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Qestions and answers
Patricia has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia's education would include:
- Use a back-up method of birth control (condom) until her next menses.
- Doxycycline may cause tendonitis and she should report any joint pain.
- Her partner will need treatment if her infection doesn't clear with the doxycycline.
4. Doxycycline is used for one-dose treatment of STIs; take the whole prescription at once. CORRECT
ANSWERS✅ 1
When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:
- Metronidazole is safe in the first trimester of pregnancy.
- Consuming alcohol in any form may cause a severe reaction.
- Sexual partners need concurrent therapy.
4. Headaches are a sign of a serious adverse reaction and need immediate evaluation. CORRECT
ANSWERS✅ 2
The treatment goals when treating urinary tract infection (UTI) include:
- Eradication of infecting organism
- Relief of symptoms
Qestions and answers
- Prevention of recurrence of the UTI
4. All of the above CORRECT ANSWERS✅ 4
Sally is a 16-year-old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line antibiotic choice for her would be:
- Azithromycin
- Trimethoprim/sulfamethoxazole
- Ceftriaxone
4. Levofloxacin CORRECT ANSWERS✅ 2
Jamie is a 24-year-old female with a urinary tract infection. She is healthy, afebrile, and her only drug allergy is sulfa, which gives her a rash. An appropriate first-line antibiotic choice for her would be:
- Azithromycin
- Trimethoprim/sulfamethoxazole
- Ceftriaxone
4. Ciprofloxacin CORRECT ANSWERS✅ 4
Qestions and answers
- Ceftriaxone
4. Ciprofloxacin CORRECT ANSWERS✅ 3
Monitoring for a healthy, nonpregnant adult patient being treated for a urinary tract infection is:
- Symptom resolution in 48 hours
- Follow-up urine culture at completion of therapy
- "Test of cure" urinary analysis at completion of therapy
4. Follow-up urine culture 2 months after completion of therapy CORRECT ANSWERS✅ 1
Monitoring for a child who has had a urinary tract infection is:
- Symptom resolution in 48 hours
- Follow-up urine culture at completion of therapy
- "Test of cure" urinary analysis at completion of therapy
4. Follow-up urine culture 2 months after completion of therapy CORRECT ANSWERS✅ 2
Monitoring for a pregnant woman who has had a urinary tract infection is:
- Symptom resolution in 48 hours
Qestions and answers
- Follow-up urine culture at completion of therapy
- "Test of cure" urinary analysis at completion of therapy
4. Follow-up urine culture every 2 weeks until delivery CORRECT ANSWERS✅ 4
Along with an antibiotic prescription, lifestyle education for a nonpregnant adult female who has had a urinary tract infection includes:
- Increasing her intake of vitamin C-containing orange juice
- Voiding 10 to 15 minutes after intercourse
- Avoiding ingesting urinary irritants, such as asparagus
4. All of the above CORRECT ANSWERS✅ 2
Lisa is a healthy nonpregnant adult woman who recently had a urinary tract infection (UTI). She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be:
- Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.
- 100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.
- There is no evidence that cranberry juice helps prevent UTIs.
4. Cranberry juice only works to prevent UTIs in children. CORRECT ANSWERS✅ 2
Qestions and answers
- Topical diphenhydramine is the treatment of choice in treating poison ivy or poison oak.
- Topical diphenhydramine should not be used in children younger than age 2 years.
4. When applying topical diphenhydramine, apply the cream liberally to all areas that itch. CORRECT
ANSWERS✅ 3
Absolute contraindications to estrogen therapy include:
- History of any type of cancer
- Clotting disorders
- History of tension headaches
4. Orthostatic hypotension CORRECT ANSWERS✅ 2
Women who have migraines with an aura should not be prescribed estrogen because of:
- The interaction between triptans and estrogen, limiting migraine therapy choices
- An increased incidence of migraines with the use of estrogen
- An increased risk of stroke occurring with estrogen use
4. Patients with migraines may be prescribed estrogen without any concerns CORRECT ANSWERS✅ 3
Qestions and answers
A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?
- Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
- Both medications are best tolerated if taken on an empty stomach.
- She should use a back-up method of birth control such as condoms for the rest of the current pill pack.
- If she gets nauseated with the medications she should call the office for an antiemetic prescription.
CORRECT ANSWERS✅ 3
A 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed:
- Low-dose oral estrogen
- A low-dose estrogen/progesterone combination
- A vaginal estradiol ring
4. Vaginal progesterone cream CORRECT ANSWERS✅ 3
The goals of treatment when prescribing for sexually transmitted infections include:
- Treatment of infection
- Prevention of disease spread
Qestions and answers
- IM ceftriaxone
- IM benzathine penicillin G
- Oral azithromycin
4. Any of the above CORRECT ANSWERS✅ 2
Treatment for suspected gonorrhea is:
- Ceftriaxone 250 mg IM x 1
- Ceftriaxone 2 grams IM x 1
- Ciprofloxacin 500 mg PO x 1
4. Doxycycline 100 mg bid x 7 days CORRECT ANSWERS✅ 1
When treating suspected gonorrhea in a nonpregnant patient, the patient should be concurrently treated for chlamydia with:
- Azithromycin 1 gram PO x 1
- Amoxicillin 500 mg PO x 1
- Ciprofloxacin 500 mg PO x 1
4. Penicillin G 2.4 million units IM x 1 CORRECT ANSWERS✅ 1
Qestions and answers
Ongoing monitoring is essential after treating for gonorrhea. The patient should be rescreened for gonorrhea and chlamydia in:
- 4 weeks
- 3 to 6 weeks
- 3 to 6 months
4. 1 year CORRECT ANSWERS✅ 3
A test of cure is recommended after treating chlamydia in which patient population?
- Men who have sex with men
- Adolescent females
- Pregnant patients
4. All of the above CORRECT ANSWERS✅ 3
Treatment for chancroid in a nonpregnant patient would be:
- Oral azithromycin
- IM ceftriaxone
Qestions and answers
- The most recent partners in the past 60 days should also be treated.
- Alcohol should not be consumed during and for 1 day after metronidazole is taken.
- Condoms should be used during intercourse if intravaginal clindamycin cream is used.
4. Co-treatment for chlamydia is necessary. CORRECT ANSWERS✅ 2
Sydney presents to the clinic with vulvovaginal candidiasis. Appropriate treatment for her would be:
- OTC intravaginal clotrimazole
- OTC intravaginal miconazole
- Oral fluconazole one-time dose
4. Any of the above CORRECT ANSWERS✅ 4
If a woman presents with recurrent vulvovaginal candidiasis she may be treated with:
- Weekly intravaginal butoconazole for 3 months
- Fluconazole 150 mg PO daily x 7 doses then monthly for 6 months
- Weekly fluconazole 150 mg PO x 6 months
4. Intravaginal tioconazole x 14 days CORRECT ANSWERS✅ 3
Qestions and answers
Zoe presents with genital warts present on her labia. Patient-applied topical therapy for warts includes:
- Podofilox 0.5% gel
- Podophyllin 10% resin
- Trichloracetic acid
4. Any of the above CORRECT ANSWERS✅ 1
Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have Trichomonas infection. Treatment for her would include:
- Metronidazole 2 grams PO x 1 dose
- Topical intravaginal metronidazole daily x 7 days
- Intravaginal clindamycin daily x 7 days
4. Azithromycin 2 grams PO x 1 dose CORRECT ANSWERS✅ 1
In addition to antimicrobial therapy, patients treated for Trichomonas infection should be educated regarding:
- Necessity of treating sexual partner simultaneously
- Abstaining from intercourse until both partners are treated
Qestions and answers
- Medication alone is the best preventative against migraines occurring.
- Medication should not be used more than four times a month.
4. The goal of treatment is to reduce migraine occurrence by 50%. CORRECT ANSWERS✅ 4
A first-line drug for abortive therapy in simple migraine is:
- Sumatriptan (Imitrex)
- Naproxen (Aleve)
- Butorphanol nasal spray (Stadol NS)
4. Butalbital and acetaminophen (Fioricet) CORRECT ANSWERS✅ 2
Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over 2 years for migraines and states one dose usually works to abort her migraine. What is the best care for her?
- Switch her to sumatriptan (Imitrex) to treat her migraines.
- Assess how often she is using Fiorinal and refill her medication.
- Switch her to a beta blocker such as propranolol to prevent her migraine.
- Request she return to the original prescriber of Fiorinal as you do not prescribe butalbital for
migraines. CORRECT ANSWERS✅ 2
Qestions and answers
When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education would include:
- Ergotamine will briefly make the migraine worse before the migraine resolves.
- The patient may experience bradycardia and dizziness.
- They may need premedication with an antinausea medication.
4. Ergotamine works best if the patient starts off with a full suppository to get the full effect. CORRECT
ANSWERS✅ 3
Migraines in pregnancy may be safely treated with:
- Acetaminophen with codeine (Tylenol #3)
- Sumatriptan (Imitrex)
- Ergotamine tablets (Ergostat)
4. Dihydroergotamine (DHE) CORRECT ANSWERS✅ 1
Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:
- Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.
Qestions and answers
- Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.
- Prescribe propranolol (Inderal) to be taken daily for at least 3 months.
- Explain that it is rare for a 9-year-old child to get migraines and she needs an MRI to rule out a brain
tumor. CORRECT ANSWERS✅ 3
Amber is a 24-year-old patient who has had migraines for 10 years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber's naratriptan, education would include:
- Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and St John's wort, and she should inform any providers she sees that she has migraines.
- Continue to monitor her headaches, if the migraine is consistently happening around her menses there is preventive therapy available.
- Pregnancy is contraindicated when taking a triptan.
4. All of the above CORRECT ANSWERS✅ 4
When prescribing for migraines, patient education includes:
- Triptans are safe to be used as often as needed as long as the patient is healthy.
- Use triptan before trying OTC meds such as acetaminophen or naproxen.
- Stress reduction and regular sleep are integral to migraine treatment.
Qestions and answers
4. If migraines worsen they are to increase their medication. CORRECT ANSWERS✅ 3
Juanita presents to the clinic with a complaint of headaches off and on for months. She reports they feel like someone is "squeezing" her head. She occasionally takes Tylenol for the pain, but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and a prescription for:
- Sumatriptan (Imitrex)
- Naproxen (Aleve)
- Ergotamine (Ergostat)
4. Tylenol with codeine (Tylenol #3) CORRECT ANSWERS✅ 2
Nonpharmacologic therapy for tension headaches includes:
- Biofeedback
- Stress management
- Massage therapy
4. All of the above CORRECT ANSWERS✅ 4
James has been diagnosed with cluster headaches. Appropriate acute therapy would be:
- Butalbital and aspirin (Fiorinal)
