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BCPS Final Study Questions & Answers with Expert Solutions | Already Graded
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BCPS Final Study Questions & Answers with ExpertSolutions | Already Graded
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(Gout) What are some medications that can contribute to elevated uric acid levels? -
✔✔Thiazide/Loop diuretics
Tacrolimus
Niacin
Cyclosporin
Ticagrelor
(Gout) What is considered WNL for uric acid and what is the target goal for tx of gout? - ✔✔2-6 mg/dL
is WNL for uric acid.
Target tx goal is <6mg/dL.
(Gout) What are some non-Rx related risk factors to developing gout? - ✔✔Seafood, EtOH
use, Metabolic disease, Family hx, Males > Females
(Gout) What is first line medication for ppx of gout? What is the MOA? - ✔✔Allopurinol/Zyloprim
- Inhibits xanthine oxidase to prevent conversion from xanthine to uric acid.
(Gout) Name some clinical pearls for allopurinol. - ✔✔Renally dosed.
SE: Rash, GI
Test for HLA-B*5801 with AA and S.Asian descent prior to starting.
Concurrent use with ACEI/Thiazide/PCN may increase risk of allergic rxn.
[Azathioprine] may be increased by allopurinol.
,(Gout) Which medication can be used for acute flare up of gout and ppx? What is the usual dose and
some clinical pearls? - ✔✔Colchicine.
Acute: 1.2mg now, repeat 0.6mg in 2-3 hours for max 1.8mg/day.
Ppx: 0.6mg qd-bid, max 1.2mg/day.
Dose limiting SE is diarrhea.
Renally dosed in CKD.
CYP3A4 inhibitors may increase [colchicine].
May increase risk of myopathy/rhabdomyolysis in statin users.
(Gout) What are some options for acute flare ups of gout? - ✔✔NSAIDs: Indomethacin/Ketorolac
highest chance of GI SE, naproxen may be safest.
Corticosteroids: First line alternative to pt intolerable to NSAIDS, colchicine.
Colchicine.
(Gout) What is an alternative ppx if pt is intolerable of allopurinol with a similar moa and what are some
clinical pearls? - ✔✔Febuxostat.
$$$ > than allopurinol.
Can increase [azathioprine] like allopurinol.
FDA safety warning for increased risk of CV death vs allopurinol.
(Gout) What is the MOA of probenecid and some clinical pearls? - ✔✔Removes uric acid from body
by increasing kidney excretion.
SE: GI upset.
Can increase [] of other meds going through kidney such as: PCN, quinolones, cephalosporins, NSAIDS,
nitrofurantoin, MTX.
Needs adequate kidney fxn to work!
, (OA) What is a key difference between osteoarthritis and rheumatoid arthritis? - ✔✔Minimal to no
swelling/inflammation/redness compared to RA.
(OA) What are some treatment options for acute pain in OA? - ✔✔Non-pharm: Massage, Heat/Ice/PT
NSAIDS (including Celebrex)
Corticosteroids
Topicals
SNRI
APAP
Opioids
Injectable
Glucosamine/Chondroitin
(OA) How long should a patient be counseled to wait until he/she might see the effects of
glucosamine/chondroitin? - ✔✔Weeks to months, often 2-3 months.
(OA) True or False? Because injectable corticosteroids work locally, they should not impact blood
glucose as much as oral corticosteroids. - ✔✔False, injectable corticosteroids can still spike BG.
(OA) What dose of tramadol is equivalent to 30 mg of morphine or hydrocodone? - ✔✔300 mg.
(OA) What is the recommended max daily dose of tramadol? For elderly? - ✔✔400 mg. 300 mg for
elderly.
(OA) What dose of oxycodone is equivalent to 30 mg of morphine or hydrocodone? - ✔✔20 mg.
(OA) What dose of fentanyl is equivalent to 30 mg of morphine or hydrocodone? - ✔✔12 mcg.
(OA) What dose of hydromorphone is equivalent to 30 mg of morphine or hydrocodone? - ✔✔7.5 mg.
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