NR601 FINAL EXAM QUESTIONS AND
WELL VERIFIED ANSWERS
Anxiety Disorders - ANS ... SSRIs or SNRIs are first-line pharmacotherapy;
cognitive-behavioral therapy is the preferred non-pharmacologic treatment.
Osteoarthritis - ANS ... Weight loss, physical therapy, and acetaminophen for pain;
NSAIDs if acetaminophen is insufficient.
Rheumatoid Arthritis - ANS ... DMARDs (disease-modifying antirheumatic drugs) such
as methotrexate, started early to prevent joint damage.
T2DM - ANS ... May be asymptomatic initially.
Signs of T2DM - ANS ... Obesity, acanthosis nigricans, HTN, neuropathy signs
(↓sensation), foot ulcers, vision changes.
Symptoms of Hyperglycemia - ANS ... Polyuria, polydipsia, fatigue if
hyperglycemia is marked.
First-line Treatment for T2DM - ANS ... Metformin (unless contraindicated).
Add-on Treatments for T2DM - ANS ... If ASCVD/CKD/HF: Add SGLT2 inhibitors
(empagliflozin, dapagliflozin) or GLP-1 RAs (semaglutide, liraglutide).
,Alternative Treatments for T2DM - ANS ... DPP-4 inhibitors, sulfonylureas, insulin (if
A1c >10% or symptomatic).
Monitoring for T2DM - ANS ... Monitor for hypoglycemia, lactic acidosis (metformin),
dehydration (SGLT2is).
Differential Diagnosis for T2DM - ANS ... Type 1 DM (esp. in younger adults), LADA
(Latent Autoimmune Diabetes in Adults), Cushing's, hemochromatosis, medication-
induced (steroids, antipsychotics).
Education & Follow-Up for T2DM - ANS ... Self-monitor glucose, foot care,
nutrition/exercise education.
A1c Monitoring for T2DM - ANS ... A1c every 3 months until controlled, then every 6
months.
Annual Exams for T2DM - ANS ... Annual: eye exam, foot exam, urine microalbumin,
lipids.
ADA 2024 A1c Goal - ANS ... Individualized A1c goal (<7% standard; <8% if
frail/elderly).
USPSTF Screening Recommendations - ANS ... Screen adults ≥35 yrs or BMI >25
with risk factors.
ACE/ADA Recommendations - ANS ... Early use of SGLT2/GLP-1 in CVD/CKD.
Hypothyroidism Symptoms - ANS ... Fatigue, cold intolerance, weight gain,
constipation, depression.
, Physical Signs of Hypothyroidism - ANS ... Bradycardia, dry skin, coarse hair, non-
pitting edema, delayed reflexes.
Goiter in Hypothyroidism - ANS ... Goiter (Hashimoto's), hoarseness, cognitive
slowing.
Pharmacologic Management of Hypothyroidism - ANS ... Levothyroxine: start low
and titrate.
Standard for levothyroxine in elderly - ANS ... 1.6 mcg/kg/day, lower for
elderly/CVD (~25-50 mcg/day)
Recheck TSH - ANS ... In 6-8 weeks, adjust dose by 12.5-25 mcg
Differential Diagnosis for hypothyroidism - ANS ... Depression, Anemia, Menopause,
Sleep apnea, Cushing's
Levothyroxine education - ANS ... Take on empty stomach, avoid iron/calcium within
4 hrs
TSH reassessment frequency - ANS ... Every 6-12 months once stable
Target TSH for elderly - ANS ... 0.5-4.5 (age-adjusted)
Subclinical hypothyroidism treatment - ANS ... If TSH >10 or symptomatic with TSH
4.5-10 + risk factors
WELL VERIFIED ANSWERS
Anxiety Disorders - ANS ... SSRIs or SNRIs are first-line pharmacotherapy;
cognitive-behavioral therapy is the preferred non-pharmacologic treatment.
Osteoarthritis - ANS ... Weight loss, physical therapy, and acetaminophen for pain;
NSAIDs if acetaminophen is insufficient.
Rheumatoid Arthritis - ANS ... DMARDs (disease-modifying antirheumatic drugs) such
as methotrexate, started early to prevent joint damage.
T2DM - ANS ... May be asymptomatic initially.
Signs of T2DM - ANS ... Obesity, acanthosis nigricans, HTN, neuropathy signs
(↓sensation), foot ulcers, vision changes.
Symptoms of Hyperglycemia - ANS ... Polyuria, polydipsia, fatigue if
hyperglycemia is marked.
First-line Treatment for T2DM - ANS ... Metformin (unless contraindicated).
Add-on Treatments for T2DM - ANS ... If ASCVD/CKD/HF: Add SGLT2 inhibitors
(empagliflozin, dapagliflozin) or GLP-1 RAs (semaglutide, liraglutide).
,Alternative Treatments for T2DM - ANS ... DPP-4 inhibitors, sulfonylureas, insulin (if
A1c >10% or symptomatic).
Monitoring for T2DM - ANS ... Monitor for hypoglycemia, lactic acidosis (metformin),
dehydration (SGLT2is).
Differential Diagnosis for T2DM - ANS ... Type 1 DM (esp. in younger adults), LADA
(Latent Autoimmune Diabetes in Adults), Cushing's, hemochromatosis, medication-
induced (steroids, antipsychotics).
Education & Follow-Up for T2DM - ANS ... Self-monitor glucose, foot care,
nutrition/exercise education.
A1c Monitoring for T2DM - ANS ... A1c every 3 months until controlled, then every 6
months.
Annual Exams for T2DM - ANS ... Annual: eye exam, foot exam, urine microalbumin,
lipids.
ADA 2024 A1c Goal - ANS ... Individualized A1c goal (<7% standard; <8% if
frail/elderly).
USPSTF Screening Recommendations - ANS ... Screen adults ≥35 yrs or BMI >25
with risk factors.
ACE/ADA Recommendations - ANS ... Early use of SGLT2/GLP-1 in CVD/CKD.
Hypothyroidism Symptoms - ANS ... Fatigue, cold intolerance, weight gain,
constipation, depression.
, Physical Signs of Hypothyroidism - ANS ... Bradycardia, dry skin, coarse hair, non-
pitting edema, delayed reflexes.
Goiter in Hypothyroidism - ANS ... Goiter (Hashimoto's), hoarseness, cognitive
slowing.
Pharmacologic Management of Hypothyroidism - ANS ... Levothyroxine: start low
and titrate.
Standard for levothyroxine in elderly - ANS ... 1.6 mcg/kg/day, lower for
elderly/CVD (~25-50 mcg/day)
Recheck TSH - ANS ... In 6-8 weeks, adjust dose by 12.5-25 mcg
Differential Diagnosis for hypothyroidism - ANS ... Depression, Anemia, Menopause,
Sleep apnea, Cushing's
Levothyroxine education - ANS ... Take on empty stomach, avoid iron/calcium within
4 hrs
TSH reassessment frequency - ANS ... Every 6-12 months once stable
Target TSH for elderly - ANS ... 0.5-4.5 (age-adjusted)
Subclinical hypothyroidism treatment - ANS ... If TSH >10 or symptomatic with TSH
4.5-10 + risk factors
