A 23-year-old female presents to your clinic complaining of intermittent throbbing headaches that usually last for several hours and are made worse by the presence of light. She endorses occasional nausea without vomiting during the most severe episodes. Physical examination is unrevealing, and she has no significant past medical history.
Which of the following treatments is considered an abortive therapy for this patient's underlying condition?
Correct: A. Migraine headaches typically affect females more often than males, and patients most frequently present in their early 20s. Classic symptoms of migraine include throbbing headaches lasting between 2--24 hours in duration, with triggers such as red wine, fasting, stress, and menses. Primary prevention is aimed at the identification and avoidance of triggers. Over the counter NSAIDS can be used if symptoms persist. Failing this, PRN abortive therapy is indicated, including the triptans (e.g. -- sumatriptan) and metoclopramide. Choice B -- Gabapentin is an anticonvulsant that is considered to be a second-line, prophylactic treatment for recurrent migraine headaches. Its utility is limited by its lengthy side effect profile. Choice C -- Amitriptyline, a tricyclic antidepressant, can also be utilized for migraine prophylaxis. However, it will not abort a migraine currently in progress, and extensive side effects limit its use. Choices D + E -- Propranolol and diltiazam are beta-blockers and calcium channel blockers, respectively. As with the anticonvulsants and tricyclic antidepressants, these
are considered migraine prophylaxis and will not interrupt a migraine once it has begun.
A patient with multibacillary leprosy is on dapsone, clofazimine, and rifampin. Which of the following is true regarding the mechanism of action of the medications listed?
A, B -- false -- dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para- aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C -- False -- A substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M. leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D -- False -- See below. E -- True -- Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase.
Which of the following is/are nominal data?
Nominal data is considered unordered categories. Sex answers fall into male or female which is unordered. Race can be multiple answers such as Caucasian, African American, Asian, etc which is unordered. Blood group can only have blood type O, A, B, or AB which is also unordered. Ordered, or ordinal data would have categories that are in some sort of order
http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one
If LN receives Dextrose 5% half Normal Saline with 20 meq of Potassium as IVF at 125mls/hour. How much dextrose is he getting in 24hrs?
0.05 (1000 mL) = 50 g 1000 mL (1 hour/125 mL) = 8 hours 50 3 = 150 g
An 18-year-old female is referred to a dermatologist for treatment of severe acne vulgaris. The dermatologist wants to start her on tetracycline.
What test should the patient have prior to starting treatment?
Pregnancy test. Tetracyclines are effective in the treatment of severe cases of acne. They are however teratogenic. As such, it is imperative to make sure female patients are not pregnant prior to starting this medication. In many instances patients are started on concurrent birth control to mitigate this risk even further.
A chest x-ray (B) is an important exam to obtain prior to starting drugs which have pulmonary toxicity as a side effect such as amiodarone. A complete blood count (C) would be useful prior to starting a medication that causes anemia, such as immunosuppressive and chemotherapeutic agents. Liver function tests (D) are important to establish as a baseline prior to starting anti-mycobacterial agents. Creatine kinase levels (E) are used to establish as a baseline prior to starting statins.
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