Naplex important questions with solutions All Verified

Naplex important questions with solutions All Verified onsets for laxatives - ANS Fast : 1-osmotics oral: 30 minutes to 96 hrs : 2-Osmotics rectal :15-30 minutes (Glycerin) 3-Emollient rectal : 2-15 minutes like docusate 4-Lubricant rectal : 2-15 minutes Rest of the orals are above 6 hrs... H.pylori treatment - ANS All therapy are for up to 14 days. First line QUAD: Pepto + flagyl + tetracycline + PPI (Tetra Flag PPPP) then : clarith + flagyl + PPI Triple: clarith + amox + PPI only use is clarith resistance 15% and no Macrolide before. levo + amox + PPI PI-BI-MET-TET CAMP CAP If you get an Amiodarone Case in the exam, please watch for the following: - ANS Look if patients in the case receive or suffer any of : 1-Digoxin and statin or warfarin (should reduce doses / Digo by 50% and statins limits) 2-Iodine sensitivity 3-No Heparin in same line. 4-pulmonary / liver ^LFTs / Thyroid 5-Sever sinus node disfunction unless patient has an artificial one) 6-Look for any drug that cause QT^ or reduce HR. Look on the process of infusion: 1-Non PVC , Need filter / slow infusion to avoid bradycardia 2-drug of choice in HF as antiarrythmic ( plus Dofelitide) 3-Always in hospital for loading Last issue : BLUE SKIN Lab test for liver - ANS AST / ALT elevated / Albumin low / Tbili and Amonia What is CK lab test? - ANS Creatinine Kinase to assess muscle damage or inflamation. Drugs could increase CK like Statin and fibrates, tenovir (Hep B and HIV)and raltegravir and dolutegravir , daptomycin Drugs that effect Thyroxine? - ANS Amiodarone and interferon (Up and dawn) / Lithium and (Oxy) carbamazepine decrease to mean hypothyrism Thyroxine lab reult test trap - ANS When TSH is elevated , it means HYPO and NOT hyper. Drugs that raise Uric acid blood level - ANS Diuretics , Niacin, pyrazinamide (TB treatment) and high dose Aspirin, Thyroxine lab result test trap - ANS When TSH is elevated , it means HYPO and NOT hyper. Drugs that can cause SJS or Ten - ANS Penicillin Phenytoin piroxicam (3P for SJS & Ten) Allopurinol, Sulfamethoxazole, Lamotrigine. carbamazepine Drugs that can induce Lupus - ANS -Procainamide -anti arythmic -Hydralazine - anti histamine -INH - TB treatment -Chlorpromazine -Anti pschotic -Methyldopa - Anti TNF agent -quinidine (Malaria and arrhythmia) - Terbinafine (Anti fungal) -Minocycline (antibiotic) Mneumonic SHIPP (Salazopirin, Hydralazin,INZ,Phytoin,Procainamide) Hydra and Procain are highest. Drugs that can cause lactic acidosis - ANS NRTIs and Metformine NRTIs are : Abacavir (brand name: Ziagen®) Emtricitabine (FTC; brand name: Emtriva®) Lamivudine (3TC; brand name: Epivir®) Tenofovir alafenamide (TAF) Tenofovir DF (TDF; brand name: Viread®) What is RPR and what is it used to test? - ANS Rapid Plasma Regain; Syphillis to remenber it R for remember and P for pencillin PPD skin test - ANS tuberculin purified protein derivative Pneimonic : Pneimonia is not TB Test Lab BNP-High NT-ProBNP-High ? - ANS Heart issue , most propably HF Low Hgb & Hct - ANS anemia / if reticulocyte is high then it is loss of blood. High AST/ALT - ANS Acute liver damage / if also GGT is high then it could be Alcoholic hepatitis High ALK-T billi - GGT - ANS Cholestatis - billary High INR and low Albumin and platlets - ANS Liver chronic Damage PO4 increase in blood - ANS "Chronic" kidney disease also look for BUN/Scr and PTH with low HGb and HCT What lab test we request for autoimmune diseases? - ANS ANA / ESR / CRP What lab test we order to monitor statins? - ANS CPK and SrCr. as it indicate Rhabdomyolysis Also LFTs Durgs causing low calcium? - ANS Loops, (Oxy) Carbamazepine , SSRIs Drugs that are contraindicated in HF? - ANS 1-NSAIDs 2-Non pyridine CCBs specially verapamil 3- C.steroids 4-some anti arrythmia drug like Flecainide and dronedarone 5-TCA , Thiazolidinediones(e.g. rosiglitazone, pioglitazone), 6-Anti cancer :Anthracyclines (doxorubicin,daunorubicin), cyclophosphamide, trastuzumab (Herceptin), tyrosine kinase inhibitors (e.g. sunitinib) may cause heart failure4