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

Question 1 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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 2 / 2 points

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.