A patient on chronic benzodiazepine therapy suddenly discontinues the drug. What is the most concerning complication? 

Which neurotransmitter system is central to reward and reinforcement in addiction? 

A 58-year-old man had a heart attack (STEMI) treated with stent placement 3 months ago. He now has frequent premature ventricular contractions (PVCs) on Holter monitoring. He asks if there is a medicine to “stop the extra beats.” Which drug class improves survival in this setting? 

A patient on donepezil develops dizziness and a heart rate of 48 bpm. This is most likely due to: 

A 54-year-old African American with HTN and no CKD/DM is starting therapy. According to guidelines, which is most appropriate? 

An 11-year-old boy with ADHD is started on amphetamine-dextroamphetamine XR after inadequate response to behavioral therapy alone. His past medical history is unremarkable, and family history is negative for congenital heart disease or sudden cardiac death. At baseline, his BP is 100/62 mmHg and HR is 84 bpm. The NP counsels his parents on adverse effects that require ongoing monitoring. Which cardiovascular risk is most important to assess during follow-up visits? 

A 62-year-old with hypertension and CAD is started on propranolol. Shortly after, he reports new wheezing and SOB. What is the best explanation? 

A 45-year-old man with a 20-year history of heavy alcohol use (one pint of whiskey daily) presents 12 hours after his last drink with tremors, diaphoresis, anxiety, nausea, tachycardia, and hypertension. His CIWA score is 18, indicating moderate withdrawal. He is alert and oriented without hallucinations or seizures. Which pharmacologic therapy is most appropriate to initiate at this time? 

A 39-year-old with bipolar disorder is stable on lithium. Labs show creatinine 2.0 mg/dL. What is the most appropriate action? 

A 72-year-old woman with hypertension and osteoarthritis is prescribed digoxin. Her renal function shows eGFR 28 mL/min. What adjustment is most critical?