PEBC Study Set| 750 Questions| With
Complete Solutions
What are the criteria for urate lowering therapy in gout correct
answer: diagnosis of gout plus 1 of:
Tophi
2 or more attacks per yer
CKD stage 2 or worse (GFR <90)
past urolithiasis
Drugs that increase uric acid correct answer: EtOH
cyclosporin
Tacrolimus
thiazide and loop diuretics
levodopa,
Ethambutol
Cytotoxic chemo
low dose salicylate
pyrazinamide
teriperatide
interferon +ribavirin
niacin
First line therapy for fibromyalgia correct answer: Pregabalin or
duloxetine
Duration of Prophylaxis in Gout when starting urate lowering
therapy? correct answer: at least 6m
3m after urate at target if no tophi
6m after urate at target if tophi
,(may get away with 2-3 weeks for febuxstat)
NSAIDS with the worst CV risk (3) correct answer: diclofenac,
celcoxib, high dose ibuprofen
NSAID with the least CV risk (1) correct answer: naproxen
Risk factors for development of upper GI adverse effects with
NSAIDs correct answer: Age >64
comorbid medical conditions
high dose NSAIDs
Hx of UGIB
presence of H. pylori
Multiple NSAID use (including low dose ASA)
Drugs that decrease seziure threshold (please continue to add if
you come across them) correct answer: tramadol
baclofen
buproprion
carbapenems
TCAs Stimulants
isoniazid
clozapine
penicillins
cephalosporins
amphotericin
Osteoarthritis diagram: Low GI risk and Low CV risk correct
answer: low dose nonselective NSAID
,Osteoarthritis diagram: Mod GI risk and Low CV risk correct
answer: low dose celocoxib
OR
low-dose NSAID + GI protection
Osteoarthritis diagram: Mod GI risk and High CV risk OR Low
GI risk and High CV risk correct answer: low dose nonselective
NSAID + GI protection
Low dose Celecoxib
OR: if ASA required --> low dose celecoxib +GI protection
Osteoarthritis diagram: High GI Risk correct answer: low dose
celecoxib + GI protection
consider alt therapy
Medications that increase fracture Risk correct answer:
Aromatase inhibitors
Anticoagulants (unfractionated and low molecular weight
heparins)
Antiretroviral therapy,
Cyclosporine,
Corticosteroid therapy (at least 3 months' cumulative therapy in
the previous year at a prednisone-equivalent dose ≥7.5 mg
daily),
Loop diuretics,
PPIs
SSRIs
thiazolidinediones
chemotherapy and high doses of vitamin A.
Depot medroxyprogesterone acetate
Valproate and AED that induce CYPs
, What are the Risk factors prompting Measurement of BMD in
patients >50. correct answer: Older Adults (≥50 y)
Age ≥65 y
Clinical risk factors for fracture (men age 50-64 y, menopausal
women):
Vertebral compression fracture
Fragility fracture after age 40
Prolonged use of corticosteroids
Use of other high-risk medications, e.g., aromatase inhibitors,
androgen deprivation therapy
Parent with hip fracture
Osteopenia identified on x-ray
Current smoking High alcohol intake
Low body weight (<60 kg) or major weight loss (>10% of
weight at age 25)
Rheumatoid arthritis
Other disorders strongly associated with osteoporosis
What are risk factors prompting BMD assessment in younger
adults <50 years old> correct answer: Fragility fracture
Prolonged use of corticosteroidsa
Use of other high-risk medications, e.g., aromatase inhibitors,
androgen deprivation therapy Hypogonadism or premature
menopause (<45 y) Malabsorption syndrome
Primary hyperparathyroidism
Other disorders strongly associated with rapid bone loss or
fracture
Patient specific RFs that exacerbate HF? correct answer:
Nonadherence to therapy
Complete Solutions
What are the criteria for urate lowering therapy in gout correct
answer: diagnosis of gout plus 1 of:
Tophi
2 or more attacks per yer
CKD stage 2 or worse (GFR <90)
past urolithiasis
Drugs that increase uric acid correct answer: EtOH
cyclosporin
Tacrolimus
thiazide and loop diuretics
levodopa,
Ethambutol
Cytotoxic chemo
low dose salicylate
pyrazinamide
teriperatide
interferon +ribavirin
niacin
First line therapy for fibromyalgia correct answer: Pregabalin or
duloxetine
Duration of Prophylaxis in Gout when starting urate lowering
therapy? correct answer: at least 6m
3m after urate at target if no tophi
6m after urate at target if tophi
,(may get away with 2-3 weeks for febuxstat)
NSAIDS with the worst CV risk (3) correct answer: diclofenac,
celcoxib, high dose ibuprofen
NSAID with the least CV risk (1) correct answer: naproxen
Risk factors for development of upper GI adverse effects with
NSAIDs correct answer: Age >64
comorbid medical conditions
high dose NSAIDs
Hx of UGIB
presence of H. pylori
Multiple NSAID use (including low dose ASA)
Drugs that decrease seziure threshold (please continue to add if
you come across them) correct answer: tramadol
baclofen
buproprion
carbapenems
TCAs Stimulants
isoniazid
clozapine
penicillins
cephalosporins
amphotericin
Osteoarthritis diagram: Low GI risk and Low CV risk correct
answer: low dose nonselective NSAID
,Osteoarthritis diagram: Mod GI risk and Low CV risk correct
answer: low dose celocoxib
OR
low-dose NSAID + GI protection
Osteoarthritis diagram: Mod GI risk and High CV risk OR Low
GI risk and High CV risk correct answer: low dose nonselective
NSAID + GI protection
Low dose Celecoxib
OR: if ASA required --> low dose celecoxib +GI protection
Osteoarthritis diagram: High GI Risk correct answer: low dose
celecoxib + GI protection
consider alt therapy
Medications that increase fracture Risk correct answer:
Aromatase inhibitors
Anticoagulants (unfractionated and low molecular weight
heparins)
Antiretroviral therapy,
Cyclosporine,
Corticosteroid therapy (at least 3 months' cumulative therapy in
the previous year at a prednisone-equivalent dose ≥7.5 mg
daily),
Loop diuretics,
PPIs
SSRIs
thiazolidinediones
chemotherapy and high doses of vitamin A.
Depot medroxyprogesterone acetate
Valproate and AED that induce CYPs
, What are the Risk factors prompting Measurement of BMD in
patients >50. correct answer: Older Adults (≥50 y)
Age ≥65 y
Clinical risk factors for fracture (men age 50-64 y, menopausal
women):
Vertebral compression fracture
Fragility fracture after age 40
Prolonged use of corticosteroids
Use of other high-risk medications, e.g., aromatase inhibitors,
androgen deprivation therapy
Parent with hip fracture
Osteopenia identified on x-ray
Current smoking High alcohol intake
Low body weight (<60 kg) or major weight loss (>10% of
weight at age 25)
Rheumatoid arthritis
Other disorders strongly associated with osteoporosis
What are risk factors prompting BMD assessment in younger
adults <50 years old> correct answer: Fragility fracture
Prolonged use of corticosteroidsa
Use of other high-risk medications, e.g., aromatase inhibitors,
androgen deprivation therapy Hypogonadism or premature
menopause (<45 y) Malabsorption syndrome
Primary hyperparathyroidism
Other disorders strongly associated with rapid bone loss or
fracture
Patient specific RFs that exacerbate HF? correct answer:
Nonadherence to therapy
