First dose phenomenon is a characteristic side effect on initiation of antihypertensive therapy with
- A. Minoxidil
- B. Clonidine
- C. Metroprolol
- D. Prazosin
Correct Answer: B
Rationale: Clonidine can cause sedation or hypotension after the first dose.
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Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry?
- A. High-dose colchicine
- B. Low-dose colchicine
- C. High-dose aspirin
- D. Acetaminophen with codeine
Correct Answer: B
Rationale: Low-dose colchicine effectively treats acute gout with fewer side effects than high-dose ; aspirin worsens gout.
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:
- A. Ensure the patient will not have increased adverse effects from the tamoxifen
- B. Identify if the patient is a poor metabolizer, potentially reducing conversion to active metabolites
- C. Evaluate risk of drug interactions with tamoxifen
- D. Determine if the patient requires a higher dose due to ultra-rapid metabolism
Correct Answer: B
Rationale: CYP2D6 testing identifies poor metabolizers who may not convert tamoxifen to its active form (endoxifen), impacting efficacy, not just ADRs or interactions .
Which of the following glucocorticosteroids are used for cerebral oedema:
- A. Triamcinolon
- B. Prednisolon
- C. Prednison
- D. Dexamethasone
Correct Answer: D
Rationale: Dexamethasone is favored for cerebral edema due to its strong anti-inflammatory properties and low mineralocorticoid activity.
NSAIDs should be avoided in which group(s) of patients?
- A. Kidney disease
- B. Myocardial infarction
- C. Irritable bowel syndrome
- D. All of the above
Correct Answer: D
Rationale: NSAIDs can worsen kidney function, increase cardiovascular risk, and exacerbate GI conditions, making them risky for all listed groups.
Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic patients because they:
- A. Improve insulin sensitivity
- B. Improve renal hemodynamics
- C. Reduce the production of angiotensin II
- D. All of the above
Correct Answer: D
Rationale: ACE inhibitors benefit diabetics by enhancing insulin sensitivity, protecting kidneys, and blocking angiotensin II.