PM is a 43-year-old non-obese female newly diagnosed with rheumatoid arthritis with poor prognosis. She has been experiencing symptoms for the past 4 months of joint pain in her first metacarpals. The only notable lab abnormalities are elevated liver function tests (AST/ALT) which are 3 times the upper limit of normal. Vitals are WNL. PMH: Past (10 years prior) alcohol abuse, cirrhosis, and hypertension Home medications: Amlodipine 5 mg PO daily Which of the following is the most appropriate initial therapy for PM?

What medication is contraindicated in patients with G6PD deficiency?

RM is a 54 year old Caucasian woman who presents for follow-up for blood pressure management.  She has concerns about osteoporosis because her mother had a history of it, including multiple fractures.  She did have her bone density tested recently at the local health fair.  She smokes 1 ppd x 30 years, rides her bike 2 miles on 3 days per week and does swim when it’s too icy to ride her bike.  Her medications include HCTZ 25mg once daily, Lisinopril 10mg once daily, Levothyroxine 150mcg once daily, Centrum Vitamin once daily, Calcium carbonate 600mg with Vitamin D twice daily. What non-pharmacologic recommendations would you make to RM at this time?   

AQ is a 52-year-old woman who presents to clinic for follow-up with her PCP to discuss worsening, severe hot flushes.  She explains that she has to get up in the night and change the bedding, is unable to work a full day at her job at least once per week.  In addition, she feels “moody and down in the dumps” most days of the week, for a couple of months now.  Her health history includes hypertension, hyperlipidemia, Crohn’s disease, recurrent DVT and PE, and she did have a hysterectomy after her last daughter was born 21 years ago, due to complications.  She reports that she is at a “point of desperation to feel like myself again”.  Recognizing your expertise in the area of Women’s Health, AQ’s physician calls on you for a treatment recommendation.  What do you recommend? 

What is the goal urine output in patient’s administered IV fluids for TLS prevention?

TT, a 25-year-old comes to clinic today for her annual well woman exam.  She has a history of migraine headaches x6 years and would like to discuss contraception today.  She reports that her migraines have been much better in the past year since she switched from topiramate to Aimovig.  She feels this is because she “hates taking pills and forgets to take them a lot – so much easier to do a shot once a month”.  She is married to her husband for 2 years and admits they are tired of using condoms.  She works full time as a high school science teacher and enjoys her job but looks forward to having kids in the next 3-5 years and staying home with them. Today’s vital signs are: BP 122/72 HR 70 O2 94% RR 18.  She is 5’ 4” tall and weighs 217#.  Which form of contraception would best meet TT’s needs today?

TG is a 59-year-old male who has recently been diagnosed with mantle cell lymphoma. He is receiving the NORDIC regimen (alternating regimens with regimen 1: rituximab, cyclophosphamide, vincristine, doxorubicin, prednisone and regimen 2: rituximab and high-dose cytarabine). He comes into the oncology clinic and you notice he has an unbalanced gait, nystagmus, and a prolonged separation of syllables. You think he might be having cerebellar neurotoxicity due to his chemotherapy. Which medication in his regimen is most likely contributing to his symptoms?  

HG is a 43-year-old female who has a primary breast cancer, with brain metastases. She is receiving cisplatin and etoposide. While the nurse is giving the IV etoposide, the patient begins to complain of painful burning at the injection site. Which of the following is the antidote for extravasation with etoposide?

(Linn Acid-Base/DKA) A patient’s DKA will be resolved when which of the following criteria are satisfied? 

JF is a 47-year-old obese Asian male the clinic today because he is experiencing his 3rd gout flare over the past 12 months.  His physical exam is notable for bony growths (tophi) on his great toe and first metacarpal joints. His renal and hepatic function are within normal limits. PMH: obesity, uric acid kidney stones, HLA-B*5801 gene mutation Social history: does not smoke, drinks 6 beers every weekend No known drug allergies Current Medications             Ibuprofen 600 mg as needed for gout pain               Which of the following statements is correct?