Review

Question 1

most important labs in thyroid

Answer 1

free t4 and TSH

Question 2

hyperthyroidism labs

Answer 2

low TSH
high T4

Question 3

hypothyroidism labs

Answer 3

low T4
high TSH

Question 4

compounds that have iodine

Answer 4

Amiodarone, lithium

Question 5

hyperthyroidism treatment

Answer 5

thioamides: methimazole and propylthiouracil

Question 6

methimazole dosing

Answer 6

free t4 1-1.5 ULN 5-10 mg
1.5-2 ULN 10-20 mg
2+ ULN 30-40 mg

Question 7

thioamides adverse effects

Answer 7

GI, rash, agranulocytosis (fever,flu, immune), hepatitis

Question 8

what to use in hyperthyroid patients with HR over 90

Answer 8

beta blockers
(prefer metoprolol and atenolol)

Question 9

hypothyroidism drugs

Answer 9

levothyroxine, liothyronine, armour thyroid

Question 10

black box warning levothyroxine

Answer 10

weight loss

Question 11

counseling for levothyroxine

Answer 11

60 mins before breakfast or 4 hours after dinner
empty stomach

Question 12

uncomplicated adult levothyroxine dosing

Answer 12

1.6 mcg/kg/day

Question 13

elderly thyroid dose

Answer 13

start 25-50 mcg / day

Question 14

cvd thyroid dose

Answer 14

12.5-25 mcg/ day

Question 15

pregnant pts thyroid dose

Answer 15

45% increase in dose

Question 16

drug interactions
levothyroxine

Answer 16

antacids, bile acid, calcium, warfarin

Question 17

GERD alarm sx

Answer 17

dysphasia
odynophagia
bleeding
weight loss

Question 18

when to refer GERD

Answer 18

alarm sx or no PPI relief after 14 days

Question 19

side effects of calcium

Answer 19

constipation

Question 20

side effects magnesium

Answer 20

diarrhea

Question 21

side effects aluminum

Answer 21

constipation

Question 22

antacids counseling
w

Answer 22

take meds 2 hours before or 4-6 hours after antacids

Question 23

H2RA mechanism

Answer 23

reversible inhibition of histamine receptors

Question 24

H2RA pearls

Answer 24

beers
tachycardia
delirium
good for nocturnal

Question 25

H2RA with side effects

Answer 25

cimetidine

Question 26

PPis MOA

Answer 26

irreversible inhibition of proton pump

Question 27

PPis with meals

Answer 27

30-60 mins before meal

Question 28

pregnancy w gerd agents preferred

Answer 28

antacids or sucralfate H2ra second line

Question 29

which agent should be avoided in kids

Answer 29

bismuth subsalicylate

Question 30

ulcer in duodenum

Answer 30

pain relieves with food

Question 31

ulcer in stomach

Answer 31

worsens with food

Question 32

h pylori tx principle

Answer 32

PPI and 2-3 antibiotics

Question 33

bismuth quad

Answer 33

PPI BID bismuth subsaliclate metronidazole tetracycline 10-14 days

Question 34

alternative to bismuth quad

Answer 34

PPI BID levofloxacin 500 mg amoxicillin 1 g BId

Question 35

prophylaxis NSAID induced ulcer drug

Answer 35

misoprostol

Question 36

treatment only drug NSAID induced ulcer

Answer 36

sucralfate

Question 37

NSAID induced ulcer treatment time

Answer 37

8 weeks if NSAID stopped 12 weeks if continued

Question 38

post of n/v risk factors

Answer 38

female non smoker history motion sickness history post op nv

Question 39

loperamide dosing

Answer 39

4 mg initially then 2 mg after each loose stool max 16 mg / day

Question 40

constipation when to refer

Answer 40

2 weeks sx black stool abe pain fever

Question 41

bulk laxatives

Answer 41

psyllium softens stools better than docusate

Question 42

surfactant

Answer 42

docusate not effective for active constipation

Question 43

hyperosmotic

Answer 43

glycerin suppository and miralax good for chronic constipation

Question 44

stimulant laxatives

Answer 44

senna and bisacodyl good for opioid induced constipation

Question 45

hip and knee tx osteoarthritis

Answer 45

acetaminophen 4 g per day

Question 46

hand tx osteoarthritis

Answer 46

oral NSAID

Question 47

osteopenia t score

Answer 47

-1.1 to -2.4

Question 48

osteoporosis t score

Answer 48

<2.5

Question 49

bisphosphonates counseling

Answer 49

take on empty stomach full glasss of water do not lie down for at least 30 mins do not chew

Question 50

serms can be used for

Answer 50

back

Question 51

raloxifine black box

Answer 51

risk vte or stroke

Question 52

denosumab risk

Answer 52

rebound risk fracture after discontinuing hypoclcemia