Category: Uncategorized

A 62-year-old man with diabetes and CAD is prescribed sildenafil for ED. Which concurrent medication is an absolute contraindication? 

A 55-year-old woman with type 2 diabetes and chronic kidney disease (eGFR 42 mL/min) has been taking ibuprofen 600 mg three times daily for back pain. Labs show worsening renal function. Which agent is the safest alternative for pain relief? 

A 35-year-old male recreational bodybuilder presents with progressive breast enlargement, decreased libido, and infertility. Exam reveals bilateral gynecomastia, testicular atrophy, and reduced muscle tone. He admits to long-term use of intramuscular anabolic steroids obtained without prescription. Which mechanism best explains these findings? 

A 65-year-old man with atrial fibrillation and weight loss is diagnosed with hyperthyroidism. Which drug controls adrenergic symptoms (palpitations, tremor)? 

A 29-year-old man with HIV presents with recurrent painful genital ulcers. PCR confirms HSV-2. He reports 8 outbreaks in the past year and a new HSV-seronegative partner. Which is the most effective strategy to reduce both recurrence frequency and transmission? 

A 52-year-old man presents with sudden-onset severe pain, swelling, and erythema of the right great toe that began overnight. He describes the pain as “unbearable.” Past medical history includes stage 3 chronic kidney disease (eGFR 45 mL/min) and hypertension, currently treated with lisinopril. Labs show uric acid 9.0 mg/dL, WBC 9,000/µL, and creatinine 1.8 mg/dL. He has no fever or systemic symptoms. Which pharmacologic option is most appropriate for management of his acute flare? 

A 30-year-old pregnant woman is newly diagnosed with hyperthyroidism. Which drug is preferred in the first trimester? 

A 72-year-old woman with COPD has chronic cough and exertional dyspnea. She uses a long-acting muscarinic antagonist (tiotropium). Despite this, she has frequent exacerbations. What is the next best pharmacologic option? 

A 45-year-old man with allergic rhinitis uses diphenhydramine daily. He reports daytime drowsiness and difficulty concentrating at work. Which strategy best addresses his concern? 

A 68-year-old man with diabetes and aortic aneurysm is prescribed levofloxacin for pneumonia. Which serious FDA warning is most relevant?