Ambulatory Care Chronic Disease Management Flashcards
7 cards from real Ambulatory Care Test practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Ambulatory Care Chronic Disease Management flashcards as text
A patient with type 2 diabetes has an A1C of 9.2% despite metformin monotherapy. Which medication class is MOST appropriate to add given the patient also has established cardiovascular disease?
Answer: GLP-1 receptor agonist
GLP-1 receptor agonists (e.g., semaglutide, liraglutide) have demonstrated cardiovascular mortality benefit in patients with established CVD and are preferred add-on therapy per ADA guidelines.
Which parameter is the BEST indicator of long-term glycemic control when monitoring a patient with diabetes in the ambulatory setting?
Answer: Hemoglobin A1C
Hemoglobin A1C reflects average blood glucose over the prior 2-3 months and is the standard measure for assessing long-term glycemic control.
A 58-year-old with COPD uses a SABA inhaler daily and wakes with symptoms twice a week. According to GOLD guidelines, what is the MOST appropriate next step?
Answer: Step up to a LAMA or LABA
Frequent SABA use and nighttime symptoms indicate inadequate control; GOLD guidelines recommend adding a long-acting bronchodilator (LAMA or LABA) as first-line maintenance therapy.
A patient with chronic kidney disease (CKD stage 3b) and hypertension is started on an ACE inhibitor. Which lab value requires close monitoring within 1-2 weeks of initiation?
Answer: Serum potassium and creatinine
ACE inhibitors can cause hyperkalemia and an acute rise in creatinine, particularly in CKD patients, requiring potassium and creatinine monitoring within 1-2 weeks of initiation.
Which blood pressure target is recommended by ACC/AHA guidelines for most patients with hypertension and confirmed cardiovascular disease?
Answer: Less than 130/80 mmHg
ACC/AHA 2017 guidelines recommend a BP target of less than 130/80 mmHg for patients with established cardiovascular disease or high cardiovascular risk.
A patient with heart failure with reduced ejection fraction (HFrEF) is on optimal medical therapy. Which device therapy has been shown to reduce sudden cardiac death risk when EF remains ≤35%?
Answer: Implantable cardioverter-defibrillator (ICD)
An ICD is indicated for primary prevention of sudden cardiac death in HFrEF patients with EF ≤35% on optimal medical therapy for at least 3 months.
A patient with rheumatoid arthritis on methotrexate reports new fatigue and mouth sores. Which supplement deficiency is MOST likely contributing to these side effects?
Answer: Folate
Methotrexate is a folate antagonist; folate supplementation (1 mg daily) is routinely co-prescribed to reduce side effects such as mucositis and fatigue.