Ambulatory Care Clerkship Rotation



Questions Set for Students - Ambulatory Care Rotation (6 pages)

1. What are the most common bacteria causing cellulitis and how does the patient present? What are your options for treatment of cellulitis?

2. In diabetic patients diagnosed with cellulitis, provide the likely organisms and treatment options.

3. What are the treatment options for CA-MRSA (community acquired)?

4. What are the 3 most common bacteria causing otitis media, pharyngitis, acute sinusitis, bronchitis, CAP? What are signs and symptoms of each?

5. Recommend three first choice antibiotics for otitis media, pharyngitis, acute sinusitis, bronchitis, and discuss dosing, AE, and patient counseling?

6. LM is a 51yo male who has been diagnosed with CAP. His PMH includes DM, HTN, and OA. He was recently treated with levofloxacin for prostatitis. Based on current guidelines what are the treatment options for empiric therapy? Based on the patient characteristics, what is your recommendation for antibiotic therapy (include dosing and length of treatment)?

7. What is the treatment of UTI? What is the difference between pylonephritis and cystitis?

8. What is the clinical presentation of a patient with a UTI? How might a geriatric patient present?

9. Differentiate between uncomplicated and complicated UTI in terms of patient population and treatment considerations.

10. If treating a patient for gonorrhea, what else should you also treat the patient for?

11. What is the treatment for the above question?

12. What is the American Urological Association symptoms index?  What is the classification?

13. Describe the role of alpha blockers and 5-alpha reductase inhibitors for BPH. (i.e. mechanism of action, dosing, advantages/disadvantages, and place in therapy).

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14. According to the Asthma guidelines, what are the classifications for Asthma, criteria for each stage and recommended therapy?

15. What are potential triggers for Asthma exacerbations?

16. Explain the different zones when using a peak flow meter.

17. What is the black box warning associated with long acting beta agonists?

18. Describe the pathophysiology, signs and symptoms of COPD.

19. Discuss the treatment guidelines for COPD (name of guidelines, diagnostic criteria, treatment)

20. Treatment options for COPD include anticholinergics, beta agonists, and corticosteroids. Discuss each of these, AE, patient counseling pointers.

21. Compare and contrast the difference in treatment options for Asthma vs. COPD.

22. As health care providers, what are the five A’s that should be addressed at each visit with patients who smoke?

23. What agents are available OTC and Rx for smoking cessation?

24. What are the contraindications for smoking cessation agents? AE?

25. For smoking cessation agents, which are not nicotine replacement, explain their MOA, side effects, dosing and contraindications.

26. Explain the starting dosing for nicotine lozenges.

27. Discuss the role of behavior modification in smoking cessation.

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28. Who does the CDC recommend receive influenza vaccination? Pneumococcal vaccination? H1N1 vaccination?

29. List the contraindications to the influenza vaccination.

30. What are the recommended screenings for adults and how often do we screen?

31. What T-scores are considered normal, osteopenic and osteoporotic bone?

32. Discuss the current treatment options for osteoporosis in terms of MOA, side effects, dosing, administration and length of therapy.

33. What are risk factors for developing osteoporosis?

34. What medications increase the risk of developing osteoporosis?

35. Which medications are indicated for use in prevention and/or treatment of non-vertebral fracture reduction in OP?

36. What is the difference between Miacalcin and Fortical?

     

37. What are the causes of peptic ulcer disease (PUD)?

38. How can you diagnosis a patient H. Pylori? What are the treatment options for a patient who tests H. Pylori positive?

39. In what patients should you consider prophylaxis options for NSAID induced ulcers? What are the prophylactic options recommended?

40. What are non-pharmacologic recommendations you can make for a patient with GERD?

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41. What are your treatment options for GERD (MOA, dosing, AE, significant drug interactions)?

42. What options are available for the treatment of allergic rhinitis?

43. How do we diagnosis thyroid disease?

44. What are the clinical findings of hypothyroidism and hyperthyroidism?

45. How do we treat both hypothyroidism and hyperthyroidism? (Discuss medications, dosage, AE, adjustments)

46. What effect does thyroid have on a patient’s cholesterol?

47. SR is a 45yo female who is on warfarin therapy for a PE. She is stable on her warfarin dose and has had therapeutic INRs. At her last office visit with her physician, she was diagnosed with hypothyroidism and started on levoxyl therapy. What effect do you expect her thyroid status to have on the management of warfarin? Explain the MOA.

48. What are the main causes of CKD? How do we monitor renal function/diagnosis CKD? What are the stages of CKD?

49. How do you calculate CrCl? GFR?

50. What is the pathogenesis of anemia of CKD?

51. How do we treat anemia of CKD? Monitoring/dosage/adjustments/AE?

52. What can we use for treatment of generalized anxiety disorder? AE of medications? Monitoring parameters?

53. What is the clinical presentation of a patient who has atrial fibrillation?

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54. How is a patient with atrial fibrillation medically managed?

55. A patient with atrial fibrillation can receive either aspirin or warfarin or strong prevention, how do you decide?

56. Explain the conditions for a patient with atrial fibrillation to be cardioverted.

57. Differentiate between osteoarthritis and rheumatoid arthritis.

58. What is the treatment of choice for osteoarthritis (give drug and dosing)?

59. ML is a 69 yo female who is currently taking metformin 1000mg BID, glipizide 5mg QD, warfarin 2.5mg QD except 5mg on Wednesday, and alendronate 70mg Qweek. She has osteoarthritis but says that APAP is not relieving her pain. What other therapeutic options are available for the treatment of OA and what is your recommendation for this patient?

60. What is the first line treatment for depression?

61. What classes of medications are available to be used for depression? Common AE for each class? What drugs are in each class? Monitoring parameters?

62. What can we use for treatment of Panic disorder? AE of medications? Monitoring parameters?

63. Triptans are often used for the treatment of migraines, what are the differences among them and AE, CI, dosing?

64. What medications can be used for migraine prophylaxis?

65. Name three drugs that are commonly known to cause a lupus like syndrome. (Brand and generic names)

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66. List an “antidote” (brand and generic name) for each of the following:

a. Heparin –

b. Coumadin –

c. Digoxin –

d. Benzodiazepines –

e. Morphine –

f. iron compounds –

67. What are some common medications, which cause hyperkalemia? Explain their MOA that contributes to this side effect.

68. How do you differentiate what type of anemia a patient has?

69. Describe 3 things/medications we can do for DVT prophylaxis.

70. State the usual therapeutic range of the following and when you should draw a level:

a. Digoxin

b. Lithium

c. Phenytoin

d. Theophylline

e. Valproic Acid

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