QUESTION: 37

A 54-year-old patient wakes up with right sided weakness. His current medication is bendroflumethiazide for
BP=160/90mmHg. CT shows left cerebral infarct.
What is the most appropriate treatment?

Alteplase
Aspirin
Simvastatin
Dipyridamole
Clopidogrel

Answer(s): A

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QUESTION: 38

A 45-year-old man has developed an annular rash with a scaly edge on his thigh. The rash has been spreading. He has some general aches and pains.
What is the single most useful investigation?

ANA
Skin scrap for mycology
Skin swab for bacteria
Biopsy lesion
Lyme antibodies

Answer(s): E

Explanation:

Spreading annular rash suggests erythema migrans of lyme disease.

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QUESTION: 39

Drug of choice of generalized anxiety disorder is ______________.

Acetalopram
Bubropion
Buspirone
beta blocker

Answer(s): A

Explanation:

What is Citalopram an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Citalopram is used to treat depression. Treatment for Anxiety Disorders Many variables influence the selection of medication for individual patients. The following is general information regarding beginning treatment. Most common - sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). These allow a low starting dose (12.5mg of Zoloft, 5mg of Celexa) and slow titration (anxiety patients are very vulnerable to initial activation and worsening of symptoms). Effective ranges: 50-200 mg of Zoloft, 20- 40 mg of Celexa, and 10-20 mg of Lexapro. We routinely utilize much higher doses than those previously listed to treat OCD. We rarely use benzodiazepines as first line drugs for these disorders and generally discourage as needed/rescue use. Benzodiazepines remain widely used drugs for panic and other anxiety disorders in both primary care and mental health settings. While they have clear value in some circumstances, we avoid them as first line treatments because they so powerfully reinforce the anxious patient's wish for a simple and quick way to avoid the distressing experience of his or her anxiety. Overcoming this desire to flee distressing circumstances or feelings is the bedrock of CBT and is absolutely critical to successful long-term outcomes. Benzodiazepines often make these efforts more difficult.

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QUESTION: 40

Fluoxetine half-life after acute administration is ______________________________

1-4 days
6-9 days

Answer(s): A

Explanation:

The relatively slow elimination of fluoxetine (elimination half-life of 1 to 3 days after acute administration and 4 to 6 days after chronic administration) and its active metabolite, nor fluoxetine (elimination half-life of 4 to 16 days after acute and chronic administration), leads to significant accumulation of these active species in chronic use. After 30 days of dosing at 40 mg/day, plasma concentrations of fluoxetine in the range of 91 to 302 ng/mL and nor fluoxetine in the range of 72 to 258 ng/mL have been observed. Plasma concentrations of fluoxetine were higher than those predicted by single dose studies, presumably because fluoxetine's metabolism is not proportional to dose. Nor fluoxetine, however, appears to have linear pharmacokinetics. Its mean terminal half-life after a single dose was 8.6 days and after multiple dosing was 9.3 days.

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QUESTION: 37

QUESTION: 38

Explanation:

QUESTION: 39

Explanation:

QUESTION: 40

Explanation:

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