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ANCC FNP REVIEW QUESTIONS AND ANSWERS
specialbyconsiderationsbyforbyThiazidesby-byanswer--Chlorthalidonebyisbypreferredbyonbythebybasisbyofbyprolongedbyhalf-
lifebyandbyprovenbytrialbyreductionbyofbyCVD.
Monitorbyforbyhyponatremiabyandbyhypokalemia,bymonitorbyuricbyacidbyandbycalciumbylevels.
Usebywithbycautionbyinbypatientsbywithbyhistorybyofbyacutebygoutbyunlessbypatientbyisbyonbyuricbyacid-loweringbytherapy.
specialbyconsiderationsbyforbyACEbyinhibitorsby-byanswer--
DobynotbyusebyinbycombinationbywithbyARBsbyorbydirectbyreninbyinhibitor.
Therebyisbyanbyincreasedbyriskbyofbyhyperkalemia,byespeciallybyinbypatientsbywithbyCKDbyorbyinbythosebyonbyK+bysuppleme
sbyorbyK+-sparingbydrugs.
Therebyisbyabyriskbyofbyacutebyrenalbyfailurebyinbypatientsbywithbyseverebybilateralbyrenalbyarterybystenosis.
DobynotbyusebyifbypatientbyhasbyhistorybyofbyangioedemabywithbyACEbyinhibitors.
ACEbyinhibitorbycoughbyisbycommon,byinby5bytoby20bypercentbyofbypatients,byduebytobybradykininbyproduction.
Avoidbyinbypregnantbyfemalesbyorbyfemalesbyofbyreproductivebyagebywithoutbyadequatebycontraception
specialbyconsiderationsbyforbyAngiotensinbyreceptorbyblockersby-byanswer--
DobynotbyusebyinbycombinationbywithbyACEbyinhibitorsbyorbydirectbyreninbyinhibitor.
TherebyisbyanbyincreasedbyriskbyofbyhyperkalemiabyinbyCKDbyorbyinbythosebyonbyK+bysupplementsbyorbyK+-sparingbydrugs.
Therebyisbyabyriskbyofbyacutebyrenalbyfailurebyinbypatientsbywithbyseverebybilateralbyrenalbyarterybystenosis.
DobynotbyusebyifbypatientbyhasbyhistorybyofbyangioedemabywithbyARBs.byPatientsbywithbyabyhistorybyofbyangioedemabywithby
byACEbyinhibitorbycanbyreceivebyanbyARBbybeginningby6byweeksbyafterbyACEbyinhibitorbyisbydiscontinued.
Avoidbyinbypregnantbyfemalesbyorbyfemalesbyofbyreproductivebyagebywithoutbyadequatebycontraception.
LowerbyriskbyofbycoughbythanbyACE-Is.
specialbyconsiderationsbyforbyCalciumbychannelbyblockersby-byanswer--Associatedbywithbydose-
relatedbypedalbyedema,bywhichbyisbymorebycommonbyinbyfemalesbythanbymen.
WhenbyshouldbyyoubyReferbytobyabyNephrologistbyorbyCardiologistbyinbyabyhypertensivebypatient?by-byanswer---
signsbyofbyend-organbydamage
-evidencebyofbyabysecondarybycausebyofbyhypertension
-onlybyonbyonebytobytwobymedications
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Generally,byfailurebytobyachievebybloodbypressurebygoalbyinbypatientsbywhobyarebyadheringbytobyfullbydosesbyofbyanbyapprop
atebythreebytobyfourbydrugbyregimenbythatbyincludesbyabydiureticbymaybywarrantbyreferralbytobyabynephrologistbyorbycardiolog
t
Beforebyreferring,bycliniciansbyshouldbyfirstbyreviewbyotherbycausesbyofbyinadequatebyhypertensionbycontrolbysuchbyas:
-Improperbybloodbypressurebymeasurement
-Whitebycoatbyhypertension
-Excessbysodiumbyintake
-Medicationbyissuesby(e.g.,bynonsteroidalbyanti-
inflammatorybydrugsby(NSAIDs),byillicitbydrugs,bysympathomimetics,byoralbycontraceptives)
-Excessbyalcoholbyintake
-Underlyingbyidentifiablebycausesbyofbyhypertensionby(secondarybyhypertension)
Abyresearcherbyisbystudyingbypotentialbyriskbyfactorsbyforbyobesity.byShebysendsbyabyquestionnairebytoby5000bypatientsbyw
ymeetbythebyCDCbycriteriabyforbyobesitybythatbyasksbythembyaboutbysedentarybylifestylebyfactors,byconsumptionbyofbyproce
edbyfood,byandbyfamilybyhistorybyofbyobesity.byThebyresearcherbysendsbythebysamebyquestionnairebytoby5000bypatientsbyw
byarebynotbyobese.byWhichbyofbythebyfollowingbybestbydescribesbythebydesignbyofbythebystudy?
A.byCross-sectionalbystudy
B.byRandomizedbycontrolledbytrialby
C.byMeta-analysis
byD.byCase-controlbystudyby-byanswer--Correct byAnswer:byD.byCase-controlbystudy
Thisbyisbyabyretrospectivebycase-
controlbystudy.byInbythisbyobservationalbystudybydesign,bysubjectsbyarebyselectedbybasedbyonbyanbyoutcome,byandbytheirby
orbyexposuresbyarebyassessedbyandbycomparedbytobysubjectsbywhobydobynotbyhavebythebyparticularbyoutcome.byThebyresu
yofbythebystudybyisbyexpressedbyasbyanbyoddsbyratio:byORby=by(#byexposedbywithbydiseaseby/
by#byexposedbywithoutbydisease)by/by(#bynotbyexposedbywithbydiseaseby/
by#bynotbyexposedbywithoutbydisease).byAbyretrospectivebycase-
controlbystudybydoesbynotbyprovebycausationbybutbydemonstratesbyanbyassociation.
Incorrectby
Answers:
A.byAbycross-sectionalbystudybyisbyusedbytobyassessbydiseasebystatusbyandbyriskbyfactorsbyatby1bypointbyinbytime.
B.byAbyrandomizedbycontrolledbytrialbyrefersbytobyabystudybywherebyabygroupbyisbygivenbyabytreatmentbyandbyoutcomesbyare
omparedbyagainstbyabycontrolbygroupbygivenbyabyplacebobyorbytreatedbywithbythebystandardbyofbycare.
C.byAbymeta-analysisbyprovidesbyabystatisticalbyanalysisbyofbythebyresultsbyofbymultiplebystudies.
VitalbyConcepts:
Inbyanbyobservationalbystudybydesign,bysubjectsbyarebyselectedbybasedbyonbyanbyoutcome,byandbytheirbypriorbyexposuresb
rebyassessedbyandbycomparedbytobysubjectsbywhobydobynotbyhavebyabyparticularbyoutcome.byThebyresultbyofbythebystudybyis
expressedbyasbyanbyoddsbyratio:byORby=by(#byexposedbywithbydiseaseby/by#byexposedbywithoutbydisease)by/
by(#bynotbyexposedbywithbydiseaseby/by#bynotbyexposedbywithoutbydisease).byAbyretrospectivebycase-
controlbystudybydoesbynotbyprovebycausationbybutbydemonstratesbyanbyassociation.
Aby49-year-
oldbyfemalebypresentsbytobythebyofficebywithbyabyhistorybyofbybreastbycancerbywhobyisbyhavingbyfrequentbyhotbyflashesbywho
lreadybytriedbyfirst-linebylifestylebychangesbywithoutbyimprovement?byWhatbyisbythebybestbytreatmentbyforbythisbypatient?
A.byHormonalbytherapybywithbyestrogenbyandbyprogesteroneby
B.byBioidenticalbyhormonesby
C.byCitalopramby
D.byBlackbycohoshby-byanswer--CorrectbyAnswer:byC.byCitalopram
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by
Selectivebyserotoninbyreuptakebyinhibitorsby(SSRI)sbyarebythebymostbyeffectivebypharmacologicbychoicebyforbythebyvasom
orbysymptomsbyofbymenopause.byCitaloprambyisbyanbySSRIbythatbyhasbygoodbyevidencebyofbyefficacybyagainstbythesebysy
ptomsbyandbyisbytypicallybywell-tolerated.
IncorrectbyAnswers:
A.byWomenbywithbyabyhistorybyofbybreastbycancerbyarebynotbycandidatesbyforbyhormonebyreplacementbytherapy.
B.by"Bioidenticalbyhormones"byarebycompoundedbymixturesbyofbymultiplebyhormones.byTherebyisbynobyevidencebytobysupp
tbytheirbyusebyatbythisbytime,byandbyagain,byhormonebytreatmentbywouldbybebycontraindicatedbyinbyabypatientbywithbyabyhisto
yofbybreastbycancer.
D.byBlackbycohoshbyisbyanbyherbalbyremedybymarketedbyforbyusebywithbyhotbyflashes.byHowever,byitbyhasbynotbybeenbydem
stratedbytobybebymorebyeffectivebythanbyabyplacebobyforbythisbyuse.byInbyaddition,byitbyhasbybeenbypositedbytobyhavebyabyposs
lebyestrogenicbyeffectbyonbybreastbytissue,bywhichbyshouldbybebyavoidedbyinbypatientsbywithbyabyhistorybyofbybreastbycancer
VitalbyConcepts:
Selectivebyserotoninbyreuptakebyinhibitorsby(SSRI)sbyarebythebymostbyeffectivebypharmacologicbychoicebyforbythebyvasom
orbysymptomsbyofbymenopause.byCitaloprambyisbyanbySSRIbythatbyhasbygoodbyevidencebyofbyefficacybyagainstbythesebysy
ptomsbyandbyisbytypicallybywell-tolerated.
Aby20-year-
oldbypresentsbytobythebyofficebyforbyabywellnessbycheck.byWhatbyisbythebyprevalencebyofbybulimiabynervosabyinbyfemalebycol
gebystudents?
A.by1%by
B.2%by
C.by4%by
D.by5%by-byanswer--CorrectbyAnswer:byD.by5%
Bulimiabynervosabyoccursbyinbyapproximatelyby5%byofbyfemalebycollegebystudents,bywhobyareby10xbymorebylikelybythanbym
ebycollegebystudentsbytobydevelopbythisbydisorder.byThebyprevalencebyofbyanorexiabynervosabyisby1.5%byinbyteenagebygirls
verall.
IncorrectbyAnswers:
(A),by(B),by(C)byarebythebynotbycorrectbyprevalence.
Aby16-year-
oldbymalebypresentsbybecausebyhebyisbyconcernedbyaboutbyacne.byHebyfirstbybeganbytobynoticebyworseningbyacneby6bymon
sbyagobyandbybeganbyusingbyover-the-
counterbybenzoylbyperoxidebyand,byafterby3bymonths,bysawbyhisbyprimarybycarebyphysicianbywhobyprescribedbytretinoinbya
byoralbytetracycline.byHebystatesbythatbyhebyhasbybeenbyusingbybothbymedicationsbyforbythebylastby3bymonthsbybutbytherebyis
obyimprovementbyinbyacne.byHebyalsobystatesbyhebyhasbynoticedbyhebyisbyverybyquickbytobyangerbyandbymoodybyoverbythebyla
byfewbymonthsbyandbywondersbywhetherbythatbyisbyabysidebyeffectbyofbythebyacnebymedications.byHebyisbyabyfootballbyplayer
orbyhisbyhighbyschoolbyandbyhasbybeenbyparticipatingbyinbyextrabypracticesbytoby"bulkbyup"byinbythebyhopesbyofbyachievingbya
ollegebyscholarship.byUponbycloserbyinspection,byhebyhasbygainedby30bypoundsbyinbythebylastby3bymonthsbybutbydoesbynotb
ppearbyoverweight,byratherbyhasbyincreasedbymusclebymass.byHebystatesbythatbyabyfriendbyonbythebyfootballbyteambyhasbyb
nbygivingbyhimbypillsbytobyhelpbyhisbyperformance.byWhichbyofbytheby-byanswer--
CorrectbyAnswer:byC.byLoweredbythyroxinebybindingbyglobulinby(TBG)bylevels
Anabolicbysteroidsbycanbylowerbythyroxine-
bindingbyglobulinby(TBG)bylevelsbywhich,byinbyturn,bycanbydecreasebytotalbyT4bylevels,byalthoughbyfreebyT4byremainsbytheb
me.
IncorrectbyAnswers:
A.byThisbypatientbyhasbymultiplebyfeaturesbythatbyarebyconsistentbywithbyanabolicbysteroidbyuse,byincludingbyacne,byabyrapi
ncreasebyinbyweightbyandbymusclebymass,byandbymoodbyswings.byInbymenbysteroidbyusebydecreasesbyserumbyluteinizingb
ormonebyandbyfollicle-
stimulatingbyhormonebylevels,bywhichbyleadsbytobydecreasedbyendogenousbytestosteronebyproduction,bydecreasedbyspe
matogenesis,byandbytesticularbyatrophy.byTherebyisbyalsobyanbyincreasedbyestrogenbyproductionbyduebytobythebyaromatiza
onbyofbycirculatingbytestosteronebywhichbycanbyleadbytobygynecomastia.
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B.byAnabolicbysteroidbyusebycanbyleadbytobyincreasedbyprothrombinbytimebyasbywellbyasbyabysuppressionbyofbyclottingbyfact
sbyII,byV,byVII,byandbyX.
D.byAnabolicbysteroidbyusebycanbyhavebymultiplebycardiovascularbyeffectsbyincludingbydecreasedbyserumbyHDLbycholeste
l,byincreasedbyserumbyLDLbycholesterol,byincreasedbytotalbycholesterol,byandbyincreasedbybloodbypressure.byThesebyeffe
sbyappearbytobybebyreversiblebywhenbyanabolicbysteroidbyusebyisbydiscontinued.byThebyriskbyofbysuddenbydeathbyfrombycard
vascularbycausesbycanbyoccurbyinbyanbyathletebyabusingbyanabolicbysteroidsbyevenbywhenbytherebyisbynobyevidencebyofbya
erosclerosis.byThisbyisbyduebytobyanbyincreasedbyriskbyofbythrombusbyformationbywhilebyusingbyanabolicbysteroids.
Aby45-year-
oldbywomanbypresentsbywithbyabnormalbyuterinebybleeding.byYoubydiscussbyyourbyrecommendationbyforbyendometrialbys
mplingbytobyrulebyoutbyendometrialbyhyperplasiabyandbycarcinoma.byWhatbyisbythebymostbycommonbycausebyofbyendometr
bycancer?
A.byHumanbypapillomabyvirus
B.byHereditarybynonpolyposisbycolorectalbycancerby
C.byMultiplebyendocrinebyneoplasia
D.byUnopposedbyestrogenby-byanswer--CorrectbyAnswer:byD.byUnopposedbyestrogen
Unopposedbyestrogenbycanbyleadbytobyovergrowthbyofbyendometrialbytissue,byultimatelybypromptingbyendometrialbyhype
asiabyandbyendometrialbycancer.byEndometrialbycancersbyoccurbythatbyarebynotbyrelatedbytobyestrogenbyexposure,bywhich
havebyabydifferentbypathologicbyappearancebyandbyabyworsebyprognosis.byWomenbywithbyanovulationbyorbyotherbytypesbyo
unopposedbyestrogenbyexposurebyshouldbyhavebyexposurebytobyprogesteronebyorbyprogestinsbyatbyleastbyeveryby3bymon
sbytobyreducebythebyriskbyofbyendometrialbyhyperplasiabyandbycancer.
IncorrectbyAnswers:
(A)byHumanbypapillomabyvirusby(HPV)byisbynotbythebymostbycommonbycausebyofbyendometrialbycancer.
(B)byHereditarybynonpolyposisbycolorectalbycancerby(HNPCC)byisbynotbythebymostbycommonbycausebyofbyendometrialbyca
cer.
(C)byMultiplebyendocrinebyneoplasiaby(MEN)byisbynotbythebymostbycommonbycausebyofbyendometrialbycancer.
Aby25-year-
oldbyrunnerbywithbynobyPMHbycomplainsbyofbypainbyinbythebyballbyofbyherbyfoot.byShebyhasbybeenbyexperiencingbythisbypainby
rby3bymonths,byandbythebypainbyalsobyspreadsbytobyherbytoesbyoccasionally.byItbyisbymitigatedbybybyrestbyandbyrelaxationbyan
yisbyaggravatedbybybyrunning.byThebypainbyoccursbyatbyallbytimesbyofbythebydaybyandbyisbynotbyrelatedbytobypsychologicalbyst
ss,bysleep,byorbytemperature.byShebyrecentlybystartedbyrunningbyabylotbymorebyeverybydaybyandbyhasbynoticedbythatbyherbyn
wbyshoesbyseembyabylittlebytight.
Thebypatient'sbytemperatureby=by98.3°F,byHRby=by70,byRRby=by16,byandbyBPby=by115/75.byPhysicalbyexambyrevealsbytende
essbyoverbythebyballbyofbythebyfootbyandbyoverbyherbymetatarsalsbyasbywell.byHerbyfootbyalsobyappearsbytobybebyquitebyarched
Thebypatientbyhasbynobytroublebyputtingbyweightbyonbythebyfootbyandbydoesbynotbyhavebyanybyerythema,byswelling,byorbydisc
oration.byWhatbyisbythebybestbystepbyinbymanagement?
A.byConservativebytherapyby(rest,byice,byNSAIDs)by
B.byX-raybyofbyfoot
C.byMRIbyofbyfoot
D.byArchbysupportbyandbyorthoticsbyofbyfoby-byanswer--CorrectbyAnswer:byA.byConservativebytherapyby(rest,byice,byNSAIDs
Metatarsalgiabyisbypainbyonbymetatarsalbyheadsbythatbyresultsbyinbytendernessbyoverbythebyballbyofbythebyfootbyandbysomet
esbythebytoes.byPatientsbywhobyrunbyabylotbyorbywhobywearbytight-
fittingbyshoesbyoftenbycomplainbyofbythesebysymptoms.byThebysymptomsbyarebyworsenedbybybyrunningbyandbyimprovebyw
byrestbyandbyrelaxation.byItbyalsobypresentsbywithbyanbyarchedbyfootbyandbyexcessbypronationbyofbythebyfoot.byMetatarsalgia
sbynotbyabyseriousbyconditionbyandbydoesbynotbyresultbyinbycomplicationsbytypically.byMostbycasesbyofbymetatarsalgiabyhea
withinbymonths,byandbythisbyself-limitedbyconditionbycanbybebytreatedbywithbyconservativebymanagement.
IncorrectbyAnswers:
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ANCC FNP REVIEW QUESTIONS AND ANSWERS
specialbyconsiderationsbyforbyThiazidesby-byanswer--Chlorthalidonebyisbypreferredbyonbythebybasisbyofbyprolongedbyhalf-
lifebyandbyprovenbytrialbyreductionbyofbyCVD.
Monitorbyforbyhyponatremiabyandbyhypokalemia,bymonitorbyuricbyacidbyandbycalciumbylevels.
Usebywithbycautionbyinbypatientsbywithbyhistorybyofbyacutebygoutbyunlessbypatientbyisbyonbyuricbyacid-loweringbytherapy.
specialbyconsiderationsbyforbyACEbyinhibitorsby-byanswer--
DobynotbyusebyinbycombinationbywithbyARBsbyorbydirectbyreninbyinhibitor.
Therebyisbyanbyincreasedbyriskbyofbyhyperkalemia,byespeciallybyinbypatientsbywithbyCKDbyorbyinbythosebyonbyK+bysuppleme
sbyorbyK+-sparingbydrugs.
Therebyisbyabyriskbyofbyacutebyrenalbyfailurebyinbypatientsbywithbyseverebybilateralbyrenalbyarterybystenosis.
DobynotbyusebyifbypatientbyhasbyhistorybyofbyangioedemabywithbyACEbyinhibitors.
ACEbyinhibitorbycoughbyisbycommon,byinby5bytoby20bypercentbyofbypatients,byduebytobybradykininbyproduction.
Avoidbyinbypregnantbyfemalesbyorbyfemalesbyofbyreproductivebyagebywithoutbyadequatebycontraception
specialbyconsiderationsbyforbyAngiotensinbyreceptorbyblockersby-byanswer--
DobynotbyusebyinbycombinationbywithbyACEbyinhibitorsbyorbydirectbyreninbyinhibitor.
TherebyisbyanbyincreasedbyriskbyofbyhyperkalemiabyinbyCKDbyorbyinbythosebyonbyK+bysupplementsbyorbyK+-sparingbydrugs.
Therebyisbyabyriskbyofbyacutebyrenalbyfailurebyinbypatientsbywithbyseverebybilateralbyrenalbyarterybystenosis.
DobynotbyusebyifbypatientbyhasbyhistorybyofbyangioedemabywithbyARBs.byPatientsbywithbyabyhistorybyofbyangioedemabywithby
byACEbyinhibitorbycanbyreceivebyanbyARBbybeginningby6byweeksbyafterbyACEbyinhibitorbyisbydiscontinued.
Avoidbyinbypregnantbyfemalesbyorbyfemalesbyofbyreproductivebyagebywithoutbyadequatebycontraception.
LowerbyriskbyofbycoughbythanbyACE-Is.
specialbyconsiderationsbyforbyCalciumbychannelbyblockersby-byanswer--Associatedbywithbydose-
relatedbypedalbyedema,bywhichbyisbymorebycommonbyinbyfemalesbythanbymen.
WhenbyshouldbyyoubyReferbytobyabyNephrologistbyorbyCardiologistbyinbyabyhypertensivebypatient?by-byanswer---
signsbyofbyend-organbydamage
-evidencebyofbyabysecondarybycausebyofbyhypertension
-onlybyonbyonebytobytwobymedications
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Generally,byfailurebytobyachievebybloodbypressurebygoalbyinbypatientsbywhobyarebyadheringbytobyfullbydosesbyofbyanbyapprop
atebythreebytobyfourbydrugbyregimenbythatbyincludesbyabydiureticbymaybywarrantbyreferralbytobyabynephrologistbyorbycardiolog
t
Beforebyreferring,bycliniciansbyshouldbyfirstbyreviewbyotherbycausesbyofbyinadequatebyhypertensionbycontrolbysuchbyas:
-Improperbybloodbypressurebymeasurement
-Whitebycoatbyhypertension
-Excessbysodiumbyintake
-Medicationbyissuesby(e.g.,bynonsteroidalbyanti-
inflammatorybydrugsby(NSAIDs),byillicitbydrugs,bysympathomimetics,byoralbycontraceptives)
-Excessbyalcoholbyintake
-Underlyingbyidentifiablebycausesbyofbyhypertensionby(secondarybyhypertension)
Abyresearcherbyisbystudyingbypotentialbyriskbyfactorsbyforbyobesity.byShebysendsbyabyquestionnairebytoby5000bypatientsbyw
ymeetbythebyCDCbycriteriabyforbyobesitybythatbyasksbythembyaboutbysedentarybylifestylebyfactors,byconsumptionbyofbyproce
edbyfood,byandbyfamilybyhistorybyofbyobesity.byThebyresearcherbysendsbythebysamebyquestionnairebytoby5000bypatientsbyw
byarebynotbyobese.byWhichbyofbythebyfollowingbybestbydescribesbythebydesignbyofbythebystudy?
A.byCross-sectionalbystudy
B.byRandomizedbycontrolledbytrialby
C.byMeta-analysis
byD.byCase-controlbystudyby-byanswer--Correct byAnswer:byD.byCase-controlbystudy
Thisbyisbyabyretrospectivebycase-
controlbystudy.byInbythisbyobservationalbystudybydesign,bysubjectsbyarebyselectedbybasedbyonbyanbyoutcome,byandbytheirby
orbyexposuresbyarebyassessedbyandbycomparedbytobysubjectsbywhobydobynotbyhavebythebyparticularbyoutcome.byThebyresu
yofbythebystudybyisbyexpressedbyasbyanbyoddsbyratio:byORby=by(#byexposedbywithbydiseaseby/
by#byexposedbywithoutbydisease)by/by(#bynotbyexposedbywithbydiseaseby/
by#bynotbyexposedbywithoutbydisease).byAbyretrospectivebycase-
controlbystudybydoesbynotbyprovebycausationbybutbydemonstratesbyanbyassociation.
Incorrectby
Answers:
A.byAbycross-sectionalbystudybyisbyusedbytobyassessbydiseasebystatusbyandbyriskbyfactorsbyatby1bypointbyinbytime.
B.byAbyrandomizedbycontrolledbytrialbyrefersbytobyabystudybywherebyabygroupbyisbygivenbyabytreatmentbyandbyoutcomesbyare
omparedbyagainstbyabycontrolbygroupbygivenbyabyplacebobyorbytreatedbywithbythebystandardbyofbycare.
C.byAbymeta-analysisbyprovidesbyabystatisticalbyanalysisbyofbythebyresultsbyofbymultiplebystudies.
VitalbyConcepts:
Inbyanbyobservationalbystudybydesign,bysubjectsbyarebyselectedbybasedbyonbyanbyoutcome,byandbytheirbypriorbyexposuresb
rebyassessedbyandbycomparedbytobysubjectsbywhobydobynotbyhavebyabyparticularbyoutcome.byThebyresultbyofbythebystudybyis
expressedbyasbyanbyoddsbyratio:byORby=by(#byexposedbywithbydiseaseby/by#byexposedbywithoutbydisease)by/
by(#bynotbyexposedbywithbydiseaseby/by#bynotbyexposedbywithoutbydisease).byAbyretrospectivebycase-
controlbystudybydoesbynotbyprovebycausationbybutbydemonstratesbyanbyassociation.
Aby49-year-
oldbyfemalebypresentsbytobythebyofficebywithbyabyhistorybyofbybreastbycancerbywhobyisbyhavingbyfrequentbyhotbyflashesbywho
lreadybytriedbyfirst-linebylifestylebychangesbywithoutbyimprovement?byWhatbyisbythebybestbytreatmentbyforbythisbypatient?
A.byHormonalbytherapybywithbyestrogenbyandbyprogesteroneby
B.byBioidenticalbyhormonesby
C.byCitalopramby
D.byBlackbycohoshby-byanswer--CorrectbyAnswer:byC.byCitalopram
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by
Selectivebyserotoninbyreuptakebyinhibitorsby(SSRI)sbyarebythebymostbyeffectivebypharmacologicbychoicebyforbythebyvasom
orbysymptomsbyofbymenopause.byCitaloprambyisbyanbySSRIbythatbyhasbygoodbyevidencebyofbyefficacybyagainstbythesebysy
ptomsbyandbyisbytypicallybywell-tolerated.
IncorrectbyAnswers:
A.byWomenbywithbyabyhistorybyofbybreastbycancerbyarebynotbycandidatesbyforbyhormonebyreplacementbytherapy.
B.by"Bioidenticalbyhormones"byarebycompoundedbymixturesbyofbymultiplebyhormones.byTherebyisbynobyevidencebytobysupp
tbytheirbyusebyatbythisbytime,byandbyagain,byhormonebytreatmentbywouldbybebycontraindicatedbyinbyabypatientbywithbyabyhisto
yofbybreastbycancer.
D.byBlackbycohoshbyisbyanbyherbalbyremedybymarketedbyforbyusebywithbyhotbyflashes.byHowever,byitbyhasbynotbybeenbydem
stratedbytobybebymorebyeffectivebythanbyabyplacebobyforbythisbyuse.byInbyaddition,byitbyhasbybeenbypositedbytobyhavebyabyposs
lebyestrogenicbyeffectbyonbybreastbytissue,bywhichbyshouldbybebyavoidedbyinbypatientsbywithbyabyhistorybyofbybreastbycancer
VitalbyConcepts:
Selectivebyserotoninbyreuptakebyinhibitorsby(SSRI)sbyarebythebymostbyeffectivebypharmacologicbychoicebyforbythebyvasom
orbysymptomsbyofbymenopause.byCitaloprambyisbyanbySSRIbythatbyhasbygoodbyevidencebyofbyefficacybyagainstbythesebysy
ptomsbyandbyisbytypicallybywell-tolerated.
Aby20-year-
oldbypresentsbytobythebyofficebyforbyabywellnessbycheck.byWhatbyisbythebyprevalencebyofbybulimiabynervosabyinbyfemalebycol
gebystudents?
A.by1%by
B.2%by
C.by4%by
D.by5%by-byanswer--CorrectbyAnswer:byD.by5%
Bulimiabynervosabyoccursbyinbyapproximatelyby5%byofbyfemalebycollegebystudents,bywhobyareby10xbymorebylikelybythanbym
ebycollegebystudentsbytobydevelopbythisbydisorder.byThebyprevalencebyofbyanorexiabynervosabyisby1.5%byinbyteenagebygirls
verall.
IncorrectbyAnswers:
(A),by(B),by(C)byarebythebynotbycorrectbyprevalence.
Aby16-year-
oldbymalebypresentsbybecausebyhebyisbyconcernedbyaboutbyacne.byHebyfirstbybeganbytobynoticebyworseningbyacneby6bymon
sbyagobyandbybeganbyusingbyover-the-
counterbybenzoylbyperoxidebyand,byafterby3bymonths,bysawbyhisbyprimarybycarebyphysicianbywhobyprescribedbytretinoinbya
byoralbytetracycline.byHebystatesbythatbyhebyhasbybeenbyusingbybothbymedicationsbyforbythebylastby3bymonthsbybutbytherebyis
obyimprovementbyinbyacne.byHebyalsobystatesbyhebyhasbynoticedbyhebyisbyverybyquickbytobyangerbyandbymoodybyoverbythebyla
byfewbymonthsbyandbywondersbywhetherbythatbyisbyabysidebyeffectbyofbythebyacnebymedications.byHebyisbyabyfootballbyplayer
orbyhisbyhighbyschoolbyandbyhasbybeenbyparticipatingbyinbyextrabypracticesbytoby"bulkbyup"byinbythebyhopesbyofbyachievingbya
ollegebyscholarship.byUponbycloserbyinspection,byhebyhasbygainedby30bypoundsbyinbythebylastby3bymonthsbybutbydoesbynotb
ppearbyoverweight,byratherbyhasbyincreasedbymusclebymass.byHebystatesbythatbyabyfriendbyonbythebyfootballbyteambyhasbyb
nbygivingbyhimbypillsbytobyhelpbyhisbyperformance.byWhichbyofbytheby-byanswer--
CorrectbyAnswer:byC.byLoweredbythyroxinebybindingbyglobulinby(TBG)bylevels
Anabolicbysteroidsbycanbylowerbythyroxine-
bindingbyglobulinby(TBG)bylevelsbywhich,byinbyturn,bycanbydecreasebytotalbyT4bylevels,byalthoughbyfreebyT4byremainsbytheb
me.
IncorrectbyAnswers:
A.byThisbypatientbyhasbymultiplebyfeaturesbythatbyarebyconsistentbywithbyanabolicbysteroidbyuse,byincludingbyacne,byabyrapi
ncreasebyinbyweightbyandbymusclebymass,byandbymoodbyswings.byInbymenbysteroidbyusebydecreasesbyserumbyluteinizingb
ormonebyandbyfollicle-
stimulatingbyhormonebylevels,bywhichbyleadsbytobydecreasedbyendogenousbytestosteronebyproduction,bydecreasedbyspe
matogenesis,byandbytesticularbyatrophy.byTherebyisbyalsobyanbyincreasedbyestrogenbyproductionbyduebytobythebyaromatiza
onbyofbycirculatingbytestosteronebywhichbycanbyleadbytobygynecomastia.
3by/
by56
, KIN 2504 Sontag Top
by by by
ic 1
by
B.byAnabolicbysteroidbyusebycanbyleadbytobyincreasedbyprothrombinbytimebyasbywellbyasbyabysuppressionbyofbyclottingbyfact
sbyII,byV,byVII,byandbyX.
D.byAnabolicbysteroidbyusebycanbyhavebymultiplebycardiovascularbyeffectsbyincludingbydecreasedbyserumbyHDLbycholeste
l,byincreasedbyserumbyLDLbycholesterol,byincreasedbytotalbycholesterol,byandbyincreasedbybloodbypressure.byThesebyeffe
sbyappearbytobybebyreversiblebywhenbyanabolicbysteroidbyusebyisbydiscontinued.byThebyriskbyofbysuddenbydeathbyfrombycard
vascularbycausesbycanbyoccurbyinbyanbyathletebyabusingbyanabolicbysteroidsbyevenbywhenbytherebyisbynobyevidencebyofbya
erosclerosis.byThisbyisbyduebytobyanbyincreasedbyriskbyofbythrombusbyformationbywhilebyusingbyanabolicbysteroids.
Aby45-year-
oldbywomanbypresentsbywithbyabnormalbyuterinebybleeding.byYoubydiscussbyyourbyrecommendationbyforbyendometrialbys
mplingbytobyrulebyoutbyendometrialbyhyperplasiabyandbycarcinoma.byWhatbyisbythebymostbycommonbycausebyofbyendometr
bycancer?
A.byHumanbypapillomabyvirus
B.byHereditarybynonpolyposisbycolorectalbycancerby
C.byMultiplebyendocrinebyneoplasia
D.byUnopposedbyestrogenby-byanswer--CorrectbyAnswer:byD.byUnopposedbyestrogen
Unopposedbyestrogenbycanbyleadbytobyovergrowthbyofbyendometrialbytissue,byultimatelybypromptingbyendometrialbyhype
asiabyandbyendometrialbycancer.byEndometrialbycancersbyoccurbythatbyarebynotbyrelatedbytobyestrogenbyexposure,bywhich
havebyabydifferentbypathologicbyappearancebyandbyabyworsebyprognosis.byWomenbywithbyanovulationbyorbyotherbytypesbyo
unopposedbyestrogenbyexposurebyshouldbyhavebyexposurebytobyprogesteronebyorbyprogestinsbyatbyleastbyeveryby3bymon
sbytobyreducebythebyriskbyofbyendometrialbyhyperplasiabyandbycancer.
IncorrectbyAnswers:
(A)byHumanbypapillomabyvirusby(HPV)byisbynotbythebymostbycommonbycausebyofbyendometrialbycancer.
(B)byHereditarybynonpolyposisbycolorectalbycancerby(HNPCC)byisbynotbythebymostbycommonbycausebyofbyendometrialbyca
cer.
(C)byMultiplebyendocrinebyneoplasiaby(MEN)byisbynotbythebymostbycommonbycausebyofbyendometrialbycancer.
Aby25-year-
oldbyrunnerbywithbynobyPMHbycomplainsbyofbypainbyinbythebyballbyofbyherbyfoot.byShebyhasbybeenbyexperiencingbythisbypainby
rby3bymonths,byandbythebypainbyalsobyspreadsbytobyherbytoesbyoccasionally.byItbyisbymitigatedbybybyrestbyandbyrelaxationbyan
yisbyaggravatedbybybyrunning.byThebypainbyoccursbyatbyallbytimesbyofbythebydaybyandbyisbynotbyrelatedbytobypsychologicalbyst
ss,bysleep,byorbytemperature.byShebyrecentlybystartedbyrunningbyabylotbymorebyeverybydaybyandbyhasbynoticedbythatbyherbyn
wbyshoesbyseembyabylittlebytight.
Thebypatient'sbytemperatureby=by98.3°F,byHRby=by70,byRRby=by16,byandbyBPby=by115/75.byPhysicalbyexambyrevealsbytende
essbyoverbythebyballbyofbythebyfootbyandbyoverbyherbymetatarsalsbyasbywell.byHerbyfootbyalsobyappearsbytobybebyquitebyarched
Thebypatientbyhasbynobytroublebyputtingbyweightbyonbythebyfootbyandbydoesbynotbyhavebyanybyerythema,byswelling,byorbydisc
oration.byWhatbyisbythebybestbystepbyinbymanagement?
A.byConservativebytherapyby(rest,byice,byNSAIDs)by
B.byX-raybyofbyfoot
C.byMRIbyofbyfoot
D.byArchbysupportbyandbyorthoticsbyofbyfoby-byanswer--CorrectbyAnswer:byA.byConservativebytherapyby(rest,byice,byNSAIDs
Metatarsalgiabyisbypainbyonbymetatarsalbyheadsbythatbyresultsbyinbytendernessbyoverbythebyballbyofbythebyfootbyandbysomet
esbythebytoes.byPatientsbywhobyrunbyabylotbyorbywhobywearbytight-
fittingbyshoesbyoftenbycomplainbyofbythesebysymptoms.byThebysymptomsbyarebyworsenedbybybyrunningbyandbyimprovebyw
byrestbyandbyrelaxation.byItbyalsobypresentsbywithbyanbyarchedbyfootbyandbyexcessbypronationbyofbythebyfoot.byMetatarsalgia
sbynotbyabyseriousbyconditionbyandbydoesbynotbyresultbyinbycomplicationsbytypically.byMostbycasesbyofbymetatarsalgiabyhea
withinbymonths,byandbythisbyself-limitedbyconditionbycanbybebytreatedbywithbyconservativebymanagement.
IncorrectbyAnswers:
4by/
by56
