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Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the: [Select ALL THAT APPLY].
 
a. IL-4
b. IL-8
c. IL-13
d. IL-20
e. IL-23


Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the: [Select ALL THAT APPLY].
 
a. IL-4
b. IL-8
c. IL-13
d. IL-20
e. IL-23

Answer: a, c

Atopic dermatitis usually develops in early childhood and is more common in people who have a family history of the condition.

The main symptom is a rash that typically appears on the arms and behind the knees, but can also appear anywhere.

The active ingredient found in Dupixent (Dupilumab) is Dupilumab. It is the first biologic medicine for children aged 6 to 11 Years with Moderate-to-Severe Atopic Dermatitis.
Dupixent (Dupilumab) is a fully-human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13) proteins, and is not an immunosuppressant.

IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in atopic dermatitis, asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP).
Dupixent (Dupilumab) is an interleukin-4 receptor alpha antagonist indicated:

1. for the treatment of patients aged 6 years and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.

2. as an add-on maintenance treatment in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid dependent asthma.

3. as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP).

The recommended dose is an initial dose of 600 mg (two 300 mg injections in different injection sites), followed by 300 mg given every other week.
 
Most common adverse reactions (incidence ≥1%) are injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, other herpes simplex virus infection, and dry eye.

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Which of the following information is the primary gene associated with an increased risk for Ankylosing Spondylitis?
 
a. HLA-B27
b. PRC-201
c. HLB-A27
d. CEA
e. RTP-PY3


Which of the following information is the primary gene associated with an increased risk for Ankylosing Spondylitis?
 
a. HLA-B27
b. PRC-201
c. HLB-A27
d. CEA
e. RTP-PY3

Answer: a

Ankylosing Spondylitis is best known as an arthritis of the joints of the spine, but it frequently affects other joints (e.g, shoulders, hips) and occasionally affects other organs such as the eyes, skin, and intestines (ie, uveitis, psoriasis, and inflammatory bowel disease, respectively).

The etiology of Ankylosing Spondylitis is unknown; however, environmental and genetic factors may play a role in its occurrence.
 
1. Human leukocyte antigen-B27 (HLA-B27) is the primary gene associated with an increased risk for Ankylosing Spondylitis;

2. The presence of interleukin 23R (IL23R) and endoplasmic reticulum aminopeptidase 1 (ERAP1) may also increase risk.

Symptom onset commonly occurs in late adolescence or early adulthood (17-45 years of age) with unilateral or alternating low back and buttock pain or stiffness that improves with activity and worsens with rest.
 
The pain is usually dull and diffuses and progresses gradually over weeks to months. Up to 35% of patients have hip arthritis.
 
 The pain eventually becomes chronic and bilateral in nature and advances to neck pain and stiffness months to years after initial presentation.
 
Of note, symptoms of Ankylosing Spondylitis may initially manifest in a peripheral joint in a minority of patients, more commonly in children, which may lead to the potential for an incorrect diagnosis. 
 
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Which of the following information IS NOT reported symptom of pediatric multisystem inflammatory syndrome?
 
a. fever
b. rash
c. persistent cough
d. swollen lymph nodes
e. belly pain


Which of the following information IS NOT reported symptom of pediatric multisystem inflammatory syndrome?
 
a. fever
b. rash
c. persistent cough
d. swollen lymph nodes
e. belly pain

Answer: c

Though the coronavirus doesn't infect as many children as adults, doctors are alarmed that a growing number of children are becoming sick with a condition called pediatric multisystem inflammatory syndrome, which may be related to the coronavirus.

Symptoms of pediatric multisystem inflammatory syndrome include a fever, rash, swollen lymph nodes, and belly pain, the Health Department said in its advisory.

A persistent cough and breathing troubles, two of the main symptoms of COVID-19, are not listed as symptoms of the condition.

The state Health Department said the condition has similarities to toxic shock syndrome and Kawasaki disease, a childhood illness.

Treatments include steroids, intravenous immunoglobulin, aspirin, antibiotics, and oxygen, sometimes use of a ventilator in the most serious cases.

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Nurtec is indicated for which of the following?

a. Hypertension
b. Gout
c. Migraine
d. Diabetes
e. Rheumatoid arthritis


Nurtec is indicated for which of the following?

a. Hypertension
b. Gout
c. Migraine
d. Diabetes
e. Rheumatoid arthritis

Answer: c

The active ingredient found in Nurtec is Rimegepant. It  is a calcitonin gene-related peptide receptor antagonist indicated for the acute treatment of migraine with or without aura in adults.
 
The recommended dose is 75 mg taken orally, as needed. The maximum dose in a 24-hour period is 75 mg. The safety of treating more than 15 migraines in a 30-day period has not been established.
 
Nausea is the most commonly reported side effect of Nurtec (Rimegepant). 
 
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Phexxi is indicated for the treatment of:
 
a. Hypertension
b. Diabetes
c. Prevention of pregnancy
d. Nausea and vomiting associated with emetogenic cancer therapy
e. Parkinsonism


Phexxi is indicated for the treatment of:
 
a. Hypertension
b. Diabetes
c. Prevention of pregnancy
d. Nausea and vomiting associated with emetogenic cancer therapy
e. Parkinsonism
 
Answer: C

Phexxi is the first non-hormonal, on-demand, vaginal pH regulator contraceptive designed to maintain vaginal pH within the normal range of 3.5 to 4.5 – an acidic environment that is inhospitable to sperm.
 
The active ingredients found in Phexxi are lactic acid, citric acid and potassium bitartrate. It is available as vaginal gel.
 
It is indicated for the prevention of pregnancy in females of reproductive potential for use as an on-demand method of contraception. Phexxi is not effective for the prevention of pregnancy when administered after intercourse.
 
Avoid use of Phexxi in females of reproductive potential with history of recurrent urinary tract infection or urinary tract abnormalities.
 
Vulvovaginal burning sensation, vulvovaginal pruritus, vulvovaginal mycotic infection, urinary tract infection, vulvovaginal discomfort, bacterial vaginosis, vaginal discharge, genital discomfort, dysuria, and vulvovaginal pain are commonly reported side effects of Phexxi.
 
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The CK test is useful to detect which of the following?
 
I. Muscular dystrophy
II. Rhabdomyolysis
III. Heart attacks

a. I only
b. III only
c. I and II only
d. II and III only
e. All


The CK test is useful to detect which of the following?
 
I. Muscular dystrophy
II. Rhabdomyolysis
III. Heart attacks

a. I only
b. III only
c. I and II only
d. II and III only
e. All

Answer: E (All).

The CK test measures the amount of creatine kinase (CK) in the blood. CK is a type of protein, known as an enzyme. It is mostly found in skeletal muscles and heart, with lesser amounts in the brain. Skeletal muscles are the muscles attached to skeleton.

A CK test is most often used to diagnose and monitor muscular injuries and diseases. These diseases include:

1. Muscular dystrophy, a rare inherited disease that causes weakness, breakdown, and loss of function of skeletal muscles. It mostly occurs in males.

2. Rhabdomyolysis, a rapid breakdown of muscle tissue. It can be caused by a serious injury, muscle disease, or other disorder.

3. The test can also be used to help diagnose a heart attack, though not very often. CK testing used to be a common test for heart attacks. 
 
 
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_______________  is characterized by recurrent binge eating episodes during which a person feels a loss of control and marked distress over his or her eating. Binge eating episodes are not followed by purging, excessive exercise or fasting.

a. Binge eating disorder
b. Bulimia Nervosa
c. Anorexia Nervosa
d. High carb eating disorder
e. Low carb eating disorder


_______________  is characterized by recurrent binge eating episodes during which a person feels a loss of control and marked distress over his or her eating. Binge eating episodes are not followed by purging, excessive exercise or fasting.

a. Binge eating disorder
b. Bulimia Nervosa
c. Anorexia Nervosa
d. High carb eating disorder
e. Low carb eating disorder

Answer: a

1. Binge eating disorder is characterized by recurrent binge eating episodes during which a person feels a loss of control and marked distress over his or her eating.
Unlike bulimia nervosa, binge eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge eating disorder often are overweight or obese.
 
2. Bulimia nervosa is characterized by binge eating (eating large amounts of food in a short time, along with the sense of a loss of control) followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives, or diuretics), fasting, and/or excessive exercise.

Unlike anorexia nervosa, people with bulimia can fall within the normal range for their weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape.
 
3. Anorexia nervosa is characterized by a significant and persistent reduction in food intake leading to extremely low body weight in the context of age, sex, and physical health; a relentless pursuit of thinness; a distortion of body image and intense fear of gaining weight; and extremely disturbed eating behavior.

Many people with anorexia see themselves as overweight, even when they are starved or severely malnourished.
 

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Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.


Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

Answer: (a,b,c,d,e)

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks).
 
CDC currently recommends a two-step testing process for Lyme disease. Both steps are required and can be done using the same blood sample. If this first step is negative, no further testing is recommended. If the first step is positive or indeterminate (sometimes called “equivocal”), the second step should be performed. The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal).
 
Key points to remember:
 
1. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
2. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
3. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
4. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
5. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days. 
 
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MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y


MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y

Answer: (a,c,d,e)

MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups A, C, W, and Y of the bacterium N meningitidis.

MenQuadfi does not prevent serogroup B disease.

In the U.S., the Centers for Disease Control and Prevention recommends vaccination against meningococcal disease at 11-12 years of age and a second dose at 16 years of age.
Despite strong public health recommendations, about half of teens have not received the recommended second dose of MenACWY vaccine by 17 years of age, leaving them vulnerable when they are at increased risk for the disease.

Hundreds of cases of vaccine-preventable meningococcal disease (caused by serogroups B, C, W, Y) still occur annually in the U.S. and, despite treatment, one in five survivors suffer from permanent complications such as hearing loss, organ damage, and limb amputations.

The most common side effects following a first dose of MenQuadfi included injection site pain, muscle ache, headache, and tiredness. In adolescents and adults receiving a MenQuadfi booster, similar rates of these reactions were observed. 
 
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Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer



Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer

Answer: (a,b,c,d,e)

The active ingredient found in Keytruda is Pembrolizumab. It is available in injection (100 mg/4 mL) form.
 
Binding of the PD-1 ligands, PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors.

Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In syngeneic mouse tumor models, blocking PD-1 activity resulted in decreased tumor growth.

Keytruda is indicated for the treatment of:

a. Melanoma
b. Non-Small Cell Lung Cancer (NSCLC)
c. Small Cell Lung Cancer (SCLC)
d. Head and Neck Squamous Cell Cancer (HNSCC)
e. Classical Hodgkin Lymphoma (cHL)
f. Primary Mediastinal Large B-Cell Lymphoma (PMBCL)
g. Urothelial Carcinoma
h. Microsatellite Instability-High Cancer
i. Gastric Cancer
k. Esophageal Cancer
l. Cervical Cancer
m. Hepatocellular Carcinoma (HCC)
n. Merkel Cell Carcinoma (MCC)
o. Renal Cell Carcinoma (RCC)
p. Endometrial Carcinoma
 
The usual recommended dose of Keytruda is 200 mg every 3 weeks or 400 mg every 6 weeks.  
 
Immune-Mediated pneumonitis, colitis, hepatitis, endocrinopathies, hypophysitis, nephritis and renal dysfunction are commonly reported side effects of the drug.
 
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