen m250 mmg mdaily mon mdays m2-5, mplus mamoxicillin m1000 mmg mBID Quinolones m(e.g. mlevofloxacin) mand mtetracyclines m(e.g. mdoxycycline) mare mteratogenic mand mshould mnot mbe mgiven mduring mpregnancy A m63-year mold mpatient mw/ mCOPD mc/o ma mpounding mheart mafter musing mhis minhaler. mWhich mof mthe mfollowing mis mthe mleast mlikely mculprit? A) mFluticasone B) mAlbuterol C) mIptratropium D) mSalmeterol m- m m m mcorrect manswer.A) mFluticasone Mr. mSmith, man m80-year mold msmoker, mhas mstage mII mCOPD. mBased mon mhis mmedications, mwhat mis mthe mmost mpredictable mdrug-disease minteraction? Losartan m50 mmg, mHCTZ m12.5 mmg, mAmlodipine m5 mmg mdaily, mTamsulosin m(Flomax) m0.8 mmg mdaily, mAtorvastatin m(Lipitor) m10 mmg mdaily, mAlbuterol minhaler m2 mpuffs mPRN mfor mSOB, mtiotropium m(Spiriva) monce mdaily A) mGlaucoma B) mFrequent murination C) mAnxiety D) mPruritis E) mHyperglycemia F) mFatigue G) mConstipation m- m m m mcorrect manswer.G) mConstipation Amlodipine m(CCB) mand mtiotropium m(short-acting manti-cholinergic) An mobese m55-year mold mwoman mwith ma mhistory mof mmoderate mpersistent masthma mhas ma mtemperature mof m101F, mbilateral mwheezes, mmild mshortness mof mbreath, mand mpurulent msputum. mHer mmed mlist mincludes: mfluticasone/salmeterol mBID, malbuterol mPRN, mamlodipine m5 mmg, mlevothyroxine m99 mmcg mdaily, mand mmetformin m1000 mmg mBID. mHow mshould mshe mbe mmanaged mtoday? A) mTreat mwith mazithromycin mdaily mfor m5 mdays B) mTreat mwith mciprofloxacin, mnebulized malbuterol mq4-6 mhours mPRN mfor mwheezing C) mTreat mwith moral msteroid mand mnebulized mlevalbuterol mq8 mhours mPRN D) mTreat mwith mlevofloxacin, mnebulized malbuterol mq4-6 mPRN mfor mwheezing m- m m m mcorrect manswer.D) mTreat mwith mlevofloxacin, mnebulized malbuterol mq4-6 mPRN mfor mwheezing She mis mmore mlikely mto mhave mStrep mpneumoniae mand mshould mbe mtreated mwith ma mquinolone. mCiprofloxacin mis mnot ma mrespiratory mquinolone An mobese m55-year mold mwoman mwith ma mhistory mof mmoderate mpersistent masthma mhas ma mtemperature mof m101F, mbilateral mwheezes, mmild mshortness mof mbreath, mand mpurulent msputum. mHer mmed mlist mincludes: mfluticasone/salmeterol mBID, malbuterol mPRN, mamlodipine m5 mmg, mlevothyroxine m99 mmcg mdaily, mand mmetformin m1000 mmg mBID. mShe mis mbeing mtreated mfor mpneumonia mwith mlevofloxacin mand mnebulized malbuterol mq4-6 mPRN mfor mwheezing. m She mdevelops mwhite mplaques mon mthe mbuccal mmucosa, mpalate, mand mtongue m(thrush). mWhat mmedications mare mthe mmost mlikely mcause mof mthis? A) mLevofloxacin mand mmetformin B) mAlbuterol mand mlevofloxacin C) mMetformin mand mfluticasone D) mFluticasone mand mlevofloxacin m- m m m mcorrect manswer.D) mFluticasone mand mlevofloxacin Anemia mis ma mreduction min mone mor mmore mof mwhat mRBC mmeasurements? m- m m m mcorrect manswer.RBC mcount m(4.2-4.9 mmil/microL), mhemoglobin m(12-15 mg/dl), mor mhematocrit m(37-51%) The mpatient mhas mthe mfollowing mCBC mresults: mIs mthe mpatient manemic? RBC m4.0 HGB m11.5 HCT m35.6% MCV m90 MCH m25.7 MCHC m33.4 RDW m14.6 PLT m265 MPV m7.1 m- m m m mcorrect manswer.Yes Name m3 mcauses mof manemia. mWhich mis mthe mmost mcommon mreason min mthe mUS? m- m m m mcorrect manswer.Blood mloss m(most mcommon), msick mbone mmarrow, mincreased mRBC mdestruction 1) mBlood mloss m- mmelena, mhematemesis, mtrauma 2) mBone mmarrow mdoes mnot mmake menough mRBCs m -not menough miron, mfolate, mB12 -bone mmarrow mdisorders m(e.g. maplastic manemia)-bone mmarrow msuppression m(e.g. mchemo) -low mlevels mof merythropoietin m(e.g. mchronic mrenal mfailure) -anemia mof minflammation m(e.g. mmalignancy, manemia mof mchronic mdisease) 3) mIncreased mRBC mdestruction m -inherited mdisorders m(e.g. mthalassemia, msickle mcell manemia) -malaria -hemolytic manemia m(e.g. mG6PD mdeficiency) How mdo mthe mfollowing mconditions maffect mHgb/Hct? m (e.g. mIncrease, mDecrease, mNeutral) COPD: CKD: HTN: DM mw/ mAIC m14: Aspirin muse: Testosterone muse: Resident mof mDenver, mCO: Age m m80: m- m m m mcorrect manswer.COPD: mIncrease m(tissues mare mchronically mdeprived mof moxygen) CKD: mDecrease HTN: mNeutral DM mw/ mAIC m14: mDecrease m(poorly mcontrolled mdisease, mstrains mRBCs mand mcauses mthem mto mdie mearly) Aspirin muse: mNeutral Testosterone muse: mIncrease Resident mof mDenver, mCO: mIncrease m(r/t mhigh maltitude) Age m m80: mDecreased m(bone mmarrow mis mnot mas mrobust...RBC mproduction mis mdecreased, mbut mDO mNOT massume mthat manemia min man molder mpatient mis mdue mto maging!) Which mof mthe mRBC mindices mtells myou mabout mRBC msize? What mlevel mis mnormal? What mlevel mindicates mmicrocytic m(small) mRBCs? What mlevel mindicates mmacrocytic m(large) mRBCs? m- m m m mcorrect manswer.Mean mCorpuscular mVolume m(MCV) m= mHct/RBC Normal m= m80-96 Microcytic m80 Macrocytic m96 Which mof mthe mRBC mindices mtells myou mabout mthe mRBC mcolor? What mdoes ma mlow mlevel mtell myou mabout mthe mRBC mcolor? m- m m m mcorrect manswer.Mean mcorpuscular mhemoglobin m(MCH) Low mMCH m= mhypochromic m(pale) mRBC Match mthe mlab mwith mthe mdefinition 1. mSerum miron m 2. mSerum mferritin 3. mReticulocyte mcount 4. mPeripheral msmear A. mA mvisual mdescription mof mred mblood mcells B. mMeasure mof miron min mcirculation C. mIndicative mof mthe mbone mmarrow's mability mto mproduce mRBCs D. mMeasure mof miron min mstorage m- m m m mcorrect manswer.1. mSerum mIron m- mB. mMeasure mof miron min mcirculation 2. mSerum mferritin m- mD. mMeasure mof miron min mstorage 3. mReticulocyte mCount m- mC. mIndicative mof mthe mbone mmarrow's mability mto mproduce mRBCs 4. mPeripheral mSmear m- mA. mA mvisual mdescription mof mred mblood mcells When mthe miron mcount mis mHIGH, mthe mTIBC m(total miron mbinding mcapacity) mis m_________ m- m m m mcorrect manswer.Low When mthe miron mcount mis mLOW, mthe mTIBC m(total miron mbinding mcapacity) mis m_________ m- m m m mcorrect manswer.High Iron mdeficiency maemia mis ma m_______cytic, m______chromic manemia. mWhat mis mthe mmost mcommon mcause? m- m m m mcorrect manswer.Microcytic, mhypochromic Blood mloss mis mthe mmost mcommon mcause (Patients mare musually masymptomatic muntil mH/H m m10/30) A mpatient's mhemoglobin mis m10.2 mand mhematocrit mis m30.6%. mWhich mfindings mare mconsistent mwith man miron mdeficiency manemia? A) mMCV m76, mMCH m28 B) mMCV m84, mMCH m26 C) mMCV m75, mMCH m25 D) mMCV m120, mMCH m30 m- m m m mcorrect manswer.C) mMCV m75 m(low), mMCH m25 m(low) Microcytic, mhypochromic manemia In mnew monset miron mdeficiency manemia, mthe mRDW m(red mcell mdistribution mwidth) mis m___________. m- m m m mcorrect manswer. m15% In m____________ miron mdeficiency manemia, mthe mRDW mis m m15%. m- m m m mcorrect manswer.Longstanding, mchronic m(all mRBCs mare msmall) A m24-year mold mwoman mwas mdiagnosed mwith miron mdeficiency manemia m4 mweeks mago m(Hgb m11.5, mHct m34.5%). mToday mher mHgb mis m12.8 mand mher mHct mis m38.4%. mHow mdo myou mproceed? A) mStop miron msupplementation msince mshe mis mno mlonger manemic B) mOrder ma mreticuloctye mcount C) mOrder ma mTIBC D) mConsider mcontinued miron msupplementation mfor manother m3-5 mmonths m- m m m mcorrect manswer.D) mConsider mcontinued miron msupplementation mfor manother m3-5 mmonths m(to mreplace miron mstores) In maddition mto macanthosis mnigricans, mwhich mof mthe mfollowing mis ma mrisk mfactor mfor minsulin mresistance? A) mDelivery mof minfant m m9 mlbs B) mSevere mobesity C) mAge m m65 D) mSleep mApnea m- m m m mcorrect manswer.B) mSevere mobesity The mADA mrecommends mannual mscreening mfor mdiabetes mfor mpatients mwith ma mBMI mgreater mthan m_______ mand mone more mmore mrisk mfactors. m- m m m mcorrect manswer.25 The mADA mrecommends mscreening mfor mthe mentire mpopulation mover mthe mage mof m_____________ mevery m____ myears mif mthe mscreening mis mnormal. m- m m m mcorrect manswer.45; m3 Mr.Smith mis ma m75-year mold mman mwith man mĀ1C mof m8.9%. mWhich mof mthe mfollowing mshould mbe mthe mprovider's mfirst maction? A) mStart mmetformin B) mDiscuss mexercise, mweight mloss C) mEstablish man mĀ1C mgoal mof m m7% D) mEstablish ma mtarget mĀ1C mgoal m- m m m mcorrect manswer.D) mEstablish ma mtarget mĀ1C mgoal Match mthe mSuggested mĀ1C mgoals mfor mT2DM A) mPatient mwith mT1DM B) mMost mpregnant mpatients C) mOlder mpatients D) mMost madults mwith mT2DM 1. mĀ1C m m7% 2. mĀ1C m m6% 3. mĀ1C m m8% 4. mĀ1C m m6% m- m m m mcorrect manswer.A m- m2) mPatients mwith mT1DM m= mgoal m m6% B m- m4) mMost mpregnant mpatients m= mgoal m6 m% C m- m3) mOlder mpatients m= mgoal m m8% D m- m1) mMost madults mwith mT2DM m= mgoal m m7& Mr. mJohnson mis ma m72-year mold mnewly mdiagnosed mType m2 mdiabetic. mWhich mof mthe mchoices mbelow mmust mbe mconsidered mprior mto mstarting mMetformin min mthis mpatient? mSelect m4. A) mCBC B) meGFR C) mLFTs D) mPresence mof mheart mfailure E) mPresence mof mbinge mdrinking F) mUse mof mCCBs G) mPresence mof mBPH m- m m m mcorrect manswer.B) meGFR C) mLFTs D) mPresence mof mheart mfailure E) mPresence mof mbinge mdrinking Mr. mJohnson mis ma m72-year mold mnewly mdiagnosed mType m2 mdiabetic. mWhich mof mthe mfollowing mcharacteristics mincrease mthe mlikelihood mof mlactic macidosis? mSelect m4. A) mConcurrent muse mof mcontrast mdye B) meGFR m m45 C) mDehydration D) mPresence mof mheart mfailure E) mPresence mof mbinge mdrinking F) mUse mof mCCBs G) mPresence mof mBPH m- m m m mcorrect manswer.A) mConcurrent muse mof mcontrast mdye C) mDehydration D) mPresence mof mheart mfailure E) mPresence mof mbinge mdrinking What mare mthe mtwo mmost mcommon mside meffects mof mMetformin? A) mDiarrhea B) mWeight mgain C) mHeadaches D) mFlatulence m- m m m mcorrect manswer.A) mDiarrhea D) mFlatulence Mr. mJohnson mis ma m62-year mold mT2DM mwith man mĀ1C mof m7.3%. mHe mhas mbeen mstarted mon mlow-dose mMetformin. mOver mthe mlast mfew mweeks mhe mhas mtolerated mincreasing mdoses mand mnow mtakes m1000 mmg mtwice mdaily. mWhat mwould myou mexpect mhis mĀ1C mto mbe mwhen myou mrecheck mit min m3 mmonths? A) m7.0% B) m6.8% C) m6.5% D) m6.0% m- m m m mcorrect manswer.D) m6.0% m Metformin m1000 mmg mBID mcan mproduce ma m1-2% mdrop min mĀ1C Based mon mthe mprimary mmechanism mof maction mof mMetformin, mwhat mlab mvalue mmust mbe mevaluated mand mmonitored? A) mALT, mAST B) mBUN, mCre C) meGFR D) mPotassium m- m m m mcorrect manswer.A) mAST, mALT Metformin mworks min mthe mliver mto mdecrease mhepatic mglucose moutput 35-year mold mfemale mwith mnewly mdiagnosed mimpaired mfasting mglucose mand mĀ1C mof m5.9% 1) mWhat mmedication mis mfirst-line? 2) mWhat mif mshe mis mcontemplating mpregnancy? m- m m m mcorrect manswer.1) mMetformin 2) mMetformin mis mOK min mpregnancy A m48-year mold mpostmenopausal mwoman mwith mT2DM mdiagnosed m6 mweeks mago mc/o mpersistent mdiarrhea mwith mMetformin. mHer mĀ1C mis m9.2% m(goal m m7%) 1) mWhat mis mthe mprimary mprescribing mstrategy? 2) mWhat mmedication mshould myou mavoid min mthis mpatient? m- m m m mcorrect manswer.1) mDual mtherapy m(Ā1C m m9%) 2) mTZDs m(Actos, mAvandia) mincrease mthe mrisk mof mfracture, mavoid min mpostmenopausal mwomen A m77-year mold mfemale mwith mnewly mdiagnosed mT2DM mand mĀ1C mof m9.5%. 1) mWhat mis mher mĀ1C mgoal? 2) mWhat moccurrence mshould mbe mavoided mif mat mall mpossible? 3) mWhat mage-related mprescribing mstrategy mwould myou mconsider min mthis mpatient mwith man mĀ1C mof m9.5%? m- m m m mcorrect manswer.1) m m8% 2) mHypoglycemia 3) mMonotherapy m(older madult mpatient) A m62-year mold mmale mis mtaking mMetformin mand mhas man mĀ1C mof m7.9% mand mis mon ma mfixed mbudget. mHis mĀ1C mgoal mis m m7%. m 1) mWhat mmed mclass mwould mbe myour mfirst mchoice? m- m m m mcorrect manswer.1) mSulfonylurea m- mlowers mĀ1C mby m1-2% 27-year mold mmale mwith mlupus mhas ma meGFR mof m48 mand mĀ1C mof m7.2%, mnewly mdiagnosed mwith mT2DM. 1) mWhat mmedication mis mfirst mchoice min mthis mpatient? m- m m m mcorrect manswer.1) mMetformin m(can mbe mgiven mas mlong mas mthe mGFT mis m m45, mmonitor mclosely) 35-year mold mobese mmale mwith mhx mof mT2DM mis mon mthe mmax mdose mof mMetformin. mHis mĀ1C mis m7.6 m(goal m m7%). mHe mdesires mweight mloss mand mis mneedle-phobic. 1) mWhat mmedication mclass mshould mbe mconsidered 2) mWhich mmed mclass(es) mshould mbe mavoided? m- m m m mcorrect manswer.1) mSGLT-2 minhibitor m(canagliflozin m- mInvokana, mempagliflozin m- mJardiance) 2)Sulfonylureas m(a/w mweight mgain) GLP-1, minsulin m(injectables) 82-year mold mmale mwith mT2DM mis mcurrently mon mmax mdose mof mMetformin. mHis mĀ1C mis m7.9%. m 1) mWhat mis myour mplan mat mthis mvisit mfor mhis mĀ1C? m- m m m mcorrect manswer.1) mA mreasonable mĀ1C mgoal mfor mhis mage mis m8%. mReview mlifestyle mmodifications mand mdecrease mcarb mintake A m60-year mold mmane mwith mT2DM mtakes mMetformin mand mGlipizide. mHis mĀ1C mis m10.2 m(goal m m7%). mThe mNP mdecides mto mstart mbasal minsulin. 1) mWhat mshould mbe mdone mwith mMetformin mand mglipizide? 2) mHow mmuch minsulin mwould myou mstart mthis mpatient mon? m- m m m mcorrect manswer.1) mContinue mMetformin. mSTOP mglipizide. 2) mStart mat m0.1-0.2 munits/kg/day mor m10 munits A m50-year mold mself-employed mman mdrives ma mbread mtruck mand mtakes mmax mdose mMetformin. mHe mcannot mtolerate mhypoglycemia. mHis mcurrent mĀ1C mis m8.0 m(goal m m7%). mHe mhas mlimited mfunds mbut mhas man maffordable mgeneric mco-pay. m 1) mWhat mmedication mwould myou mstart mthis mpatient mon? m- m m m mcorrect manswer.1) mTZD m(Actos mor mAvandia), mDPP-4 m(sitagliptin)? The mtypical mpatient mwith mprimary mhypothyroidism mhas: A) mskin, mhair, mand mnail mchanges B) man mabnormal mlipid mpanel C) mfailure mof mthe mthyroid mgland D) minvolvement mof mthe mpituitary-hypothalamic maxis m- m m m mcorrect manswer.C) mfailure mof mthe mthyroid mgland m- mPRIMARY mhypothyroidism m(the mthyroid mgland mcannot mproduce mthyroid mhormones) ~95% mof mhypothyroidism mis mdue mto mprimary mhypothyroidism SECONDARY mhypothyroidism minvolves mthe mpituitary-hypothalamic maxis A mpatient mwho mcomplains mof mfatigue mhas ma mTSH mof m13.4 m(normal m0.4-4.8 mmU/ml). mWhat mshould mbe mdone mnext? A) mOrder ma mTSH mnext mweek B) mOrder ma mthyroid mpanel C) mRepeat mthe mTSH mand madd ma mfree mT4 D) mPrescribe mlevothyroxine m- m m m mcorrect manswer.C) mRepeat mthe mTSH mand madd ma mfree mT4 L-thyroxine m(synthetic mT4) mis mgiven mPO mdaily min mthe mmorning mon man mempty mstomach. mThe musual mreplacement mdose mis mbased mon mideal mbody mweight. mHow mmuch mL-thyroxine mwould myou mstart ma mhealthy, myoung madult? m- m m m mcorrect manswer.1.6 mmcg/kg/day (e.g. m120 mlbs m= m55 mkg m-- mreplacement m88 mmcg) Levothyroxine mtabs: m25 mmcg, m50, m75, m88, m100, m112, m125, m137, m150, m175, m200, m300 A m58-year mold mman mhas mthe mfollowing mlab mresults. m TSH m13.5 m(normal m0.4-4.8), mT4 m1.1 m(norm m0.8-1.8) 6 mweeks mlater: mTSH m15.6, mT4 m0.9 Select mthe mbest manswer. A) mDiagnose mas mprimary mhypothyroidism, mtreat mwith mlevothyroxine B) mDiagnose mas msubclinical mhypothyroidism, mtreat mwith mlevothyroxine C) mDiagnose mas msubclinical mhypothyroidism, mdo mnot mtreat D) mDiagnose mas msubclinical mhyperthyroidism, mtreat mwith mmethimazole m- m m m mcorrect manswer.B) mDiagnose mas msubclinical mhypothyroidism, mtreat mwith mlevothyroxine Treatment mof msubclinical mhypothyroidism mis mcontroversial.... If mpatient mhas msubclinical mhypothyroidism mwith mTSH m m10 m-- mTreat mto mPREVENT mconversion mto mprimary mhypothyroidism If mTSH m m10 m-- mmonitor. mAssociated mwith mrisk mof mafib m(immediate mrisk), maccelarated mbone mloss m(long-term mrisk, mleeches mcalcium mand mvit mD mfrom mthe mbones) A m45-year mold mpatient mhas msubclinical mhypothyroidism. mHer mTSH mis m6.2. mWhat mare mthe mmajor mrisks mof mprescribing mlevothyroxine? A) mThere mare mvery mfew mrisks B) mHyperlipidemia, matrial mfibrillation C) mAccelerated mbone mloss, matrial mfibrillation D) mShe mmay mdevelop mhypertension mand mtachycardia m- m m m mcorrect manswer.C) mAccelerated mbone mloss, matrial mfibrillation A m45- myear mold mpatient mwas mdiagnosed mwith mhypothyroidism m12 mweeks mago. m 12 mweeks mago: mTSH m14.3 m(normal m0.4-4.8). mOn mLevothyroxine m50 mmcg m 6 mweeks mago: mTSH m5.4. mOn m75 mLevothyroxine m75 mmcg Today: mTSH m0.4 How mshoulder mher mlevothyroxine mdose mbe mmanaged mtoday? A) mRefer mto mendocrinology B) mDecrease mlevothyroxine mto m50 mmcg mdaily C) mDiscontinue mlevothyroxine D) mResume mlevothyroxine m50 mmcg mdaily mand mhave mher mtake m2 mtabs mon mSaturdays/Sundays m- m m m mcorrect manswer.D) mResume mlevothyroxine m50 mmcg mdaily mand mhave mher mtake m2 mtabs mon mSaturdays/Sundays 50 mmcg mdaily mx m7 mdays m= m350 mmcg mweekly m(not menough, mpatient mwas mnot mat mgoal mafter m6 mweeks) 75 mmcg mdaily mx m7 mdays m= m525 mmcg mweekly m(too mmuch mher mTSH mdecreased mto m0.4 mafter m6 mweeks) 50 mmcg mM-F m= m250 mmcg m 100 mmcg mSat/Sun m= m200 mmcg 250+200 m= m450 mmcg mweekly A mpatient mhas mhypothyroidism. mHer mlast mTSH mwas m2.5. mShe mtakes mher mlevothyroxine min mthe mAM mon man mempty mstomach. mWhat mwill mhappen mto mher mTSH mif mshe mtakes mthe mlevothyroxine mafter mdinner? m- m m m mcorrect manswer.TSH mwill mINCREASE m(due mto mdecreased mabsorption mof mlevothyroxine) A mpatient mhas mhypothyroidism. mHer mlast mTSH mwas m2.5. mShe mtakes mher mlevothyroxine min mthe mAM mon man mempty mstomach. mWhat mwill mhappen mto mher mTSH mif mshe mtakes mtwo mpills minstead mof mone? m- m m m mcorrect manswer.TSH mwill mDECREASE A mpatient mhas mhypothyroidism. mHer mlast mTSH mwas m2.5. mShe mtakes mher mlevothyroxine min mthe mAM mon man mempty mstomach. mWhat mwill mhappen mto mher mTSH mif mshe mtakes mthe mlevothyroxine mwith man mOTC mPPI? m- m m m mcorrect manswer.TSH mwill mINCREASE m(PPIs mincrease mgastric macid mand maffect mabsorption) A mpatient mhas mhypothyroidism. mHer mlast mTSH mwas m2.5. mShe mtakes mher mlevothyroxine min mthe mAM mon man mempty mstomach. mWhat mwill mhappen mto mher mTSH mif mshe mtakes mthe mlevothyroxine mwith mher mmorning mcoffee? m- m m m mcorrect manswer.TSH mwill mINCREASE A mpatient mhas mhypothyroidism. mHer mlast mTSH mwas m2.5. mShe mtakes mher mlevothyroxine min mthe mAM mon man mempty mstomach. mWhat mwill mhappen mto mher mTSH mif mshe mswtiches mto ma mGENERIC mform mof mlevothyroxine? m- m m m mcorrect manswer.TSH mcould mgo mup, mor mdown, mor mstay mthe msame... Which mmedication mcombination mpresents mthe mlowest mrisk mfor mhypoglycemia mto ma mpatient? A) mMetformin m+ mNPH minsulin B) mMetformin m+ msulfonylurea C) mTZD m+ mDPP-4 D) mSGLT2 m+ mbasal minsulin m- m m m mcorrect manswer.C) mTZD m+ mDPP-4 A m75-year mold mpatient mwas mdiagnosed mwith mhypothyroidism mtoday. mHer mcalculated mlevothyroxine mreplacement mis m88 mmcg mdaily. mHow mshoulder mher mlevothyroxine mdose mbe mmanaged? A) mRefer mto mendocrinology B) mStart mLevothyroxine m25 mmcg mdaily C) mStart mLevothyroxine m44 mmcg mdaily D) mStart mLevothyroxine m50 mmcg mdaily m- m m m mcorrect manswer.B) mStart mLevothyroxine m25 mmcg mdaily Older mpatients mand mthose mwith munderlying mcardiac missues mor mmultiple mcomorbidites mshould mstart mlow mand mtitrate mslowly a m58-year mold mfemale mw/ mhypothyroidism mis mtaking m88 mmcg mof msynthroid mdaily. mShe mhas ma mroutine mTSH mwith mher mannual mlabs. mToday mher mTSH mwas m1.4 mmU/L m(normal m0.5-4.5) mand mT4 mwas m2.5 m(normal m0.8-1.8). mWhat maction mis mappropriate? A) mIncrease mher mdose mto m100 mmcg mdaily B) mIncrease mher mdose mto m112 mmcg mdaily C) mDecrease mher mdose D) mContinue mthe msame mdose m- m m m mcorrect manswer.D) mContinue mthe msame mdose Her mTSH mis mnormal What mclass mof mdiabetes mmedications mis mconsidered mweight mneutral? m- m m m mcorrect manswer.DPP-4 minhibitors m"gliptins" m sitagliptin m(Januvia), mlinagrliptin m(Tradjenta) Which mdiabetes mmedications mare massociated mwith mweight mloss? m- m m m mcorrect manswer.GLP-1 magonists m- mexenatide m(Byetta, mBydureon), mliraglutide m(Victoza) -AND- SGLT m2 minhibitors m- mcanagliflozin m(Invokana), mdapagliflozin m(Farxiga) Which mdiabetes mmedications mare massociated mwith mweight mgain? m- m m m mcorrect manswer.Sulfonylureas m- mglipizide m(Glucotrol), mglyburide m(DiaBeta), mglimeperide m(Amaryl) -AND- Insulin Which mof mthe mfollowing mcharacteristics mapply mto mT1DM? A) msignificant mhyperglycemia mand mketoacidosis mresults mfrom mlack mof minsulin B)T1DM mis mcommonly mdiagnosed mon mroutine mexam mor mworkup mfor mother mhealth mproblems C) mInitial mresponse mto moral msulfonylureas mis musually mfavorable D) mInsulin mresistance mis ma msignificant mpart mof mthe mdisease m- m m m mcorrect manswer.A) msignificant mhyperglycemia mand mketoacidosis mresults mfrom mlack mof minsulin Which mof mthe mfollowing mcharacteristics mapply mto mT2DM? A) mHeredity mand mobesity mare mmajor mrisk mfactors B) mPear-shaped mbody mtype mis mcommon C) mExogenous minsulin mis mneeded mfor mcontrol mof mdisease D) mPhysical mactivity menhances minsulin mresistance m- m m m mcorrect manswer.A) mHeredity mand mobesity mare mmajor mrisk mfactors You mconsider mprescribing minsulin mglargine m(Lantus) mbecause mof mits A) mextended mduration mof maction B) mrapid monset mof maction C) mability mto mprevent mdiabetic mend-organ mdamage D) mability mto mpreserve mpancreatic mfunction m- m m m mcorrect manswer.A) mextended mduration mof maction After muse, mthe monset mof maction mof mlispro m(Humalog) moccurs min m A) mless mthan m30 mminutes B) mapproximately m1 mhour C) m1-2 mhours D) m3-4 mhours m- m m m mcorrect manswer.A) mless mthan m30 mminutes Which mof mthe mfollowing mmedications mshould mbe mused mwith mcaution min ma mperson mwith ma mknown mor msuspected msulfa mallergy? A) mmetformin B) mglyburide C) mrosglitazone D) mNPH minsulin m- m m m mcorrect manswer.B) mglyburide The mmechanism mof maction mof mmetformin m(Glucophage) mis mas A) man minsulin-production menhancer B) ma mproduct mvirtually midentical min maction mto msulfonylureas C) ma mdrug mthat mincreases minsulin maction min mthe mperipheral mtissues mand mreduces mhepatic mglucose mproduction D) ma mfacilitator mof mrenal mglucose mexcretion m- m m m mcorrect manswer.C) ma mdrug mthat mincreases minsulin maction min mthe mperipheral mtissues mand mreduces mhepatic mglucose mproduction Generally, mtesting mfor mT2DM min masymptomatic, mundiagnosed mindividuals mover mthe mage mof m45 myears, mshould mbe mdone mevery m______________. A) myear B) m3 myears C) m5 myears D) m10 myears m- m m m mcorrect manswer.B) m3 myears You mare mseeing ma m17-year mold mgirl. mAll mof mthe mfollowing mwould mbe mconsidered mrisk mfactors mfor mT2DM mexcept: A) mobesity B) mNative mAmerican mancestry C) mFamily mhistory mof mT1 mDM D) mpersonal mhistory mof mpolycystic movary msyndrome m- m m m mcorrect manswer.C) mfamily mhistory mof mT1DM Criteria mfor mthe mdiagnosis mof mT2DM mincludes: A) mclassic msymptoms, mregardless mof mfasting mplasma mglucose mmeasurement B) mplasma mglucose mlevel mof m126 mmg/dL mas ma mrandom mmeasurement C) ma m2-hour mglucose mmeasurement mof m156 mmg/dl mafter ma m75-gram manhydrous mglucose mload D) ma mplasma mglucose mlevel mof m126 mmg/dl mor mgreater mafter man m8-hour mfast mon mmore mthan mone moccasion m- m m m mcorrect manswer.D) ma mplasma mglucose mlevel mof m126 mmg/dl mor mgreater mafter man m8-hour mfast mon mmore mthan mone moccasion The mmechanism mof maction mof mpioglitazone mis mas: A) man minsulin-production menhancer B) ma mreducer mof mpancreatic mglucose moutput C) man minsulin msensititizer D) ma mfacilitator mof mrenal mglucose mexcretion m- m m m mcorrect manswer.C) man minsulin msensititizer pioglitazone m(Actos) mis ma mthiazolidinedione Which mof mthe mfollowing mshould mbe mthe mgoal mmeasurement min ma mperson mwith mDM mand mhypertension? A) mSBP m m140 mand mDBP m m90 B) mĀ1C mequal mto mor mgreater mthan m7% C) mTriglyceride mlevel m200-300 D) mHDL mlevel m35-40 m- m m m mcorrect manswer.A) mSBP m m140 mand mDBP m m90 In mcaring mfor ma mpatient mwith mDM, mmicoralbuminuria mmeasurement mshould mbe mobtained A) mannually mif murine mprotein mis mpresent B) mperiodically min mrelation mto mglycemic mcontrol C) myearly D) mwith mevery mdiabetes-related moffice mvisit m- m m m mcorrect manswer.C) myearly The mmechanism mof maction mof msulfonylureas mis mas m A) man mantagonist mof minsulin mreceptor msite mactivity B) ma mproduct mthat menhances minsulin mrelease C) ma mfacilitator mof mrenal mglucose mexcretion D) man magent mthat mcan mreduce mhepatic mglucose mproduction m- m m m mcorrect manswer.B) ma mproduct mthat menhances minsulin mrelease When mcaring mfor ma mpatient mwith mDM, mHTN, mand mpersistent mproteinuria, mthe mNP mshould mprescribe m___________. A) mfurosemide B) mmethyldopa C) mfosinopril D) mnifedipine m- m m m mcorrect manswer.C) mfosinopril Clinical mpresentation mof mT1DM musually mincludes mall mof mthe mfollowing, mexcept