Internal Medicine

Question 1

starting at what GOLD category do COPD pt’s need a controller med

Answer 1

category B

Question 2

what is GOLD category B

Answer 2

moderate to severe symptoms →

walks slower than people same age

stops to catch breath at level ground

more severe breathlessness

Question 3

two options for controller med for COPD

Answer 3

tiotropium (Spiriva)

aformoterol (Brovana)

Question 4

tiptropium (Spiriva) is a __

aformoterol (Brovana) is a __

Answer 4

LAMA

LABA

Question 5

dosing for Tiotropium (Spiriva)

Answer 5

1 puff inhaled daily

Question 6

dosing for aformoterol (Brovana)

Answer 6

15 mcg via nebulizer BID

Question 7

important education for pt on controller med for COPD

Answer 7

difference btw controller med and PRN

Question 8

3 assessment tools for COPD

Answer 8

mMRC

CAT

GOLD

Question 9

mMRC scoring

Question 10

what does mMRC measure

Answer 10

level of dyspnea

Question 11

CAT scoring

Question 12

what does CAT measure for COPD

Answer 12

impact of symptoms on pt’s life

how it changes over time

Question 13

GOLD scoring is based on

Answer 13

spirometry → FEV1

Question 14

GOLD scoring

Question 15

what FEV1 value confirms COPD

Answer 15

FEV1 < 80%

Question 16

the GOLD classifications take into account what 2 assessment tests

Answer 16

mMRC

CAT

Question 17

treatment for COPD based on GOLD classification

Question 18

what med is recommended for secondary prevention with all patients 75 yo or younger w. CV dz

Answer 18

statin

Question 19

what 2 statins are recommended for a pt 75 yo or younger w. CVD

Answer 19

Atorvastatin (Lipitor)

Rosuvastatin (Crestor)

Question 20

what 2 other meds are recommended for a pt w. CAD post MI

Answer 20

ASA

beta blocker

Question 21

in terms of CKD, when do you need to d.c Metformin

Answer 21

CrCl < 30

Question 22

2 medication options for T2DM w. when Metformin is contraindicated

Answer 22

insulin

Glipizide

Question 23

starting dose for Glipizide:

starting dose for Lantus:

Answer 23

Glipizde: 2.5 mg qd

Lantus: 10 u daily

Question 24

how often is A1C rechecked for pt w. T2DM

Answer 24

q 3 months

Question 25

what BP med is best for diabetic pt

Answer 25

Lisinopril

Question 26

how does decrease in Lasix affect BP

Answer 26

BP may elevate w. d.c of Lasix

Question 27

what heart med is a major culprit of orthostatic hypotn

Answer 27

beta blocker

Question 28

2 tx steps in pt w. hypotention PLUS HTN

Answer 28

1. decrease Lasix
2. consider increasing Lisinopril

Question 29

how should Synthroid be taken

Answer 29

without other meds

with food

Question 30

how often should TSH be re-checked after adjusting Synthroid

Answer 30

q 6-8 weeks

Question 31

important at home monitoring for pt w. HF

Answer 31

daily weight checks

Question 32

in terms of weight monitoring, when should a pt w. HF call provider

Answer 32

weight gain of:

3 lb or more in 1 day

OR

5 or more pounds in 1 week

Question 33

common cause of orthostatic hypotn in a pt w. HF

Answer 33

overdiuresis

Question 34

what does hypernatremia plus hypokalemia make you think in a pt on HF meds

Answer 34

overdiuresed

Question 35

when should pt follow up after adjusting Lasix

Answer 35

5-7 days for BMP

Question 36

med that is effective for HTN and CKD (especially in a diabetic)

Answer 36

ACEI → Lisinopril

Question 37

how might decreasing Lasix affect CBC

Answer 37

might make anemia slightly worse