Andrea, a 27 y/o F with a history of asthma, has followed yo…

Andrea, a 27 y/o F with a history of asthma, has followed your prescribed asthma treatment plan and is doing much better (she is well controlled). Concerned about using the lowest effective dose of medications and still maintaining control of the asthma, you decide to step down therapy. The current guidelines suggest this is possible because Andrea has been well controlled for at least how long?

Peter is a 48 year old man with hypertension, COPD, erectile…

Peter is a 48 year old man with hypertension, COPD, erectile dysfunction and stable but moderately intense angina with physical exertion.  He typically fails to keep appointments and declines invasive diagnostic and therapeutic interventions.  His hypertension has been poorly controlled until recently.  His current medications include metoprolol (Toprol*), ramipril (Altace*), amlodipine (Norvasc*), atorvastatin (Lipitor*) and a nitroglycerin patch (Nitro-Dur*) worn from 10AM to 10PM.  He recently received tadalafil tablets (Cialis*) for erectile dysfunction from a questionable internet pharmacy and wants to know how to use them safely.  Which statement is true about the use of tadalafil (Cialis*) in Peter?  (Note: tadalafil inhibits phosphodiesterase for 36-48 hours)

Nancy is a 78 yo Caucasian female with a past medical histor…

Nancy is a 78 yo Caucasian female with a past medical history of heart failure (Class I, Stage B), hypertension and diabetes who arrives for a regular follow-up visit.  She monitors her weight daily and has kept her weight consistent for several weeks.  She avoids salt and is very careful with her fluid intake. She swims for 20-30 minutes each day.  Her current medications include: Candesartan (Atacand*) 32mg daily Metoprolol succinate XL (Toprol XL) 100mg twice daily Furosemide (Lasix*) 40mg twice daily K-dur (potassium supplement) 20mEq once daily Insulin glargine (Lantus*) 35 units at bedtime Insulin aspart (Novolog*) 10 units with meals.  Her physical exam shows no JVD, clear lung sounds, and minimal edema of her feet.  Her labs and vitals include Na 139 , K 2.9 , Cl 109 , Mg 2.0 , BUN 14 , Cr 1.2 [

JK is a 51 year old woman who made an appointment with you a…

JK is a 51 year old woman who made an appointment with you as she is beginning to experience some symptoms of menopause.  For the past 6 months, she has been experiencing frequent vasomotor symptoms (severe hot flashes, night sweats and flushes), pain during intercourse, and mood swings.  She complains that these symptoms have been so severe they’ve kept her out of daytime and work activities, and are disrupting her relationship.  Her PMHx is significant only for HTN controlled with medications. She has no surgical history (i.e No hysterectomy / intact uterus). What is the best course of action to follow for JK?