Family med pharm/tx Exam latest (Solved 100%)

ASA + nitro + BB + statin + CCB + heparin - ANSWER initial stable angina ASA + statin+ BB +/- nitro - ANSWER stable angina post event ASA + nitro + hep+ anxiolytics **NO BB - ANSWER cocaine induced MI 1st line ...

ASA + nitro + BB + statin + CCB + heparin - ANSWER initial stable angina ASA + statin+ BB +/- nitro - ANSWER stable angina post event ASA + nitro + hep+ anxiolytics **NO BB - ANSWER cocaine induced MI 1st line: CCB 2nd line: nitro **no BB - ANSWER variant angina (vasospastic) nitro + dual anti-plt - ANSWER unstable angina observation - ANSWER 1st degree AV block if sx : atropine if asx : observe - ANSWER 2nd degree AV block, mobitz 1 atropine - ANSWER anticholinergic tx for BRADYcardia initial: atropine or transcutaneous pacemaker definitive: permanent pacemaker - ANSWER 2nd degree AV block, mobitz 2 acute/sx: transcutaneous pacemaker definitive: permanent pacemaker - ANSWER 3rd degree AV block 1st line: BB (metoprolol) or CCB (diltiazem/verapamil) 2nd line: digoxin - ANSWER afiblflutter rate control <48 hours = cardiovert >48 hours = amiodarone - ANSWER afib/flutter rhythm control amiodarone - ANSWER anti-arrhythmic (afib) cardiovert - ANSWER unstable afib/flutter digoxin - ANSWER anti-arrhythmic (AFIB) & BP support *never for diastolic HF diltiazem - ANSWER CCB verapamil - ANSWER CCB CPR + defibrillation - ANSWER vfib IV magnesium sulfate - ANSWER torsades BB + nitro + ASA + hep + ACE + PCI (cath) ASAP - ANSWER STEMI BB+ nitro + ASA+ hep **no emergent reperfusion PCI - ANSWER NSTEMI nitro - ANSWER angina dose: 0.3-0.4 NOT for hypotension, viagra in last 24 hours, or R sided MI clopidogrel (plavix)/ticagrelor - ANSWER p2y12 inhibitor anti-plt therapy nsaids, PT - ANSWER costochondritis ace + BB + loop diuretic - ANSWER systolic L HF ace + BB or CCB *no diuretics - ANSWER diastolic HF zolpidem - ANSWER sedative tx for insomina furosemide brand name - ANSWER lasix POND 1st diuretics + pressors + o2 + nitrates (hydralazine) - ANSWER acute CHF exacerbation hydralazine - ANSWER nitrate - chf exacerbation - malignant htn** BAM BB + ace/arb + +/-mineralocorticoid blockers - ANSWER chronic CHF o2 + nitro + ASA + ace + morphine - ANSWER acute CAD ASA, BB, ace/arb, HMG CoA reductase **not CCB - ANSWER post MI 800 units (mcg) vitamin d + 2000 mg calcium - ANSWER daily dosage for osteopenia/porosis Alendronate (Fosamax) - ANSWER bisphosphonate **1st line for osteoporosis "-nate" and zoledronic acid - ANSWER bisphosphonates initial: lifestyle change - ANSWER htn newly diagnosed mono therapy of any of the following ace arb tzd CCB - ANSWER htn uncomplicated **no ace/arb alone in AA dual therapy of: ace arb tzd CCB ** ace + CCB - ANSWER refractory htn to monotherapy or still >20/10 from goal TF: losartan is the only arb to not cause hyperuricemia (gout) - ANSWER true drug of choice: clonidine (decrease slowly) - ANSWER htn urgency IV anti-htn - sodium nitroprusside**** but not if renal failure - BB (lobetalol) - CCB (nicardipine) - nitro - ANSWER htn emergency initial: increase salt and fluids persistent: fludrocortisone - ANSWER orthostatic hypotension ace protective for... - ANSWER DM, kidney function, ascvd hx statins VS fenofibrate VS niacin - ANSWER best for lowering LDL best for lowering triglycerides best for raising HDL atorvastatin 40-80 rosuvastatin 20-40 - ANSWER high intensity statin lovastatin 20 pravastatin 10-20 - ANSWER low intensity statin atorvastatin 10-20 simvastatin 20-40 lovastatin 40 - ANSWER moderate intensity statin high intensity statin for... - ANSWER - <75 yo with ascvd - if ascvd >20% - if LDL >190 moderate intensity statin if... - ANSWER - >75 yo with ascvd - if DM - if ascvd <20% empiric therapy: - native valve: pcn+ ceftriaxone or gent - prosthetic valve: vanco + gent + rifampin - ANSWER infective endocarditis amoxicillin 2g ~1 hour prior to procedure OR clindamycin 600mg if pcn allergy ^ - ANSWER endocarditis prophylaxis 1st line: nsaids or asa 2nd line: colchicine - ANSWER pericarditis - risk factor modification - Rx: anti-plt (cilostazol, ASA, clopidogrel) - revascularization (percutaneous angioplasty, fem-pop bypass) - ANSWER PAD cilostazol - ANSWER ADP inhib/vasodilator tx for PAD elevation, compression, avoid long standing - ANSWER chronic venous insufficiency the only effective tx: valve replacement - ANSWER aortic stenosis med: ace/arb, nifedipine surg - ANSWER aortic regurg best: percutaneous balloon valvuloplasty - ANSWER mitral stenosis med: ace/arb surg: repair >>> replace - ANSWER mitral regurg BB only if dysfunction - ANSWER mitral valve prolapse no tx needed - ANSWER pulm regurg SABA (albuterol) prn - ANSWER mild intermittent asthma low dose ICS daily + saba prn - ANSWER mild persistent asthma low dose ICS + LABA (formoterol) OR med dose ICS + LABA - ANSWER moderate persistent asthma high dose ICS + LABA +/- oral corticosteroids - ANSWER severe persistent asthma o2 + SABA + ipratropium bromide + oral corticosteroids - ANSWER acute asthma fomoterol salmeterol - ANSWER LABA ipratropium - ANSWER SAMA (anticholinergic) budesomide fluticasone - ANSWER ICS for asthma tiotropium - ANSWER LAMA sx tx, no abx bc mostly viral - ANSWER acute bronchitis abx (macrolide or ceph), bronchodilators, supportive - ANSWER bronchiectasis MC caused by cystic fibrosis SABA prn - ANSWER COPD class a (low sx, low risk) LAMA> LABA + saba prn - ANSWER COPD class b (high sx, low risk) LAMA/LABA combo + saba prn - ANSWER COPD class c (low sx, high risk) LAMA/LABA combo + ICS + saba prn - ANSWER COPD class D (high sx, high risk) macrolides (azithromycin) or doxy - ANSWER mycoplasma pna (WALKING) macrolides (azith) or fluro (levofloxacin) - ANSWER legionella pna out pt healthy: 1st macrolide (zpack 500mg), 2nd doxy out pt unhealthy: b lactam + macrolide ICU: ceph + azith/levofloxacin - ANSWER CAP vanco + piperacillin - ANSWER HAP adenosine vs amiodarone - ANSWER adenosine: proven psvt tx BUT fatal if rhythm incorrectly identified amiodarone: not 1st line but MORE safe s/e of amoxicillin in mono pt's - ANSWER generalized maculopapular rash stage 1-2: surgery stage 3: chemo then surgery stage 4: palliative - ANSWER non small cell carcinoma NO surgery, only chemo + radiation - ANSWER small cell carcinoma thoracentesis (needle) - ANSWER pleural effusion long term corticosteroid - ANSWER sarcoidosis weight loss CPAP - ANSWER OSA bupropion varenicline (chantix) patches/gum/etc - ANSWER tobacco use disorder chest tube (if small just o2) - ANSWER pneumothorax isoniazid for 9 months - ANSWER latent TB RIPE rifampin (orange pee) isoniazid (peripheral neuropathy/vit B6) pyrazinamide (hyperuricemia) ethambutol (eyes) - ANSWER active TB 1. supportive (sitz bath, stool softener) 2. topical vasodilators (nitroglycerin***, nifedipine, botox) - ANSWER anal fissures NPO IVF abx (3GC or doxy + flagyl OR --> appendectomy - ANSWER appendicitis single dose cefotetan 2g IV - ANSWER pre op prophylaxis for appendectomy