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Question 1. Monitoring for a patient who is using androgens includes:
Complete blood count and C-reactive protein level
Lipid levels and liver function tests
Serum potassium and magnesium levels
Urine protein and potassium levels

Question 2. 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.

Question 3. Medroxyprogesterone (Depo Provera) injection has an FDA Black Box warning due to:
Development of significant hypertension
Increased risk of strokes when on Depo
Decreased bone density while on Depo
Risk of life-threatening rash such as Stevens-Johnson

Question 4. The mechanism of action of oral combined contraceptives which prevents pregnancy is:
Estrogen prevents the LH surge necessary for ovulation
Progestins thicken cervical mucous and slow tubal motility
Estrogen thins the endometrium making implantation difficult
Progestin suppresses FSH release

Question 5. Obese women may have increased risk of failure with which contraceptive method?
Combined oral contraceptives
Progestin-only oral contraceptive pill
Injectable progestin
Combined topical patch

Question 6. Ashley comes to clinic with a request for oral contraceptives. She has successfully used oral contraceptives before and has recently started dating a new boyfriend so would like to restart contraception. She denies recent intercourse and has a negative urine pregnancy test in the clinic. An appropriate plan of care would be:
Recommend she return to the clinic at the start of her next menses to get a Depo Provera shot
Prescribe oral combined contraceptives and recommend she start them at the beginning of her next period and use a back-up method for the first 7 days
Prescribe oral contraceptives and have her start them the same day with a back-up method used for the first 7 days
Discuss the advantages of using the topical birth control patch and recommend she consider using the patch

Question 7. Women with an intact uterus should be treated with both estrogen and progestin due to:
Increased risk for endometrial cancer if estrogen alone is used
Combination therapy provides the best relief of menopausal vasomotor symptoms
Reduced risk for colon cancer with combined therapy
Lower risk of developing blood clots with combined therapy

Question 8. Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide Angela about her risk?
She is correct, black women do not have much risk of developing osteoporosis due to their dark skin
Black women are at risk of developing osteoporosis due to their lower calcium intake as a group
If she does not drink alcohol, her risk of developing osteoporosis is low
If she has not lost more than 10% of her weight lately, her risk is low

Question 9. Before beginning treatment of patients over age 65 years with alendronate (Fosamax) or any other bisphosphonate order a:
DEXA scan
Vitamin D level
Renal function evaluation
Serum electrolytes
All of the above

Question 10. Demione is a 24-year-old who is 32 weeks pregnant and has tested positive for syphilis. The best treatment for her would be:
IM ceftriaxone
IM benzathine penicillin G
Oral azithromycin
Any of the above

Question 11. Jamie was treated for chancroid. Follow-up testing after treatment of chancroid would be:
Syphilis and HIV testing at 3-month intervals
Chancroid-specific antigen test every 3 months
Urine testing for Haemophilusducreyiin 3 to 6 months for test of cure
Annual HIV testing if engaging in high-risk sexual behavior

Question 12. Helima presents with a complaint of vaginal discharge that when tested meets the criteria for bacterial vaginosis. Treatment of bacterial vaginosis in a non-pregnant symptomatic women would be:
Metronidazole 500 mg PO BID x 7 days
Doxycycline 100 mg PO BID x 7 days
Intravaginal tinidazole daily x 5 days
Metronidazole 2 grams PO x 1 dose

Question 13. Which of the following drug classes is NOT associated with significant differences in metabolism based on gender?
Beta blockers
Antibiotics
Serotonin reuptake inhibitors
ACE inhibitors

Question 14. Factors common in women that can affect adherence to a treatment regimen include all of the following EXCEPT:
Number of drug taken: Women tend to take less drugs but over longer periods of time
Fear that medications can cause disease: Information obtained from social networks may be inaccurate for a specific woman
Nutritional status: Worries about possible weight gain from a given drug may result in non-adherence
Religious differences: A patient's belief system that is not congruent with the treatment regimen presents high risk for nonadherence

Question 15. Prescribing for women during their childbearing years requires constant awareness of the possibility of:
Pregnancy
Risk for silent bacterial or viral infections of the genitalia
High risk for developmental disorders in their infants
Decreased risk for abuse during this time

Question 16. Premenstrual dysphoric disorder (PMDD) occurs in a fairly small number of patients. Theories of the pathology behind PMDD that are supported in research include:
Altered sensitivity in the serontonergic system
Inhibition of the cyclooxygenase system
Fluctuations in the adrenal hormones
All of these are theories supported by research

Question 17. Sophie presents to 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
Azithromycin 2 grams PO x 1 dose

Question 18. The Best Pharmaceuticals for Children Act:
Includes a pediatric exclusivity rule which extends the patent on drugs studied in children
Establishes a committee that writes guidelines for pediatric prescribing
Provides funding for new drug development aimed at children
Allows for safe off-label prescribing for children

Question 19. The developmental variation in Phase I enzymes has what impact on pediatric prescribing?
None, Phase I enzymes are stable throughout childhood.
Children should always be prescribed lower than adult doses per weight due to low enzyme activity until puberty.
Children should always be prescribed higher than adult doses per weight due to high enzyme activity.
Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child.

Question 20. Drugs that require close monitoring of infants when prescribed for their lactating mothers include:
Cardio-selective beta blockers such as atenolol
Antiepileptic drugs such as carbamazepine
Antineoplastic drugs such as methotrexate
All of the above

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