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Which of the following is an appropriate nonpharmacologic intervention for gout?

Lynette is a 68 yo female who presents to your clinic for a follow up appointment after her recent heart failure diagnosis.  She complains of weakness, loss of appetite, and she is seeing a blue/green halo.  Her daughter comments that she has appeared confused over the past day or so.  Which medication may be causing these side effects?

A 45-year-old female presents to the clinic with complaints of persistent headaches for the past two weeks. She describes the pain as sudden and severe, unlike any headache she has experienced before. She denies any visual disturbances but reports feeling nauseous during the headaches. She has no significant past medical history. Which of the following red flags suggests a potentially serious underlying cause of her headaches?

Which of the following statements regarding warfarin (Coumadin*) is correct?

Josina is a 65 yo AA woman presents to clinic feeling tired for the last 3 months.  She is able to complete some light housework and cook her dinners, but she has difficulty breathing when doing more activity such as grocery shopping and walking up stairs.  She sleeps on 2 pillows at night to help with her breathing. PMH:  Heart failure with reduced ejection fraction (class III, stage C) HTN, arthritis. Physical exam: Edema of her feet and ankles (2+) with some crackles noted in the lungs on inspiration Medications:  HCTZ (Hydrodiuril*) 12.5mg daily, and ibuprofen (Advil* / Motrin*) 200mg BID for arthritis in knee. Vitals:  height 5’2″, 63kg, BP 134/84, HR 78, EF 35% per echocardiogram.  Which of the following is/are accurate regarding the use of a beta-blocker (BB) in Josina?

Jonathan is a 72yo Caucasian male with a history of hypertension and stable angina.  His home medications include chlorthalidone (Hygroton*) 12.5mg daily, lisinopril (Zestril*) 10mg daily, and amlodipine (Norvasc*) 5mg once daily.  His father died at age 50 of a heart attack.  Recently he experienced episodes of chest pain so he was scheduled for an exercise stress test which supported a diagnosis of coronary artery disease (CAD).  At his follow-up appointment, Jonathan’s BP is his normal of 130/68 but he has continued to experience chest pain during exertion.  The pain resolves when he sits down.  He is very compliant with his heart healthy diet and exercise routine, but is concerned that this angina limits his ability to exercise.  He started smoking 10 years ago after his sister died of pancreatic cancer, but is trying to quit.  He weighs 165 lbs and is 5’9″ tall.  Fasting labs include total cholesterol 155 [

Michelle, a 35 y/o woman, is hospitalized for evaluation of severe chest pain, which occurs almost daily at about 5 AM. Michelle rates the pain as about a 7 /10. It is associated with diaphoresis and is not relieved by change in position or rest. She has no cardiovascular risk factors, her hobbies include triathlon competition and rock climbing, neither of which cause chest pain. She follows a strict vegetarian diet. Michelle is diagnosed with variant (Prinzmetal’s) angina. The next day Michelle is abruptly awakened by severe chest pain, which was relieved within 60 seconds by one 0.4mg SL NTG. Which of the following agents would be appropriate to prevent her (now daily) symptoms?

Alexis is a 67 y/o female with COPD. All of the following are appropriate recommendations except?

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?

All of the following statements are correct except?