FREE Ambulatory Care MCQ Questions and Answers
Which research design would be most suitable to evaluate the impact of a putative metabolic enzyme inhibitor on the clearance of warfarin?
To assess the effect of a potential metabolic enzyme inhibitor on the clearance of warfarin, the most appropriate study design would be a randomized crossover study with a washout period between phases.
A randomized crossover study involves each participant receiving multiple interventions in a random order. In this case, participants would be randomly assigned to receive either the potential metabolic enzyme inhibitor or a placebo/control, and then after a washout period to eliminate any lingering effects, they would cross over to the other intervention. By exposing each participant to both the potential inhibitor and the control, within-subject variability is reduced, making the study more robust.
How may inherent inequalities between groups at baseline be reduced when planning a clinical trial?
In designing a clinical trial, inherent differences between groups at baseline can be minimized through random assignment of patients to study groups.
Random assignment is a fundamental principle in clinical trial design that helps ensure comparability between groups at the start of the study. It involves assigning participants to different treatment groups or interventions randomly, without any systematic bias or preference. Randomization helps distribute both known and unknown factors that could potentially influence the outcome of the study equally among the groups.
Which physical examination finding would be in line with a worsening of heart failure?
The presence of rales would be consistent with an exacerbation of heart failure.
Rales, also known as crackles, are abnormal lung sounds that can be heard during a physical examination. They are characterized by fine crackling or bubbling sounds and are typically heard on auscultation of the lungs. Rales occur when there is fluid accumulation in the small airways and alveoli of the lungs.
A rural community outpatient clinic's pharmacy manager is considering launching a diabetic disease management program. What should the pharmacist do initially to support this new service?
The first step the pharmacy manager should take to justify starting a diabetes disease management service is to collect patient data to assess the need for the service.
Collecting patient data will provide essential information about the prevalence of diabetes in the community, the specific needs and characteristics of the patient population, and the potential impact of a diabetes disease management service. The pharmacy manager can gather data on the number of patients with diabetes, their current management practices, any gaps in care, and the overall health outcomes of the diabetic population in the community.
In the primary care clinic, a 40-year-old patient is identified as having group A streptococcal pharyngitis. No additional recent illnesses or known medication allergies are reported by the patient. Which substance is best for antibacterial therapy?
Penicillin is the most appropriate agent for antimicrobial therapy in a patient diagnosed with group A streptococcal pharyngitis.
Group A streptococcal pharyngitis, commonly known as strep throat, is primarily caused by the bacteria Streptococcus pyogenes. Penicillin is the treatment of choice for this bacterial infection due to its effectiveness against Streptococcus pyogenes.
Which source would offer the strongest degree of proof when making a choice based on evidence?
The highest level of evidence would be provided by a randomized controlled trial (RCT) where patients with chronic migraines are randomly assigned to a placebo or feverfew and followed for 3 months to assess effectiveness.
Randomized controlled trials are considered the gold standard in evidence-based decision-making. They involve randomly assigning participants to different interventions or treatment groups and comparing the outcomes between them. This randomization helps minimize bias and confounding variables, making RCTs the most robust method for determining the effectiveness of interventions.
A woman who has previously had poison ivy allergic contact dermatitis exhibits well-defined erythematous patches on her body as well as vesicles that are seeping and weeping on her hands and face. Which medication is best for this patient?
Oral prednisone is the most appropriate drug for a patient with a history of poison ivy allergic contact dermatitis presenting with well-demarcated patches of erythema and vesicles that are oozing and weeping on the face and hands.