Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

  Answer  

Which of the following information is/are TRUE ABOUT Lyme disease tests? [Select ALL That Apply].

a. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
b. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
c. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
d. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
e. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

Answer: (a,b,c,d,e)

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks).
 
CDC currently recommends a two-step testing process for Lyme disease. Both steps are required and can be done using the same blood sample. If this first step is negative, no further testing is recommended. If the first step is positive or indeterminate (sometimes called “equivocal”), the second step should be performed. The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal).
 
Key points to remember:
 
1. Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
2. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
3. Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure.
4. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
5. Some tests give results for two types of antibody, IgM and IgG.  Positive IgM results should be disregarded if the patient has been ill for more than 30 days. 
 
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MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y

  Answer  

MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups ___________ of the bacterium N meningitidis. [Select ALL That Apply].

a. A
b. B
c. C
d. W
e. Y

Answer: (a,c,d,e)

MenQuadfi is a vaccine given to people 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by serogroups A, C, W, and Y of the bacterium N meningitidis.

MenQuadfi does not prevent serogroup B disease.

In the U.S., the Centers for Disease Control and Prevention recommends vaccination against meningococcal disease at 11-12 years of age and a second dose at 16 years of age.
Despite strong public health recommendations, about half of teens have not received the recommended second dose of MenACWY vaccine by 17 years of age, leaving them vulnerable when they are at increased risk for the disease.

Hundreds of cases of vaccine-preventable meningococcal disease (caused by serogroups B, C, W, Y) still occur annually in the U.S. and, despite treatment, one in five survivors suffer from permanent complications such as hearing loss, organ damage, and limb amputations.

The most common side effects following a first dose of MenQuadfi included injection site pain, muscle ache, headache, and tiredness. In adolescents and adults receiving a MenQuadfi booster, similar rates of these reactions were observed. 
 
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Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer

  Answer  

Keytruda is indicated for the treatment of: [Select ALL That Apply].
 
a. Non-Small Cell Lung Cancer
b. Head and Neck Squamous Cell Cancer
c. Gastric Cancer
d. Esophageal Cancer
e. Cervical Cancer

Answer: (a,b,c,d,e)

The active ingredient found in Keytruda is Pembrolizumab. It is available in injection (100 mg/4 mL) form.
 
Binding of the PD-1 ligands, PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors.

Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In syngeneic mouse tumor models, blocking PD-1 activity resulted in decreased tumor growth.

Keytruda is indicated for the treatment of:

a. Melanoma
b. Non-Small Cell Lung Cancer (NSCLC)
c. Small Cell Lung Cancer (SCLC)
d. Head and Neck Squamous Cell Cancer (HNSCC)
e. Classical Hodgkin Lymphoma (cHL)
f. Primary Mediastinal Large B-Cell Lymphoma (PMBCL)
g. Urothelial Carcinoma
h. Microsatellite Instability-High Cancer
i. Gastric Cancer
k. Esophageal Cancer
l. Cervical Cancer
m. Hepatocellular Carcinoma (HCC)
n. Merkel Cell Carcinoma (MCC)
o. Renal Cell Carcinoma (RCC)
p. Endometrial Carcinoma
 
The usual recommended dose of Keytruda is 200 mg every 3 weeks or 400 mg every 6 weeks.  
 
Immune-Mediated pneumonitis, colitis, hepatitis, endocrinopathies, hypophysitis, nephritis and renal dysfunction are commonly reported side effects of the drug.
 
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What are the possible side effects of Farxiga? [Select All That Apply]:
 
a. Dehydration
b. Ketoacidosis
c. Urinary tract infections
d. Vaginal yeast infections
e. Balanitis

  Answer  

What are the possible side effects of Farxiga? [Select All That Apply]:
 
a. Dehydration
b. Ketoacidosis
c. Urinary tract infections
d. Vaginal yeast infections
e. Balanitis

Answer: (a,b,c,d,e)
 
The active ingredient found in Farxiga is Dapagliflozin (Farxiga).  
 
Farxiga may cause serious side effects including:
1. Dehydration
2. Ketoacidosis
3. Serious urinary tract infections (UTI)
4. Low blood sugar (hypoglycemia)
5. Bacterial infections under the skin of the genitals and areas around them
6. Vaginal yeast infections
7. Yeast infection of skin around the penis (balanitis) in men.

The most common side effects of Dapagliflozin (Farxiga) include yeast infections of the vagina or penis, and changes in urination, including urgent need to urinate more often, in larger amounts, or at night.

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Farxiga is indicated to [Select All That Apply]:
 
a. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
b. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
c. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
d. reduce the risk of diabetic ketoacidosis in adults with type 1 diabetes.

  Answer  

Farxiga is indicated to [Select All That Apply]:
 
a. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
b. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
c. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
d. reduce the risk of diabetic ketoacidosis in adults with type 1 diabetes.

Answer: (a,b,c)
 
The active ingredient found in Farxiga is Dapagliflozin (Farxiga).  Farxiga is indicated to:
 
1. improve blood sugar control along with diet and exercise in adults with type 2 diabetes.
2. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes.
3. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
 
Farxiga should not be used to treat people with type 1 diabetes or diabetic ketoacidosis (increased ketones in your blood or urine).
 
To improve glycemic control, the recommended starting dose of Farxiga is 5 mg orally once daily, taken in the morning, with or without food. In patients tolerating Farxiga 5 mg once daily who require additional glycemic control, the dose can be increased to 10 mg once daily.

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Farxiga is:

a. 5HT-1 receptor Antagonist
b. Alpha-2 inhibitor
c. Renin inhibitor
d. SGLT2 inhibitor
e. SSRI

  Answer  

Farxiga is:

a. 5HT-1 receptor Antagonist
b. Alpha-2 inhibitor
c. Renin inhibitor
d. SGLT2 inhibitor
e. SSRI

The active ingredient found in Farxiga is Dapagliflozin (Farxiga). It is the first sodium glucose co-transporter 2 (SGLT2) inhibitor approved by the US FDA. It is available as tablets (5mg and 10mg).

Sodium-glucose co-transporter 2 (SGLT2) is the predominant transporter responsible for reabsorption of glucose from the glomerular filtrate back into the circulation. Dapagliflozin (Farxiga) is an inhibitor of SGLT2. By inhibiting SGLT2, Dapagliflozin (Farxiga) reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose, and thereby increases urinary glucose excretion.

Dapagliflozin (Farxiga) also reduces sodium reabsorption and increase the delivery of sodium to distal tubule. This may influence several physiological functions including, but not limited to, lowering both pre-and afterload of the heart and downregulation of sympathetic activity.

Dapagliflozin (Farxiga) is a prescription medicine used to:

1. improve blood sugar control along with diet and exercise in adults with type 2 diabetes

2. reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and known cardiovascular disease or multiple cardiovascular risk factors

3. reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure (when the heart is weak and cannot pump enough blood to the rest of your body)

Dapagliflozin (Farxiga) should not be used to treat people with type 1 diabetes or diabetic ketoacidosis (increased ketones in your blood or urine).

Usual Adult Dose for Diabetes Type 2:

a. To improve glycemic control (can be taken with or without food):

1. Initial dose: 5 mg orally once a day
2. May increase to 10 mg orally once a day for additional glycemic control if lower dose has been tolerated
3. Maximum dose: 10 mg/day

b. To reduce the risk of hospitalization for heart failure: 10 mg orally once a day.

Dehydration, ketoacidosis, UTI infection, hypoglycemia and vaginal yeast infection are reported side effects of the drug.

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An immunofixation (IFE) blood test is used to identify which of the following types of proteins in blood? [Select All That Apply]
 
a. Albumin
 
b. Alpha-1 globulin
 
c. Alpha-2 globulin
 
d. Beta globulin
 
e. Gamma globulin

  Answer  

An immunofixation (IFE) blood test is used to identify which of the following types of proteins in blood? [Select All That Apply]
 
a. Albumin
 
b. Alpha-1 globulin
 
c. Alpha-2 globulin
 
d. Beta globulin
 
e. Gamma globulin

Answer: (a,b, c, d, e)
 
An immunofixation blood test, also known as protein electrophoresis, measures certain proteins in the blood. Proteins play many important roles, including providing energy for the body, rebuilding muscles, and supporting the immune system.
 
There are two main types of proteins in the blood: albumin and globulin. The test separates these proteins into subgroups based on their size and electrical charge. The subgroups are:
 

1. Albumin
2. Alpha-1 globulin
3. Alpha-2 globulin
4. Beta globulin
5. Gamma globulin

 
Measuring the proteins in each subgroup can help diagnose a variety of diseases.

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Which of the following statements is/are TRUE ABOUT D-Dimer Test? [Select All That Apply]
 
a. A D-dimer test looks for trimethyl occulin in blood.
 
b. D-dimer is a protein fragment that's made when a blood clot dissolves in a body.
 
c. It is used to diagnose deep vein thrombosis.
 
d. The test is also known as fibrin degradation fragment.

  Answer  

Which of the following statements is/are TRUE ABOUT D-Dimer Test? [Select All That Apply]
 
a. A D-dimer test looks for trimethyl occulin in blood.
 
b. D-dimer is a protein fragment that's made when a blood clot dissolves in a body.
 
c. It is used to diagnose deep vein thrombosis.
 
d. The test is also known as fibrin degradation fragment.

Answer: (b, c, d)

A D-dimer test looks for D-dimer in blood. D-dimer is a protein fragment (small piece) that's made when a blood clot dissolves in a body. It is also known as a fragment D-dimer or fibrin degradation fragment test.
 
A D-dimer test is most often used to find out whether you have a blood clotting disorder. These disorders include:
 
1. Deep vein thrombosis (DVT), a blood clot that's deep inside a vein. These clots usually affect the lower legs, but they can also happen in other parts of the body.
 
2. Pulmonary embolism (PE), a blockage in an artery in the lungs. It usually happens when a blood clot in another part of the body breaks loose and travels to the lungs. DVT clots are a common cause of PE.
 
3. Disseminated intravascular coagulation (DIC), a condition that causes too many blood clots to form. They can form throughout the body, causing organ damage and other serious complications. DIC may be caused by traumatic injuries or certain types of infections or cancer.
 
4. Stroke, a blockage in the blood supply to the brain.

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Which of the following drugs is indicated for the treatment of nausea and vomiting in pregnancy?

a. Zofran
b. Diclegis
c. Antivert
d. Benadryl
e. Motrin

  Answer  

Which of the following drugs is indicated for the treatment of nausea and vomiting in pregnancy?

a. Zofran
b. Diclegis
c. Antivert
d. Benadryl
e. Motrin

Answer: (b) Diclegis.

Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP.

The recommended dosing is as follow:

For oral dosage form (delayed-release tablets):

Adults-2 tablets taken at bedtime (Day 1). If symptoms are controlled the following day, continue taking 2 tablets at bedtime. If symptoms persist in the afternoon of Day 2, take 2 tablets at bedtime and start taking 3 tablets on Day 3 (1 tablet in the morning and 2 tablets at bedtime). If symptoms are controlled on Day 4, continue taking 3 tablets daily. Otherwise, take 1 tablet in the morning, 1 tablet in the mid-afternoon, and 2 tablets at bedtime (total of 4 tablets).

For oral dosage form (extended-release tablets):

Adults-1 tablet taken at bedtime (Day 1). If symptoms are controlled the following day, continue taking 1 tablet at bedtime. If symptoms persists on Day 2, take 1 tablet in the morning and 1 tablet at bedtime. However, the dose is usually not more than 2 tablets per day.

The drowsiness is more frequently reported side effect of the drug.

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Which of the following is the first FDA-approved intravenous (IV) treatment for migraine prevention?
 
a. Imitrex
b. Relpax
c. Zomig
d. Cambia
e. Vyepti

  Answer  

Which of the following is the first FDA-approved intravenous (IV) treatment for migraine prevention?
 
a. Imitrex
b. Relpax
c. Zomig
d. Cambia
e. Vyepti
 
Answer: (e). 

The active ingredient found in Vyepti is Eptinezumab-jjmr. It is the first FDA-approved intravenous (IV) treatment for migraine prevention.
 
Vyepti (Eptinezumab-jjmr) is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor.
 
The recommended dose is 100 mg every 3 months; some patients may benefit from a dose of 300 mg.

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