globin chains is decreased or absent. Causes low hemoglobin. Which medication is contraindicated in a patient with Beta Thalassemia? - Answer Ferrous Sulfate What drug is used in combination with other agent to treat lymphoid tissue (leukemi a). Directly toxic to lymphoid tissues Selective estrogen receptor modulators (SERM) - for hormone receptor positive and advanced breast cancer. (Tomaxafin - reduces risk and recurrence risk) - Answer Glucocorticoids What is the normal ejection fraction? - Answer 55 -60%. Less than 50% is BAD Is an ejection fraction of 50% reduced or preserved? - Answer Preserved What are symptoms of left sided heart failure? - Answer Think PULMONARY. JVD, FVO, rails, S3 murmurs. Number one cause of right sided heart fail ure! What are symptoms of right sided heart failure? - Answer Think peripheral vascular. Lower extremity edema, abdominal distension. What is the gold standard lab test for heart failure? - Answer BNP. Heart failure is a result greater than 100 What hea rt disease is worse with exertion? - Answer Ischemic heart disease because the demand requirements are higher. What should you assess before giving Digoxin? - Answer Apical pulse How should Warfarin be started? - Answer Start initial dose at half to moni tor the effects What causes the destruction of alveolar walls? Air goes in but can't get out which leads to hyperinflation - Answer Emphysema What causes excess mucus production and smooth muscle hypertrophy? - Answer Bronchitis What is a chronic inflammatory obstruction of bronchi? - Answer Asthma, Triggers cause mucus to clog bronchial tubes. What causes an overbite and buffalo hump? - Answer Endocrine disorder called acromegaly (overproduction of growth hormone) What causes Addison's disease? - Answer Decreased glucocorticoid (due to autoimmune destruction of adrenal cortex) What causes Cushing's syndrome? - Answer excess cortisol What causes Grave's disease? - Answer overproduction of thyroid hormone. HYPERthyroidism. When should you instru ct the patient to take their FIRST dose of antihypertensive? - Answer At night to avoid orthostatic hypotension. Educate slow position changes and lay down if needed . What are side effects of ACE inhibitors? - Answer dry cough angioedema hyperkalemia *Con traindicated in pregnancy Which type of antihypertensive should NOT be given to patients with Asthma? - Answer Nonselective beta blocker ( -lol) because both beta -2 receptors are effected What is the first choice of calcium channel blocker? - Answer Verap amil What side effect should you watch for in a patient taking a statin drug? - Answer Muscle pain which can lead to rhabdomyolysis, kidney failure, and death. Which diuretic is NOT used in patients with kidney failure and sickle cell disease? - Answer T hiazide diuretics What type of drug is spironolactone? - Answer potassium sparing diuretic Which type of insulin is the most painful during injection? - Answer Lantus (long -
acting) Why test glycosylated hemoglobin (HgbA1c)? - Answer Most reliable assessment of blood sugar over the past 3 months. The goal is < 6.5%. A poor result is > 9%