Which of the following best explains the mechanism by which nonsteroidal anti-inflammatory drugs (NSAIDs) contribute to the development of gastrointestinal ulcers? (Mark all that apply)

Which drug class should be added to a persistently symptomatic African-American patient despite therapy with Calcium channel blocker and Thiazide diuretic? 

LJ is a 23 yo female diagnosed with rheumatoid arthritis.  She has had mild joint discomfort and refused steroid and methotrexate therapy.  She was placed on Hydroxychloroquine (Plaquenil).  Which of the following monitoring tests are necessary and why? 

A 62-year-old postmenopausal woman presents for evaluation of osteoporosis. She has no history of fractures but reports a family history of hip fractures in her mother. Her dual-energy X-ray absorptiometry (DEXA) scan shows a T-score of -2.6 at the lumbar spine. She has no significant renal or liver disease. Laboratory tests, including calcium, vitamin D, and renal function, are within normal limits. Which of the following is the most appropriate initial treatment for this patient? 

1. Name this layer. 

RT is a 48 yo female on hydrochlorothiazide 25 mg po daily for mild hypertension. She should be counseled on the following as possible adverse effects of this thiazide diuretic:

A 60-year-old male with hypertension and prior myocardial infarction is prescribed metoprolol succinate. What is the primary pharmacologic effect that reduces blood pressure?

A 50-year-old woman presents with joint pain, swelling, and morning stiffness lasting more than an hour. She has tenderness and synovitis in multiple joints, including the wrists and small joints of the hands. Laboratory tests reveal positive rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are elevated. Radiographs show early erosive changes in the metacarpophalangeal joints. Which of the following is the most appropriate initial pharmacological treatment for this patient? 

A 29-year-old female at 9 weeks gestational pregnancy presents with palpitations, weight loss, tremor, and heat intolerance. Laboratory evaluation reveals suppressed TSH and elevated free T4. Thyroid-stimulating immunoglobulins are positive. She is diagnosed with Graves disease. Which of the following is the most appropriate initial pharmacologic management?  

A class of medications, the biologics, including etanercept (Enbrel) and adalimumab (Humira), are used for moderate to severe rheumatoid arthritis. Etanercept works by: