1. A 63-year old male presents to clinic with complaints of tremors and muscle spasms.
The patient has a history of Parkinson's disease and has been taking Levodopa 50mg TID.
What is an appropriate treatment plan for this patient?
A. Decrease the amount of levodopa the patient is taking per day.
B. Inform the patient that these side effects are common as Parkinson's disease
progresses and start the patient on amantadine.
C. Refer the patient to a neurologist for further evaluation.
D. Continue to monitor the patient for increase in tremors.
,Give this one a try later!
Inform the patient that these side effects are common as Parkinson's disease
progresses and start the patient on amantadine.
Levodopa-induced dyskinesias are common in later Parkinson's disease.
Dyskinesias can occur in the form of chorea, tremors, tics, and dystonia.
According to Papadakis and McPhee (2018), although levodopa-induced
dyskinesias are dose related, decreasing the dose can alter the therapeutic
benefit of the medication. The patient can begin taking amantadine or
levetiracetam to help decrease the dyskinesias.
Which birth control method is considered safest in a female with active breast cancer?
a. Copper IUD
b. Combined Oral Contraceptive
c. Transdermal Patch
d. Levonorgestrel IUD
Give this one a try later!
Copper IUD
Rationale: a) breast cancer is estrogen dependent and a non-hormonal birth
control is considered the safest Papadakis, M. A., McPhee, S. J., & Rabow, M.
W. (2018). 2018 Current medical diagnosis & treatment. New York: McGraw-Hill
Education. Chapter 18, page 794
141. A diagnostic mammography is indicated as first-line evaluation for which woman?
a. A 29-year-old Hispanic woman with a painless 3 cm nodule in her left breast at 3
o'clock.
b. A 38-year-old white woman with bilateral diffusely painful breasts that occur 2 days
before her menses and then resolve.
,c. A 46-year-old African American woman with cystic breasts and a new painless lump in
her right breast at 11 o'clock.
d. A 35-year-old Japanese woman with a positive history for first degree relative with
breast cancer.
Give this one a try later!
A 46-year-old African American woman with cystic breasts and a new
painless lump in her right breast at 11 o’clock.
Rationale: Diagnostic imaging is indicated for any woman with a palpable
breast mass, regardless of her age. Under age 30, ultrasound is the initial test
of choice. Between the ages of 30 to 39, ultrasound is the preferred initial
imaging modality (diagnostic mammography or digital breast tomosynthesis is
considered if there is a concerning clinical exam or evident risk factors). For
ages 40 and greater, diagnostic mammography, with or without ultrasound or
digital breast tomosynthesis, are the preferred imaging modalities. Cyclical
breast pain is usually generalized, bilateral, and associated with the menstrual
cycle or hormonal therapy (birth control or HRT).
Regarding blood pressure in pediatric patients, all of the following are correct EXCEPT:
a. Hypertension can be diagnosed after 2 elevated manual blood pressure readings
within a single office visit.
b. Blood pressure measurement at a well-child visit starts at 3 years of age.
c. Cuffs that are too wide will underestimate the true blood pressure while cuffs that are
too narrow will overestimate the true blood pressure.
d. Children with repeated blood pressure readings from the 90th to the 95th percentile
are classified as having prehypertension.
Give this one a try later!
, Hypertension can be diagnosed after 2 elevated manual blood pressure
readings within a single office visit.
Correct Answer A
A. 3 separate occasions of documented hypertension are required to make a
diagnosis of hypertension in pediatric patients.
B. It is appropriate and recommended to start blood measurements during
well-child visits at age 3.
C. The appropriately sized cuff is required to obtain accurate blood pressure
readings.
D. Repeated blood pressure readings from the 90th to the 95th percentile
would be classified as prehypertension.
You diagnose a 72-year-old female with Community Acquired Pneumonia based on her
chest xray. One month ago, she was on levofloxacin for a UTI. What is the preferred
treatment for this patient?
A. Azithromycin 500mg x1 day, then 250mg daily for 4 days
B. Azithromycin 500mg x1 day, then 250mg daily for 4 days & Augmentin 2g BID
C. Doxycycline 100mg BID
D. Moxifloxacin 400mg daily
Give this one a try later!
Azithromycin 500mg x1 day, then 250mg daily for 4 days & Augmentin 2g BID
Rationale: Age greater than 65 years and antibiotic use within the previous
three months places a person at risk for antibiotic resistance. The preferred
treatment options for high risk patients is a respiratory fluroquinolone
(moxifloxacin, Gemifloxacin, or levofloxacin) or a macrolide PLUS a beta-
lactam. An antibiotic should be chosen from a class that is different from the
antibiotic the patient recently took. Since the patient was recently on
levofloxacin, a macrolide and beta-lactam are the preferred treatment
(Papadakis & McPhee, P. 273).
The patient has a history of Parkinson's disease and has been taking Levodopa 50mg TID.
What is an appropriate treatment plan for this patient?
A. Decrease the amount of levodopa the patient is taking per day.
B. Inform the patient that these side effects are common as Parkinson's disease
progresses and start the patient on amantadine.
C. Refer the patient to a neurologist for further evaluation.
D. Continue to monitor the patient for increase in tremors.
,Give this one a try later!
Inform the patient that these side effects are common as Parkinson's disease
progresses and start the patient on amantadine.
Levodopa-induced dyskinesias are common in later Parkinson's disease.
Dyskinesias can occur in the form of chorea, tremors, tics, and dystonia.
According to Papadakis and McPhee (2018), although levodopa-induced
dyskinesias are dose related, decreasing the dose can alter the therapeutic
benefit of the medication. The patient can begin taking amantadine or
levetiracetam to help decrease the dyskinesias.
Which birth control method is considered safest in a female with active breast cancer?
a. Copper IUD
b. Combined Oral Contraceptive
c. Transdermal Patch
d. Levonorgestrel IUD
Give this one a try later!
Copper IUD
Rationale: a) breast cancer is estrogen dependent and a non-hormonal birth
control is considered the safest Papadakis, M. A., McPhee, S. J., & Rabow, M.
W. (2018). 2018 Current medical diagnosis & treatment. New York: McGraw-Hill
Education. Chapter 18, page 794
141. A diagnostic mammography is indicated as first-line evaluation for which woman?
a. A 29-year-old Hispanic woman with a painless 3 cm nodule in her left breast at 3
o'clock.
b. A 38-year-old white woman with bilateral diffusely painful breasts that occur 2 days
before her menses and then resolve.
,c. A 46-year-old African American woman with cystic breasts and a new painless lump in
her right breast at 11 o'clock.
d. A 35-year-old Japanese woman with a positive history for first degree relative with
breast cancer.
Give this one a try later!
A 46-year-old African American woman with cystic breasts and a new
painless lump in her right breast at 11 o’clock.
Rationale: Diagnostic imaging is indicated for any woman with a palpable
breast mass, regardless of her age. Under age 30, ultrasound is the initial test
of choice. Between the ages of 30 to 39, ultrasound is the preferred initial
imaging modality (diagnostic mammography or digital breast tomosynthesis is
considered if there is a concerning clinical exam or evident risk factors). For
ages 40 and greater, diagnostic mammography, with or without ultrasound or
digital breast tomosynthesis, are the preferred imaging modalities. Cyclical
breast pain is usually generalized, bilateral, and associated with the menstrual
cycle or hormonal therapy (birth control or HRT).
Regarding blood pressure in pediatric patients, all of the following are correct EXCEPT:
a. Hypertension can be diagnosed after 2 elevated manual blood pressure readings
within a single office visit.
b. Blood pressure measurement at a well-child visit starts at 3 years of age.
c. Cuffs that are too wide will underestimate the true blood pressure while cuffs that are
too narrow will overestimate the true blood pressure.
d. Children with repeated blood pressure readings from the 90th to the 95th percentile
are classified as having prehypertension.
Give this one a try later!
, Hypertension can be diagnosed after 2 elevated manual blood pressure
readings within a single office visit.
Correct Answer A
A. 3 separate occasions of documented hypertension are required to make a
diagnosis of hypertension in pediatric patients.
B. It is appropriate and recommended to start blood measurements during
well-child visits at age 3.
C. The appropriately sized cuff is required to obtain accurate blood pressure
readings.
D. Repeated blood pressure readings from the 90th to the 95th percentile
would be classified as prehypertension.
You diagnose a 72-year-old female with Community Acquired Pneumonia based on her
chest xray. One month ago, she was on levofloxacin for a UTI. What is the preferred
treatment for this patient?
A. Azithromycin 500mg x1 day, then 250mg daily for 4 days
B. Azithromycin 500mg x1 day, then 250mg daily for 4 days & Augmentin 2g BID
C. Doxycycline 100mg BID
D. Moxifloxacin 400mg daily
Give this one a try later!
Azithromycin 500mg x1 day, then 250mg daily for 4 days & Augmentin 2g BID
Rationale: Age greater than 65 years and antibiotic use within the previous
three months places a person at risk for antibiotic resistance. The preferred
treatment options for high risk patients is a respiratory fluroquinolone
(moxifloxacin, Gemifloxacin, or levofloxacin) or a macrolide PLUS a beta-
lactam. An antibiotic should be chosen from a class that is different from the
antibiotic the patient recently took. Since the patient was recently on
levofloxacin, a macrolide and beta-lactam are the preferred treatment
(Papadakis & McPhee, P. 273).
