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A 55-year-old female presents to the clinic with complaints of knee pain and stiffness, particularly worse in the mornings and with activity. She reports a history of osteoarthritis (OA) in her family and is interested in using dietary supplements to manage her symptoms. Based on the information provided, which of the following statements regarding the use of glucosamine and chondroitin in osteoarthritis is most accurate?

HP is a 73 yo female who brought to the ED with altered mental status, but is unable to reliably describe any other symptoms. Urinalysis would demonstrate cloudy colored urine, (+) for  RBCs, WBCs, nitrites as well as leukocyte esterases.  Her culture shows >100,000 bacteria in the urine.  TRUE or FALSE:  You would treat this patient for a urinary tract infection (UTI).  

LA is 30-year-old pregnant woman. She is 16 weeks pregnant (the start of the  second trimester) and reports dysuria at her appointment today. Urinalysis and urine culture are conducted, and she is started on TMP-SMX (Bactrim / Septra) 1 (one) double strength (DS) tablet po bid. Three days later the clinic calls LA to tell her the culture results are back and she needs to change therapy. The culture was positive for E. coli, and it is resistant to TMP-SMX (Bactrim / Septra) only. What would be the new appropriate therapy (drug and duration) for LA?

TL is a 24 yo male with a mild methicillin-sensitive staphylococcus aureus (MSSA) cellulitis.  He has an allergy to penicillins / cephalosporins (anaphylaxis).  Which of the following would be the best treatment choice for this patient?

Kern, 72-year-old male presented at the hospital complaining of severe pain in his left leg, shortness of breath, and pleuritic type chest pain following a long drive from Connecticut to Florida with minimal stopping. The patient had a history of pulmonary embolism, degenerative joint disease, and previously was a chronic smoker. His vital signs were: temperature 38.4 °C, pulse 98 bpm, respiratory rate 20 breaths per minute, and blood pressure 138/90 mm Hg. Basic metabolic panel and complete blood count values were within the normal range. Kern is  diagnosed with a new DVT. Kern is given an appropriate loading dose (bolus) of heparin (Half-Life ≈ 1.5 hrs) and started on a heparin infusion at an initial rate of 18 units/kg/hr. Six hours after starting the initial infusion, Kern’s aPTT is 37 seconds. (Institution-specific therapeutic range is 46-70 seconds). What should be done?

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?