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Exam l 1 : l NU664B/ l NU l 664B l (NEW l 2025/ l
2026 l Update) l Primary l Care l of l Family l I l
Review l | l Questions l & l Answers| l Grade l A| l
100% l Correct l (Verified l Solutions)- l Regis
QUESTION
whatl isl thel maxl effectivel dosel ofl HCTZ? Answer: 25 l mgl daily
QUESTION
ACEl drugs Answer:
- prill drugs firstl linel for: 1.l HFl 2.l LVl dysfunction 3.l DM 4.l Proteinuricl kidneyl disease NOTl forl breastfeedingl orl pregnantl women
QUESTION
sidel effectsl ofl ACE-Il andl howl tol manage Answer: 1.l angioedemal - l morel commonl inl blacks,l ifl thisl happens,l drugl shouldl bel stopped.l patientl shouldl alsol NOTl tryl ARB 2.l coughl - l morel commonl inl blacksl andl women,l canl switchl tol anl ARBl
3.l hyperkalemia 4.l renall insufficiencyl - l checkl baselinel creatininel beforel starting) 5.l hypotensionl - l restartl atl halfl dose
QUESTION
ARBl drugs Answer:
- sartanl drugs
- l goodl forl ptsl whol don'tl toleratel ACE-I's
- l don'tl givel wl anl ACE
- l peakl effectl =l 4 - 6 l weeks
QUESTION
calciuml channell blockers Answer: agentsl thatl inhibitl thel entryl ofl calciuml ionsl intol heartl musclel cells,l causingl al slowingl ofl thel heartl rate,l al lesseningl ofl thel demandl forl oxygenl andl nutrients,l andl al relaxingl ofl thel smoothl musclel cellsl ofl thel bloodl vesselsl tol causel dilation;l usedl tol preventl orl treatl anginal pectoris,l somel arrhythmias,l andl hypertension
- l adversel effect:l peripherall edemal - l mostl commonl inl women,l dosel >l 5mg
- l addingl anl ACEl decreasesl riskl ofl edema twol types: dyhydropyridinesl (workl morel peripherally)l =l amlodipine OR non-dihydropryidinesl (morel workl onl thel SAl nodel tol slowl cardiacl conduction)l =l verapamill orl diltiezem
QUESTION
bestl cardiacl medl forl anl elderlyl person? Answer:
needl tol thinkl aboutl ratel controll =l betal blockersl orl nondihydropyridinel CCBSl (verapamil)
QUESTION
whatl isl thel mostl commonl contraindicationl ofl betal blockers? Answer: concernl forl BRONCHOSPASM
- l shouldl notl bel usedl forl ptsl wl asthma okayl inl COPD
- l shouldl alsol notl considerl ACEl asl firstl linel forl personsl wl asthmal d/tl increasel riskl ofl cough
QUESTION
whatl medsl shouldl NOTl bel usedl forl patient'sl withl al heartl block? Answer: betal blockersl or nondihydropyridinel CCBSl *l canl exacerbatel sympsl inl patientsl withl decompensatedl HFl (whenl thel heartl isl purposefullyl speedl up)
QUESTION
thresholdl forl SABAl usagel inl controll asthma Answer: nol morel thanl 2 - 3 l timesl weeklyl whenl NOTl sick
QUESTION
cromolynl sodium Answer: mastl celll inhibitor
- l notl anl antihistamine,l howeverl usefull forl allergies,l notl oftenl usedl anymore
- l doesl NOTl workl rightl awayl (morel similarl tol singular
QUESTION
Duol Nebl vsl albuterol Answer:
- l duonebl isl goodl forl chronicl airwayl inflammatoryl diseasel (?)
- l albuteroll onlyl forl children
QUESTION
FEV
Answer: forcedl expiratoryl volumel inl 1 l second
- l reducedl inl asthmal /l COPD
QUESTION
FVC
Answer: Standsl forl forcedl vitall capacity;l amountl youl canl blowl outl afterl largestl breathl in
QUESTION
FEV1/FVCl ratio Answer: diagnosisl ofl COPDl shouldl bel <70%
QUESTION
Answer: cloudingl ofl thel lens,l doesn'tl allowl lightl tol passl through graduall loss causedl by:
- l aging
- congenitall (espl ifl moml hadl ruebella)
- traumal /l diseasel (exl DM)
- l unprotectedl sunlightl exposure
- l corticosteroidl usage
- l smokingl /l ETOH willl presentl with:
- l Cloudyl ,l blurredl visionl (gradual)
- Acquiringl frequentl eyeglassl rx
- l Tonedl downl colors
- l Sensitivityl atl NIGHTl (cannotl see,l botheredl byl thel light) howl tol stopl developmentl ofl cataracts
- l sunglassesl /l eyel protection
- l fruitsl andl vegetablesl
- l smokingl /l ETOHl reduction
- l regularl eyel exams
QUESTION
retinall detachment Answer: twol layersl ofl thel retinal separatel froml eachl other thisl isl sightl threatening *l NOl PAINl ASSOCIATED
- l canl comel onl slowlyl orl suddenly Symps:
- l floatersl orl flashl ofl light
- l flashl isl usuallyl followedl byl blackl cloudl coveringl partl ofl visionl (curtain-like)
- l graduallyl reducedl peripherall vision Management thisl isl anl EMERGENCY.l sendl ptl tol ED
QUESTION
macularl degeneration Answer: progressivel damagel tol thel maculal ofl thel retina
- l centerl visionl loss
- l treatmentl aimsl tol SLOWl lossl ofl vision,l doesl NOTl restorel vision
- l doesl NOTl hurt RFsl -
- l mostlyl inl agesl 60 l + Sympsl
- l blurredl vision
- l blackl spotsl overl centrall vision
QUESTION
pterygium Answer: triangularl opaquel tissuel onl thel nasall sidel ofl thel conjunctival thatl growsl towardl thel centerl ofl thel cornea "surferl eye" doesl notl affectl vision,l justl visible
QUESTION
Virall conjunctivitis Answer: usuallyl concurrentl withl al URI stringy,l clearl dischargel froml eye,l willl usuallyl havel thel grittyl sensation typicallyl bilateral willl oftenl wakel upl withl crustyl dischargel tol eyes,l doesl resolvel throughoutl thel day
QUESTION
maxl dailyl dosel ofl amoxicillinl inl children Answer: 3 l gramsl /l dayl =l MAX shouldl dosel atl 90mg/kgl /l dayl inl TWOl doses
QUESTION
OMl inl adults Answer: samel sympsl andl treatmentl asl children
- l startl wl amoxl 500mgl BIDl xl 10 l days switchl tol augmentinl ifl nol responsel inl 48 l hours
QUESTION
otitisl externa Answer: severel earl pain,l purulentl discahrge,l hearingl lossl andl sometimesl fever PEl findings:
- l conductivel hearingl loss
- l painl tol thel touch
- l swellingl ofl canal
- l purulentl discharge *oftenl d/tl staphl bacteria tol treat: topicall abx/steroid
- l neomycin/polymixinl Bl wl hydrocortisone OR
- l Ciprol wl dextamethasone
QUESTION
weberl test Answer: Conductivel hearingl loss:l soundl lateralizesl tol affectedl (bad)l ear Sensorineural:l soundl lateralizesl tol unaffectedl (good)l ear
QUESTION
Rinnel test Answer: hearingl testl usingl al tuningl fork;l checksl forl differencesl inl bonel conductionl andl airl conduction conductivel hearingl lossl BCl >l AC Sensorineurall =l rinnel isl normall (ACl >l BC)
QUESTION
causesl ofl sensorineurall hearingl loss Answer: age drugl induced:l genamycin,l lasix,l ASA
QUESTION
Acutel Rhinosinusitisl (ARS)l - l GUIDLINESl FORl BACTERIALl TX Answer: 1.l 10(+)l daysl ofl sympsl withoutl improvement 2.l severel sympsl (l 102 l fever,l purulentl nasall discharge,l faciall pain)l forl 3 - 4 l daysl atl beginningl ofl illness 3.l doublel sickening:l newl onsetl ofl worseningl sympsl (fever,l headaches,l increasedl nasall discharge)l followingl 5 - 6 l daysl ofl virall URIl symps
Answer: Beclomethasonel (QVAR) Budesonidel (Pulmicort) Fluticasonel (Flovent)
- l usedl forl rhinitisl orl asthmal management
- l decreasel LOCALl inflammationl ofl thel lungs Sidel effects:
- l headaches
- l pharyngitis
- l orall thrushl (shouldl washl outl mouth) *ifl usingl inl combol withl bronchodilator,l shouldl takel thatl first,l thenl waitl 5 l minsl thenl takel ICS
QUESTION
Leukotrienel Receptorl Antagonists Answer: Montelukastl (singular)l - l takel inl evening Zafirlukastl *usedl forl asthmal andl preventionl ofl exercisel inducedl decreasel affectl ofl leukotrienesl (thesel arel inflammatoryl chemicalsl thatl arel releasedl inl responsel tol anl allergy) -->l thisl reducesl airwayl inflammationl andl bronchoconstrictionl thinkl lukastl =l leukotrienes
QUESTION
antitussives Answer: relievel orl suppressl coughingl byl blockingl thel coughl reflexl inl thel medullal ofl thel brain benzonatatel -->l anestheticl effectl onl vagall nervel receptorsl inl thel airway
l - l sidel effectsl =l sedation,l constipation,l GIl upset codeinel -->l thisl isl anl opioidl med dextromethorphanl (Delsym)l -->l suppressesl coughl reflexl inl thel medulla
QUESTION
PEl findingsl forl COPD Answer:
- l prolongedl expirationl andl wheezesl onl forcedl expiration
- l inspiration:l decreasedl movementl ofl ribl (morel abdl work)
- l forwardl sitting
- l clubbingl ofl fingers
- l neckl veinl distention
- l edemal tol extremities
- l increasedl anteriorl tol posteriorl chestl =l barrell chest
QUESTION
whatl isl thel goldl standardl forl COPDl diagnosis? Answer: spirometry includes:l FVCl - l amountl ofl airl expelledl afterl largestl possiblel inhalation FEC1l - l volumel ofl airl expiredl inl 1stl secondl (1l sec)l afterl maxl inspirationl note:l COPDl =l FEV1/FCVl ratiol ofl 70%l orl LESS
QUESTION
GOLDl standardl COPDl Stagel 1 Answer: mild,l FEV1l >l 80%
Chestl X-rayl tol r/ol pneumonia EKG *typicallyl NOTl sputuml culturel inl outpatientl setting
QUESTION
medicationl forl mildl COPDl (Goldl stagel 1) Answer: patientl isl notl veryl symptomatic,l typicallyl breathlessl withl strenuousl exercisel SABAl (Albuterol) SAMAl (ipratropium/l Atrovent) ORl Combol SABAl +l SAMAl (Combivent)l ifl needed
QUESTION
Medicationl forl moderatel COPDl (Goldl Stagel 2) Answer: patientl isl morel symptomatic:l hasl tol walkl morel slowly,l hasl tol stopl walkingl andl catchl breath 1.l regularl treatmentl withl al longl terml bronchodilator,l eitherl LABAl (salemeterol,l indacaterol)l orl LAMAl (tiotropiuml bromide) 2.l SABAl forl symptoml reliefl (endl inl - ol)
QUESTION
whatl isl symbicort Answer: budesonide/formoterol (COMBOl OFl ICSl andl LABA)
QUESTION
Asthmal management Answer: 1stl - l SABAl -->l albuteroll 2ndl - l ICSl -->l QVAR,l Flovent 3rdl - l LABAl -->l fotmoterol,l ect 4thl - l LAMAl -->l "bromide" *combinel ICSl andl LABAl (advair,l symbicort)
QUESTION
COPD
Answer: 1stl SABA 2ndl LAMA 3rdl LABA 4thl ICS COPDl youl seel LAMA/LABAl combo
QUESTION
orall steroidsl forl COPDl exacerbation Answer: prednisonel 40 - 60mgl /l day
QUESTION
tacticlel fremitus:l whatl causesl increasel andl decrease
Answer: leftl axilla
QUESTION
Whichl murmursl arel mostl commonlyl benign...sytolic/diastolic? Answer: systolic
QUESTION
mitrall stenosis Answer: calcifiedl mitrall valvel impedesl forwardl flowl ofl bloodl intol leftl ventriclel duringl DIASTOLE
- l bestl heardl atl mitrall space:l 5thl intercostall Ll sternall borderl (akal apex)l nol radiationl lowl pitchl andl rumblingl sound
QUESTION
whatl isl al commonl causel ofl mitrall stenosis? Answer: rheumaticl heartl diseasel (multiplel boutsl ofl RF)
QUESTION
whatl canl causel mitrall regurgitation? Answer: Mitrall valvel prolapse MIl damage Rheumaticl feverl (early) endocarditis Leftl ventricularl hypertrophy
QUESTION
aorticl regurgitation Answer: (aorticl insufficiency)l incompetentl aorticl valvel thatl allowsl backwardl flowl ofl bloodl intol leftl ventriclel duringl DIASTOLE heardl 2ndl intercostall spacel Rl sternall border highl pitchedl andl BLOWINGl - l typicallyl decrescendol sound
QUESTION
mitrall valvel prolapse Answer: improperl closurel ofl thel mitrall valve *S2l clickl followedl byl systolicl murmur loudl andl musicall sounding
QUESTION
whenl willl youl hearl mitrall valvel prolapse? Answer: inl Leftl laterall recumbentl atl apex willl hearl al systolicl click symptomsl =l palpitations,l chestl pain,l dyspnea oftenl asymptomatic
QUESTION
continuousl murmurs Answer:
