Kaizen Flashcards
Which condition would provide increased risk for the use of oral contraceptive pills?
1. Gallbladder disease
1. Hx of ectopic pregnancy
1. Polycystic Ovary Syndrome (PCOS)
1. Anxiety disorder
Relative CI
* diabetes
* HTN
* cardiac disease
* hx cholestatic jaundice of pregnancy
* gallbladder disease
* uterine leiomyoma
* epilepsy
* migraine
Absolute CI
* thrombophlebitis
* thromboemolic disorders
* cerebral vascular disease
* coronary occlusion
what is the primary goal of hypoglycemic therapy after the administration of glucagon for acute needs?
1. correct acidosis
1. treat the adverse effect of diarrhea
1. correct cachexia
1. restore liver glycogen stores
restore glycogen stores
Glucagon:
* promotes breakdwon of glycogen to glucose
* reduces the conversion of glucose to glycogen
* stimulates biosynthesis of glucose
Which condition is NOT a risk of anabolic steroid use
1. gynecomastia
1. hypotension
1. sterility
1. testicular shrinkage
hypotension
Salt and water retention can lead to HYPERtension
A hypothyroid pt is considering pregnancy. Which of the following reinforces the proper use of her thyroid replacement medication?
1. “Generally, your thyroid meds will decrease during pregnancy because of hormonal changes”
1. “It is important that your thyroid function is normal before conception to provide adequate thyroid hormones for your fetus”
1. “Once your thyroid functions are normal, we will keep you on the same dose throughout your pregnancy”
1. “You can feel comfortable taking your thyroid meds and your prenatal vitamins at the same time”
“It is important that your thyroid function is normal before conception to provide adequate thyroid hormones for your fetus”
- By 2nd trimester, the fetal thyroid gland is fully functional. To assure adequate development, TSH levels should be normal during the 1st trimester.
- Generally, increased thyroid hormone is needed during pregnancy because of the increased production of TBG
- Thyroid meds should never be taken at the same time as prenatal vitamins because of the calcium and thyroid interaction
A 59 year old female presents to your clinic with urinary urgency, frequency, and nocturia for the past 6 months. Her past medial history includes glaucoma. A urinalysis has rulled out UTI, and she is diagnosed with overactive bladder.
What is the best medication to treat this patient?
1. urecholine (Bethanecol)
1. tolterodine (Detrol)
1. mirabegron (Myrbetriq)
1. solifenacin (Vesicare)
- urecholine (Bethanecol) - muscarinic agonist indicated for urinary retention
- tolterodine (Detrol) - anticholinergic; CI in glaucoma
- mirabegron (Myrbetriq) - beta 3 adrenergic agonist
- solifenacin (Vesicare) - anticholinergic; CI in glaucoma
Which antihypertensive drug class would require blood glucose monitoring rather than symptom monitoring for hypoglycemia?
1. ACE inhibitors
1. Beta-blockers
1. Loop diuretics
1. Thiazide diuretics
- ACE inhibitors
- Beta-blockers - mask hypoglycemia symptoms
- Loop diuretics
- Thiazide diuretics
Which category of beta-blockers is safest for patients with diabetes?
1. nonselective
1. cardioselective
1. agonist
1. permissive
- nonselective
- cardioselective
- agonist
- permissive
Beta-2 blockade will inhibit the breakdown of glycogen into glucose, posing a risk for hypoglycemia in diabetes patients
A 9 year old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances.
Which aspect of the nervous ystem would her healtcare providers focus their diagnostic efforts?
1. damage to cerebellum
1. afferent and efferent cranial nerve function
1. impaired function of hypothalamus
1. damage to pons and medulla
- damage to cerebellum
- afferent and efferent cranial nerve function
- impaired function of hypothalamus
- damage to pons and medulla
A patient with osteopenia asks her NP about the benefits of hormone therapy in preventing osteoporosis.
Which of the following statements are correct?
1. “Estrogen, when taken properly, can help reverse bone loss”
1. “Hormone replacement therapy (HRT) will increase bone resorption”
1. “Long term HRT does not decrease fracture risk”
1. “When HRT is disontinued, bone mass is lost quickly”
- “Estrogen, when taken properly, can help reverse bone loss”
- “Hormone replacement therapy (HRT) will increase bone resorption”
- “Long term HRT does not decrease fracture risk”
- “When HRT is disontinued, bone mass is lost quickly”
For protection against osteoporosis HRT must be taken long term. When discontinued, 12% of bone mass is lost.
Because of risks associated with prolonged HRT, alternative therapies are preferred
* raloxifene
* biophosphonates
* calcitonin
* teriparatide
To promote bone health, all women should
* perform weight-bearing exercise
* ensure adequate intake of calcium and vit D
* avoid smoking
* avoid excessive intake of alcohol
A NP prescribed dutasteride (Avodart) for a pt with BPH. Which teaching point would be used?
1. “Take this med 1hr before sexual intercourse is planned. You should have an erection that lasts at least 1hr”
1. “I will need to monitor your PSA in 6-8wks as I expect it will increase over time”
1. “I would like to see you back in 8-10wks to perform a post-void sonar of your bladder to make sure your residual urine is < 50mL”
1. “It is important that you return to the office every 2wks for digital prostate exam to make sure it is reducing in size”
- “Take this med 1hr before sexual intercourse is planned. You should have an erection that lasts at least 1hr”
- “I will need to monitor your PSA in 6-8wks as I expect it will increase over time”
- “I would like to see you back in 8-10wks to perform a post-void sonar of your bladder to make sure your residual urine is < 50mL”
- “It is important that you return to the office every 2wks for digital prostate exam to make sure it is reducing in size”
Dutasteride (Avodart) can reduce PSA, and should relieve symptoms of BPH over time. As a result, the post-void residual should decrease over time. With symptoms improving, bi-weekly prostate exams would be unnecessary (and unfeasible).
