A 45-year-old female presents to the clinic with complaints of chronic lower back pain that has been ongoing for the past two years following a motor vehicle accident. She has tried various nonpharmacologic therapies such as physical therapy and acupuncture with limited relief. She expresses interest in exploring opioid therapy for her pain management. Which of the following statements regarding opioid therapy for chronic pain aligns with current CDC recommendations? 

Tess is a 55yo African American female with a PMH of HTN, DM and hyperlipidemia.  She weighs 175 lbs and is 5’4″. She sometimes eats processed foods and admits to having trouble with portion control. She does not exercise regularly and she does not smoke.  Her mother had a MI at the age of 70.  Her fasting lipid profile shows TC 200 [

Tyson is a 50 yo black male with a past medical history significant for hypertension and a heart attack (resulting in reduced LVEF) one year ago.  He is currently taking lisinopril (Zestril*) and a higher dose of amlodipine (Norvasc*).  He says he is having ankle edema over the past couple months since amlodipine (Norvasc*) was started.  His kidney function is normal, and he has no other signs/symptoms of fluid accumulation (e.g. pulmonary congestion, weight gain).  His BP is 138/70, and HR 72. His laboratory values are normal. Considering not only hypertension, but his past medical history ( prior MI / stable HFrEF) and most recent complaint (ankle edema), which of the following recommendations is most appropriate for Tyson to correct the edema and optimize heart failure therapy?

Nancy is a 78 yo Caucasian female with a past medical history of heart failure (Class I, Stage B), hypertension and diabetes who arrives for a regular follow-up visit.  She monitors her weight daily and has kept her weight consistent for several weeks.  She avoids salt and is very careful with her fluid intake. She swims for 20-30 minutes each day.  Her current medications include: Candesartan (Atacand*) 32mg daily Metoprolol succinate XL (Toprol XL) 100mg twice daily Furosemide (Lasix*) 40mg twice daily K-dur (potassium supplement) 20mEq once daily Insulin glargine (Lantus*) 35 units at bedtime Insulin aspart (Novolog*) 10 units with meals.  Her physical exam shows no JVD, clear lung sounds, and minimal edema of her feet.  Her labs and vitals include Na 139 [136-145], K 2.9 [3.5-5], Cl 109 [98-106], Mg 2.0 [1.8-3], BUN 14 [10-20], Cr 1.2 [

Larry is a 60 year old male with symptomatic BPH, hypertension and moderately severe allergic rhinitis. His biggest complaint are nasal symptoms unrelieved by fexofenadine (Allegra*), which he purchased over the counter. Current medications: Finasteride (Proscar*) 5mg QD for benign prostatic hyperplasia (BPH) Prazosin (Minipress*) 1mg HS for benign prostatic hyperplasia (BPH) Losartan (Cozaar*) 50mg QD for hypertension Which of the following choices would be the BEST approach for controlling Larry’s symptoms?

Alexis is a 67 y/o female with COPD. All of the following are appropriate recommendations except?

Michelle, a 35 y/o woman, is hospitalized for evaluation of severe chest pain, which occurs almost daily at about 5 AM. Michelle rates the pain as about a 7 /10. It is associated with diaphoresis and is not relieved by change in position or rest. She has no cardiovascular risk factors, her hobbies include triathlon competition and rock climbing, neither of which cause chest pain. She follows a strict vegetarian diet. Michelle is diagnosed with variant (Prinzmetal’s) angina. The next day Michelle is abruptly awakened by severe chest pain, which was relieved within 60 seconds by one 0.4mg SL NTG. Which of the following agents would be appropriate to prevent her (now daily) symptoms?

Edward is a 65 yo male with chronic kidney disease (CKD) and hypertension. Based on the 2017 ACC/AHA guidelines, which of the following is Edward’s BP goal?

Click here to read the passage before answering the question. Which sentence from the passage best states the main idea of “The Greatest Gift?”

Case Study: A 55-year-old male patient presents to your clinic complaining of erectile dysfunction. Upon further assessment, he reports occasional difficulty achieving and maintaining an erection, particularly during sexual activity with his partner. He has a past medical history significant for hypertension and dyslipidemia, both of which are well-controlled with medication. He denies any history of diabetes mellitus or significant psychological stressors. After discussing potential treatment options, you decide to prescribe a phosphodiesterase type 5 (PDE5) inhibitor. Question: Which of the following medications acts by selectively inhibiting PDE5, thereby facilitating smooth muscle relaxation and inducing an erection?