Question 1
Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:

Question options:
Omeprazole (Prilosec) twice a day
Ranitidine (Zantac) twice a day
Famotidine (Pepcid) once a day
Metoclopramide (Reglan) four times a day

Question 2
An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:

Question options:
Electrolytes, including potassium and chloride
Bone mineral density for osteoporosis
Magnesium level
Liver function

Question 3
The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:

Question options:
Add a prokinetic (metoclopramide)
Referral for endoscopy
Switch to another proton pump inhibitor
Add a cytoprotective drug

Question 4
If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is:

Question options:
Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days
Test H. pylori for resistance to common treatment regimens
Proton pump inhibitor plus clarithromycin plus amoxicillin for 14 days
Proton pump inhibitor and levofloxacin for 14 days

Question 5
Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck's Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point?

Question options:
Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressant
Refer her to a mental health therapist
Contact her dermatologist about discontinuing the isotretinoin
Reassure her that mood swings are normal and schedule follow up in a week

Question 6
Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:

Question options:
That tazarotene is applied in a thin film to the psoriasis plaque lesions
To apply it liberally to all psoriatic lesions
To apply tazarotene to nonaffected areas to prevent breakout
That tazarotene may cause hypercalcemia if it is overused

Question 7
Nicolas is a football player who presents to the clinic with athlete's foot. Patients with tinea pedis may be treated with:

Question options:
OTC miconazole cream for 4 weeks
Oral ketoconazole for 6 weeks
Mupirocin ointment for 2 weeks
Nystatin cream for 2 weeks

Question 8
Vanessa has been diagnosed with scabies. Her education would include:

Question options:
She should apply the scabies treatment cream for an hour and wash it off.
Scabies may need to be retreated in a week after initial treatment.
All members of the household and close personal contacts should be treated.
Malathion is flammable and she should take care until the solution dries.

Question 9
Ciprofloxacin otic drops are contraindicated in:

Question options:
Children
Patients with acute otitis externa
Patients with a perforated tympanic membrane
Swimmer's ear

Question 10
Janie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include:

Question options:
Moisten a cotton swab (Q-tip) and swab the ear canal twice daily.
Instill tap water in both ears while bathing.
Squirt hydrogen peroxide into ears with each bath.
Instill carbamide peroxide (Debrox) twice daily until canals are clear.