Melanie Jaeger T4 Tutoring

Adult Obesity

Which of these would be an indication to discontinue Qsymia? A. After 6 weeks at 7.5/46 mg the patient has not lost at least 3% of their total weight. B. After 12 weeks at 7.5/46 mg the patient has not lost at least 5% of their total weight. C. After 12 weeks at 15/92 mg the patient has not lost at least 5% of their total weight. D. After 12 weeks at 15/92 mg the patient has not lost at least 10% of their total weight. C

Which of the following weight loss agents should not be taken by a patient on Cialis? Orlistat Qsymia Belviq Contrave C

Which of the following agents is not removed by HD in overdose? Orlistat Qsymia Belviq Contrave C

LH is a 35 yo F, 150 kg. PMH includes seizure disorders. BP 161/99 LH is a 35 yo F, 150 kg. PMH includes seizure disorders. BP 161/99. Which of the following agents is contraindicated for LH? Orlistat Qsymia Belviq Contrave D

What is the appropriate way to titrate Contrave upon initiation What is the appropriate way to titrate Contrave upon initiation? Why does Contrave need to be titrated up? Week 1: 1 tablet QAM Week 2: q tab QAM and QPM Week 3: 2 tabs QAM and 1 tab QPM Week 4: 2 tabs QAM and 2 tabs QPM

Which of the following patients is not seeing the expected results of the weight loss agent they are taking? AK taking Orlistat. Has lost 7 lbs over 1 year. BP taking Belviq. Has lost 9 lbs over 1 year. CM taking Contrave. Weighed 270 lbs. Has lost 14 lbs. DT taking Qsymia. Has lost 10 lbs over 1 year. D

Which of these agents may interact with Belviq? Levofloxacin Tramadol Guaifenasin ibuprofen B

Short Bowel Syndrome

In which section of the intestines is B12 absorbed? Duodenum Jejunum Ileum Colon C

Which of these is a function of the ileocecal valve? Sodium and glucose uptake Recycles bile salts Regulates rate of gastric emptying Prevents bacterial overgrowth D

Where does the majority of fluid and electrolyte absorption occur? Duodenum Jejunum Ileum colon D

What is the biggest concern in the first 2 weeks of small bowel syndrome? Bowel atrophy Fluid and electrolyte loss Weight loss Biliary sludging B

What is the most important intervention in stage 2 of SBS? Fluid replacement Water soluble vitamin replacement Enteral nutrition Pancreatic enzyme supplementation C

Which of the following agents could be helpful for a patient on chronic PN showing signs of cholestasis? Rifaximin Ursodiol IV lipids (soybean oil formulation) cholecystokinin B

What is more common in SBS? Metabolic alkalosis Metabolic acidosis B

Childhood Obesity

At what age does childhood obesity begin to show a correlation with adult obesity? 1 yo 2 yo 3 yo 4 yo D

Which of the following drugs is approved for weight loss in children? Metformin Octreotide Topiramate orlistat D

Match the drug with the MOA. Orlistat Metformin Octreotide Liraglutide Enhances insulin sensitivity Suppresses pancreatic insulin secretion GLP-1 analog, stimulates insulin release Gastric and pancreatic lipase inhibitor A-4 B-1 C-2 D-3

Inflammatory Bowel Disease

What is the hallmark feature of ulcerative colitis? Abdominal pain Diarrhea Bloody diarrhea Weight loss C

Which of these statements about sulfasalazine is false? Sulfasalazine acts topically in the colon. Sulfasalazine’s toxicity is due to the aminosalicylic component. The active form of sulfasalazine is 5-ASA. Sulfasalazine should be started at lower doses (~500 mg BID). B

Which of these statements is true about infliximab? Patients should be screened for TB before beginning infliximab. Induction doses should be given three times, on week 0, 4, and 8. Infliximab is given SQ. Infliximab is safe in patients with hepatic disease. A

Tips for Pancreatitis Know your risk factors Early and aggressive IV fluids Antibiotics

Tips for Hepatitis Hepatitis A prevention How to interpret Hepatitis B serology Hepatitis B treatment drugs Hepatitis B post-exposure prophylaxis Ribavirin-hemolytic anemia New agents: Harvoni, Viekira Pak