Plant/Herb/Food Flashcards
Patients often use echinacea for the prevention and treatment of: (check one)
Memory loss
Upper respiratory symptoms
Gastrointestinal illnesses
Depression
Fatigue
Upper respiratory symptoms
Echinacea is a genus of native North American plants commonly known as purple coneflower. It has been recommended as a prophylactic treatment for upper respiratory infection, and is widely used for this indication, although it appears to be relatively ineffective. The research is difficult to evaluate because of the heterogeneity of the products used in various studies.
Children under 1 year of age should not be given honey because of possible contamination with which one of the following? (check one)
Staphylococcus aureus
Clostridium botulinum
Clostridium difficile
Escherichia coli
Hepatitis A
Clostridium botulinum
The most common cause of infant botulism is ingestion of Clostridium botulinum spores in honey.
A 54-year-old male presents to your office with a 10-day history of increasing cough. A physical
examination reveals coarse crackles in the left lower lobe. You make a diagnosis of pneumonia.
The patient’s only current medication is simvastatin (Zocor).
Which one of the following is CONTRAINDICATED in this patient?
(check one)
Amoxicillin/clavulanate (Augmentin)
Azithromycin (Zithromax)
Clarithromycin (Biaxin)
Doxycycline
Levofloxacin (Levaquin)
Clarithromycin (Biaxin)
In older adults, coprescription of clarithromycin or erythromycin with a statin that is metabolized by CYP
3A4 (atorvastatin, simvastatin, lovastatin) increases the risk of statin toxicity. The other antibiotics listed
do not interact with statins.
Which one of the following supplements has been associated with an increased risk of lung cancer in people who smoke? (check one)
β-Carotene
Magnesium
Vitamin B2
Vitamin B12
Vitamin C
β-Carotene
While many supplements are harmless, β-carotene has been shown to increase the risk of lung cancer in smokers and increase the risk of cardiovascular mortality. It can also cause reversible skin yellowing. The U.S. Preventive Services Task Force recommends against (D recommendation) β-carotene supplementation for the prevention of cardiovascular disease or cancer. There is insufficient evidence to draw conclusions on the use of magnesium, vitamin B2, or vitamin B12 for the prevention of cardiovascular disease or cancer. Vitamin C can increase the risk of nephrolithiasis.
The dietary herbal supplement with the highest risk for drug interactions is (check one)
black cohosh
ginseng
St. John’s wort (Hypericum perforatum)
saw palmetto
valerian
St. John’s wort (Hypericum perforatum)
St. John’s wort can reduce the effectiveness of multiple medications because it is an inducer of CYP3A4 and P-glycoprotein synthesis. Concurrent use of St. John’s wort with drugs that are metabolized with these systems should be avoided. These include cyclosporine, warfarin, theophylline, and oral contraceptives. St. John’s wort should be avoided in patients taking either over-the-counter or prescription medications.
A 41-year-old healthy female presents for a health maintenance examination. Her last preventive care visit was 3 years ago, when she had negative cervical cytology and HPV co-testing and a normal lipid panel. She does not use tobacco, alcohol, or illicit drugs. She has not been sexually active since her last visit, and her menstrual periods are regular. A complete physical examination is normal, including blood pressure.
Which one of the following is recommended by the U.S. Preventive Services Task Force for this patient at this time? (check one)
Daily folic acid supplementation
A manual breast examination
Chlamydia screening
A fasting lipid profile
A Papanicolaou test
Daily folic acid supplementation
The U.S. Preventive Services Task Force (USPSTF) recommends that all women planning or capable of pregnancy take a daily folic acid supplement containing 0.4–0.8 mg (400–800 μg) (A recommendation). A manual breast examination by the clinician or patient is not recommended by the USPSTF. Cervical cytology (a Papanicolaou test) is recommended every 5 years if results are normal and it is combined with negative high-risk HPV testing (A recommendation). Chlamydia screening is recommended yearly for all sexually active females under age 25 and older individuals at higher risk. For women who are over 25 and not at increased risk the USPSTF makes no recommendation for or against screening (C recommendation). This patient was screened for lipid disorders 3 years ago. While the best screening interval for lipids is not clearly defined, there is no clear recommendation to repeat screening lipids at this time. The USPSTF makes no recommendation for or against screening for lipid disorders in women who are not at increased risk for coronary heart disease (C recommendation).
A 29-year-old mother of three young children asks your opinion on giving probiotics to her children. Which one of the following is a benefit of the use of probiotics in children? (check one)
They reduce diarrhea associated with irritable bowl syndrome
They reduce colic symptoms in formula-fed infants
They prevent the development of allergies
They prevent antibiotic-associated diarrhea
They prevent antibiotic-associated diarrhea
A wealth of evidence-based research has established the benefits of probiotics, especially in children. Probiotics, particularly Saccharomyces boulardii , have been shown to prevent the antibiotic-associated diarrhea that occurs in 5%–30% of children who receive antibiotics (SOR A). The number needed to treat to prevent one case of diarrhea is 10.
Probiotics reduce the pain associated with irritable bowel syndrome (IBS) but have not been shown to be helpful in reducing diarrhea or constipation in pediatric IBS patients (SOR A).
In breastfed infants, probiotics reduce daily crying time by up to an hour. Similar benefits have not been found in formula-fed infants or infants who are combining breastfeeding and formula. Probiotics have not been shown to prevent colic in any infants.
Other benefits of probiotics include the prevention of eczema and upper respiratory infections (SOR A). However, their use has not been shown to prevent allergies and asthma.
