Patient Care and Management Flashcards

A healthy 40-year-old with community-acquired pneumonia, no comorbidities, and a CURB-65 score of 0 should be managed with which regimen?

Answer: Outpatient oral amoxicillin

ATS/IDSA guidelines recommend outpatient amoxicillin for healthy adults with low-severity CAP and no comorbidities.

A patient with type 2 diabetes and established atherosclerotic cardiovascular disease has an A1c of 8.2% on metformin. Which add-on agent is most appropriate?

Answer: GLP-1 receptor agonist with proven cardiovascular benefit

GLP-1 receptor agonists such as liraglutide lower major adverse cardiovascular events in patients with ASCVD.

A 35-year-old presents with 5 days of acute low back pain without red flags. What is the most appropriate initial management?

Answer: Staying active, NSAIDs, and OMT as indicated

Imaging is not indicated for acute low back pain without red flags, and staying active with NSAIDs and manipulation is first-line.

In which patient is cervical HVLA most clearly contraindicated?

Answer: A 55-year-old with rheumatoid arthritis

Rheumatoid arthritis can cause atlantoaxial instability, which makes cervical HVLA dangerous.

A patient with a potassium of 7.1 mEq/L has peaked T waves and a widened QRS. What is the first treatment?

Answer: IV calcium gluconate

IV calcium stabilizes the cardiac membrane right away, while other therapies shift or remove potassium.

In a patient with diabetic ketoacidosis, insulin infusion should be held until potassium is at least what level?

Answer: 3.3 mEq/L

Insulin shifts potassium into cells, so it is held when K is below 3.3 mEq/L until potassium is replaced.

What is the correct initial treatment for an adult with anaphylaxis?

Answer: Epinephrine 0.3–0.5 mg IM (1 mg/mL) in the anterolateral thigh

IM epinephrine in the anterolateral thigh is first-line for anaphylaxis, and antihistamines and steroids are only adjuncts.