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At 1000 mg dose, Acetaminophen is usually effective treating which of the following Migraine related symptoms? [Select ALL THAT APPLY]

a. Nausea
b. Vomiting
c. Blurry vision
d. Photophobia
e. Phonophobia



At 1000 mg dose, Acetaminophen is usually effective treating which of the following Migraine related symptoms?[Select ALL THAT APPLY]

a. Nausea
b. Vomiting
c. Blurry vision
d. Photophobia
e. Phonophobia

Answer: (d,e). Acetaminophen has been shown in studies to reduce pain, as well as improve photophobia and phonophobia in individuals with migraine and tension-type headache. They have not been shown to improve symptoms of nausea, vomiting, or blurry vision with migraine.

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Which of the following statements is NOT TRUE about the tension-type headaches? [Select ALL THAT APPLY]

a. Pain associated with this type of headache is unilateral
b. Mild photophobia or phonophobia is reported with the headache
c. Routine physical activity usually aggravates the headache
d. Headache has fast onset of action and last for few hours.
e. It is also known as stress headache.


Which of the following statements is NOT TRUE about the tension-type headaches? [Select ALL THAT APPLY]

a. Pain associated with this type of headache is unilateral
b. Mild photophobia or phonophobia is reported with the headache
c. Routine physical activity usually aggravates the headache
d. Headache has fast onset of action and last for few hours.
e. It is also known as stress headache.

Answer: (a,c,d)

1. Tension-type headaches often are caused by stress, depression, anxiety, emotional conflicts, or other stimuli.

2. They are sometimes called stress headaches and may result from pericranial muscle contraction.

3. Patients experience bilateral symptoms that may be over the top of the head to the neck and vary from diffuse ache to tight, pressing, and constricting pain.

4. They have gradual onset and may last minutes to days.

5. They are not accompanied by nausea or vomiting but may have either mild photophobia or phonophobia.

6. Routine physical activity such as walking or climbing stairs does not aggravate the headache.

7. Tension-type headaches may be episodic or chronic. Episodic headaches occur less than 15 days per month. Chronic headaches occur 15 or more days per month for at least 3 months.


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Medication-overuse headache is generally classified as a:

a. Primary-headache
b. Secondary-headache
c. Tertiary-headache
d. Category II-headache
e. Category V-headache


Medication-overuse headache is generally classified as a:

a. Primary-headache
b. Secondary-headache
c. Tertiary-headache
d. Category II-headache
e. Category V-headache

Answer (b): Headaches are classified as primary or secondary according to the International Classification of Headache Disorders (ICHD) 2018.

Primary headaches are not caused by underlying illness. ICHD further classifies primary headaches as tension-type headache, migraine, trigeminal autonomic cephalalgias, or other primary headache disorders.

Secondary headaches are associated with an underlying condition (e.g., head injury or trauma, infection, stroke, substance withdrawal, or facial or cranial disorders).

Medication-overuse headaches are considered secondary by ICHD although they are not caused by an underlying disease (but are attributed to the withdrawal effect of analgesic medication).

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The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?

a. Lopressor
b. Humira
c. Ultram
d. Ritalin
e. Levaquin


The simultaneous administration of which of the following with Qdolo is considered as a duplication of therapy?

a. Lopressor
b. Humira
c. Ultram
d. Ritalin
e. Levaquin

Answer: (c).

The active ingredient found in Qdolo is Tramadol hydrochloride. It is available as an oral solution. It is a schedule IV controlled substance. The simultaneous administration of Ultram (Tramadol) with Qdolo (Tramadol) is considered duplication of therapy; concurrent use should be avoided.

Qdolo is an opioid agonist indicated in adults for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.
Start at 25 mg/day and titrate in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg four times a day). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg /day (50 mg four times a day). After titration, Qdolo 50 mg to 100 mg can be administered as needed for pain relief every 4 to 6 hours not to exceed 400 mg/day.

Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate; limit dosages and durations to the minimum required; and follow patients for signs and symptoms of respiratory depression and sedation.

Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with Qdolo and adjust the dosage accordingly.

The most common incidence of treatment-emergent adverse events in patients from clinical trials were dizziness/vertigo, nausea, constipation, headache, somnolence, vomiting and pruritus.


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Which of the following statements is/are TRUE ABOUT Spravato? [Select ALL THAT APPLY].

a. It is indicated for the treatment of treatment-resistant depression.
b. Lketamine is its active ingredient.
c. It is a schedule IV controlled substance.
d. It is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist.
e. It is available as a nasal spray.


Which of the following statements is/are TRUE ABOUT Spravato? [Select ALL THAT APPLY].

a. It is indicated for the treatment of treatment-resistant depression.
b. Lketamine is its active ingredient.
c. It is a schedule IV controlled substance.
d. It is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist.
e. It is available as a nasal spray.

Answer: (a,d,e)

The active ingredient found in Spravato is Esketamine. It is available in a nasal spray. It is a schedule III controlled substance.

Spravato is a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist indicated, in conjunction with an oral antidepressant, for the treatment of:

1. Treatment-resistant depression (TRD) in adults.

2. Depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.

Spravato is administered intranasally under the supervision of a healthcare provider.

The recommended dosage of Spravato (Esketamine) for the treatment of depressive symptoms in adults with MDD with acute suicidal ideation or behavior is 84 mg twice per week for 4 weeks. Dosage may be reduced to 56 mg twice per week based on tolerability.

Spravato (Esketamine) is for nasal use only. The nasal spray device delivers a total of 28 mg of Esketamine. To prevent loss of medication, do not prime the device before use. Use 2 devices (for a 56 mg dose) or 3 devices (for an 84 mg dose), with a 5-minute rest between use of each device.

Dissociation, dizziness, nausea, sedation, vertigo, hypoesthesia, anxiety, lethargy, blood pressure increased, vomiting, and feeling drunk are commonly reported side effects of Spravato.

Because of the risks for sedation, dissociation, and abuse and misuse, Spravato (Esketamine) is only available through a restricted program called the Spravato (Esketamine) Risk Evaluation and Mitigation Strategy (REMS) Program.

Spravato (Esketamine) can only be administered at healthcare settings certified in the Spravato (Esketamine) REMS Program and to patients enrolled in the program.



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Kesimpta (Ofatumumab) is indicated for the treatment of:

a. Hypertension
b. Gout
c. Multiple sclerosis
d. Type II diabetes
e. Parkinsonism


Kesimpta (Ofatumumab) is indicated for the treatment of:

a. Hypertension
b. Gout
c. Multiple sclerosis
d. Type II diabetes
e. Parkinsonism

The active ingredient found in Kesimpta is Ofatumumab. It is available in a single-dose prefilled syringe.

Kesimpta (Ofatumumab) is a CD20-directed cytolytic antibody indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

The precise mechanism by which Ofatumumab exerts its therapeutic effects in multiple sclerosis is unknown, but is presumed to involve binding to CD20, a cell surface antigen present on pre-B and mature B lymphocytes. Following cell surface binding to B lymphocytes, ofatumumab results in antibody-dependent cellular cytolysis and complement-mediated lysis.

Hepatitis B virus (HBV) and quantitative serum immunoglobulins screening are required before the first dose.

Initial Dosing: 20 mg subcutaneously administered at Week 0, 1, and 2.

Subsequent Dosing: 20 mg subcutaneously administered monthly starting at Week 4.

Respiratory tract infection, headache, injection-related reactions, and local injection site reactions are reported side effects of drug.

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Which of the following glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) is administered subcutaneously once daily? [Select ALL THAT APPLY].

a. Byetta
b. Adlyxin
c. Victoza
d. Trulicity
e. Tanzeum


Which of the following glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) is administered subcutaneously once daily? [Select ALL THAT APPLY].

a. Byetta
b. Adlyxin
c. Victoza
d. Trulicity
e. Tanzeum

Answer (b,c)



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Which of the following statements is/are TRUE ABOUT Winlevi? [Select ALL THAT APPLY].

a. The active ingredient is Clascoterone.
b. It is an estrogen receptor inhibitor.
c. Indicated for the treatment of acne vulgaris.
d. It should only be used in patients 12 years of age or younger.
e. It is available as topical gel.


Which of the following statements is/are TRUE ABOUT Winlevi? [Select ALL THAT APPLY].

a. The active ingredient is Clascoterone.
b. It is an estrogen receptor inhibitor.
c. Indicated for the treatment of acne vulgaris.
d. It should only be used in patients 12 years of age or younger.
e. It is available as topical gel.

Answer: (a,c).

The active ingredient found in Winlevi is Clascoterone. It is available as cream. Each gram of Winlevi cream contains 10 mg of Clascoterone. It is an androgen receptor inhibitor indicated for the topical treatment of acne vulgaris in patients 12 years of age and older. Erythema/reddening, pruritus, scaling/dryness, edema, stinging, and burning are commonly reported side effects of Winlevi.

Clascoterone is first-in-class topical androgen receptor inhibitor that tackles the androgen hormone component of acne in both males and females. Androgen receptor inhibitors act by limiting the effects of these hormones on increasing sebum production and inflammation.

Acne is a multifactorial skin condition, affected by four distinct pathways: excess oil (sebum) production, clogged pores (hyperkeratinization), bacteria growth (C. acnes), and inflammation. Topical treatment options that target androgens, which largely drive sebum production and inflammation, presented a significant unmet need in the acne treatment market until now.

Elevated potassium levels (Hyperkalemia) were observed in some patients during the clinical trials.

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Which of the following is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening of these fibers?

a. Dilated cardiomyopathy
b. Hypertrophic cardiomyopathy
c. Restrictive cardiomyopathy
d. Arrhythmogenic cardiomyopathy


Which of the following is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening of these fibers?

a. Dilated cardiomyopathy
b. Hypertrophic cardiomyopathy
c. Restrictive cardiomyopathy
d. Arrhythmogenic cardiomyopathy

Answer: (b). Hypertrophic cardiomyopathy.

1. Dilated cardiomyopathy: Dilated cardiomyopathy is the most common form of the disease. It typically occurs in adults between the ages of 20 and 60 years.
The disease often starts in the left ventricle, but it can eventually also affect the right ventricle.
Dilated cardiomyopathy can affect the structure and function of the atria, too.

2. Hypertrophic cardiomyopathy:

Hypertrophic cardiomyopathy is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening or "hypertrophy" of these fibers. The thickening makes the chambers of the heart stiff and affects blood flow. It can also increase the risk of electrical disturbances, called arrhythmias.
According to the Children's Cardiomyopathy Foundation, it is the second most common form of cardiomyopathy in children. In about one-third of affected children, diagnosis occurs before the age of 1 year.

3. Restrictive cardiomyopathy:

Restrictive cardiomyopathy occurs when the tissues of the ventricles become rigid and cannot fill with blood properly. Eventually, it may lead to heart failure. It is more common in older adults and can result from infiltrative conditions - those involving the accumulation of abnormal substances in bodily tissues - such as amyloidosis.

4. Arrhythmogenic cardiomyopathy:

In arrhythmogenic cardiomyopathy, fibrotic and fatty tissue replaces the healthy tissues of the right ventricle, which may cause irregular heart rhythms. In some cases, this process can also occur in the left ventricle.

According to research in the journal Circulation Research, arrhythmogenic cardiomyopathy increases the risk of sudden cardiac death, especially in young people and athletes. It is a hereditary genetic condition.

Symptoms:

In some cases, usually mild ones, there are no symptoms of cardiomyopathy.

However, as the condition progresses, a person may experience the following symptoms with varying degrees of severity:

  1. fatigue
  2. shortness of breath
  3. swelling of the legs and ankles
  4. heart palpitations
  5. dizziness
  6. fainting

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What is the primary sign or symptom that differentiate bulimia from anorexia? [Select All That Apply]

a. lose weight rapidly
b. eating in secret
c. frequent overeating
d. developing acid reflux
e. developing anemia


What is the primary sign or symptom that differentiate bulimia from anorexia? [Select All That Apply]

a. lose weight rapidly
b. eating in secret
c. frequent overeating
d. developing acid reflux
e. developing anemia

Answer: (b,c and d). According to the National Institute of Mental Health, about 0.6% of adults in the United States experienced anorexia between 2001 and 2003, compared to 0.3% who experienced bulimia.

There are essential differences between anorexia and bulimia, and it is possible for a person to have both at the same time.

People with anorexia and bulimia may fixate on weight and appearance, and they may have a distorted body image. Both conditions result in a person trying to lose weight using unhealthy strategies.

There are key differences between anorexia and bulimia. People with anorexia tend to adopt extreme diets. They may restrict their food intake to a degree that can lead to malnourishment and even death.

Some people with anorexia exercise to excess. If a person is already malnourished, this amount of exercise may cause them to faint or experience other potentially severe adverse effects. Also, a person with anorexia may vomit or take laxatives to lose weight.

The primary characteristic of bulimia is episodes of binge eating followed by 'purging.' An episode may involve overeating and later vomiting, using laxatives, or administering enemas to get rid of the calories consumed.

The primary symptom of anorexia is restricting food intake with extreme dieting. The main symptom of bulimia is compensating for episodes of overeating by trying to purge the food.

Anorexia can cause a person to:

  1. lose weight rapidly
  2. avoid meals
  3. eat very little at meals
  4. try to hide how much they eat
  5. have brittle hair and nails
  6. fixate on their weight
  7. develop anemia
  8. have constipation
  9. experience weakness
  10. experience fainting and fatigue
  11. stop menstruating, which doctors call amenorrhea
  12. develop infertility
  13. experience organ failure

Some signs and symptoms of bulimia include:

  1. frequent overeating
  2. eating in secret
  3. disappearing after meals
  4. having a swollen throat or neck
  5. developing acid reflux
  6. having oral health problems, such as tooth loss or broken teeth
  7. experiencing severe dehydration
  8. having electrolyte imbalances, which can cause health problems

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