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WorksheetsOutpatient Comprehensive OSCE Review
Total questions: 25
Worksheet time: 50mins
Which of the following blood pressures is NOT correctly matched to the stage of HTN?
128/78: Pre-hypertension
132/82: Stage 1 HTN
132/82 and ASCVD risk 20%: Stage 2 HTN
138/94: Stage 2 HTN
148/82: Stage 2 HTN
Which of the following would NOT be considered a first-line antihypertensive per the 2017 ACC/AHA HTN Guidelines?
Amlodipine
Chlorthalidone
HCTZ
Lisinopril
Metoprolol
In which of the following patients would an ACE inhibitor NOT be the preferred first-line therapy per the 2017 ACC/AHA HTN Guidelines?
African American without comorbidities
Chronic kidney disease
Diabetic with albuminuria
History of stroke
Which of the following is NOT correctly listed with its maximum recommended dose for treatment of hypertension?
Amlodipine 10 mg/day
Chlorthalidone 50 mg/day
HCTZ 25 or 50 mg/day
Lisinopril 40 mg/day
Which of the following correctly pairs the antihypertensive agent with a reason NOT to initiate that agent?
Losartan - cough on ACE inhibitor
HCTZ - elevated potassium
Metoprolol - elevated heart rate
Spironolactone - elevated potassium
In which of the following situations is warfarin the preferred anticoagulant per CHEST guidelines?
Treatment of venous thromboembolism
Prevention of venous thromboembolism after hip replacement
Prevention of stroke in nonvalvular atrial fibrillation
Prevention of thromboembolism with mechanical prosthetic valves
A CHA2DS2-VASc score must be calculated to determine:
Need for anticoagulation after VTE
Need for anticoagulation in non-valvular AFib
Need for aspirin therapy in diabetic patients
INR goal in patients following MVR
A parenteral anticoagulant (ex. LMWH) does NOT need to be used when starting which of the following oral anticoagulants for treatment of VTE?
Apixaban
Edoxaban
Dabigatran
Warfarin
What is the *most* appropriate VTE treatment dose of Lovenox for an 83 kg patient with normal renal function?
75 mg every 12 hours
80 mg every 12 hours
85 mg every 12 hours
90 mg every 12 hours
Which of the following must you counsel a patient about when starting a DOAC? (There may be more than one right answer)
Monitoring (CBC, SCr)
Bleeding risk (w/ examples)
Importance of compliance
Drug-drug interactions
Alcohol avoidance
For which of the following would you NOT need to wipe a rubber seal on the pen with an alcohol swab before attaching a pen needle?
Lantus
Ozempic
Trulicity
Victoza
Which of the following are common adverse effects to counsel on related to GLP-1 RAs?
Nausea, vomiting, diarrhea
UTIs, volume depletion, hypotension
Pancreatitis, joint pain
Fluid retention, heart failure
A patient has an A1c of 10% despite adherence to Glucophage 1g BID, Victoza 1.8mg QD, & Jardiance 25mg QD. Which of the following would you start?
Novolog 4 units prior to meals
Lantus 24 units daily
Januvia 100 mg once daily
Tresiba 10 units daily
Which of the following should be discontinued when starting someone on basal insulin?
Metformin
Glipizide
Empagliflozin
Liraglutide
When might you consider addition of prandial insulin?
In conjunction with initiation of basal regimen
Basal insulin dose >0.1-0.2 u/kg/day
FBG at goal but postprandial glucoses elevated
Prior to adding GLP-1 RA to regimen
Which of the following would be most appropriate to recommend for opioid-induced constipation in a treatment-naive patient per 2019 AGA Guidelines?
Methylnaltrexone QD
Bisacodyl suppository PRN
Docusate-senna BID
Lubiprostone BID
When would you advise a second dose of naloxone be administered to a patient by a bystander in the setting of opioid overdose?
Once breathing returns to normal
10-15 minutes after the initial dose
Once patient is awake
If patient remains unresponsive
How many doses of naloxone are in a Narcan Nasal Spray or Evzio Auto-Injector device?
One
Two
Three
Five
Which of the following correctly pairs the antidepressant with its *most common* short-term/transient adverse effects?
SNRIs - serotonin syndrome
SSRIs - GI upset, headache, anxiety, insomnia or sedation
Trazodone - insomnia, hypertension
Bupropion - sedation, drowsiness, weight gain
How long can it take for the full effects of antidepressants to be seen in a patient?
3-5 days
1-3 weeks
4-8 weeks
3-6 months
Which patient would NOT qualify for a high intensity statin?
42 yo w/ diabetes and microvascular complications
45 yo w/ ASCVD risk 22.5%
55 yo w/ ASCVD risk 12.5%, LDL 120 on moderate intensity statin
70 yo w/ stroke last year
Which of the following is a moderate intensity statin?
Atorvastatin 40mg
Pravastatin 20mg
Rosuvastatin 20mg
Simvastatin 20mg
Which patient qualifies for low-dose aspirin for *primary prevention* per USPTF and/or ADA based on the information provided?
42 yo w/ diabetes and HTN
48 yo w/ MI last year
55 yo w/ diabetes who smokes
66 yo w/ ASCVD 12.5% on apixaban
Which patient qualifies for PCV-13 (Prevnar) based on the information provided?
35 yo w/ diabetes
45 yo on dialysis
60 yo who smokes
66 yo otherwise healthy
Which patient does NOT qualify for PPSV23 (Pneumovax) based on the information provided?
45 yo with asthma
35 yo with diabetes
29 yo who smokes
66 yo who had PPSV23 2 years ago
