1. Melanie Jaeger
T4 Tutoring

2. Adult Obesity

3. Which of these would be an indication to discontinue Qsymia?
A. After 6 weeks at 7.5/46 mg the patient has not lost at least 3% of their total weight. B. After 12 weeks at 7.5/46 mg the patient has not lost at least 5% of their total weight. C. After 12 weeks at 15/92 mg the patient has not lost at least 5% of their total weight. D. After 12 weeks at 15/92 mg the patient has not lost at least 10% of their total weight. C

4. Which of the following weight loss agents should not be taken by a patient on Cialis?
Orlistat
Qsymia
Belviq
Contrave C

5. Which of the following agents is not removed by HD in overdose?
Orlistat
Qsymia
Belviq
Contrave C

6. LH is a 35 yo F, 150 kg. PMH includes seizure disorders. BP 161/99
LH is a 35 yo F, 150 kg. PMH includes seizure disorders. BP 161/99. Which of the following agents is contraindicated for LH?
Orlistat
Qsymia
Belviq
Contrave D

7. What is the appropriate way to titrate Contrave upon initiation
What is the appropriate way to titrate Contrave upon initiation? Why does Contrave need to be titrated up?
Week 1: 1 tablet QAM
Week 2: q tab QAM and QPM
Week 3: 2 tabs QAM and 1 tab QPM
Week 4: 2 tabs QAM and 2 tabs QPM

8. Which of the following patients is not seeing the expected results of the weight loss agent they are taking?
AK taking Orlistat. Has lost 7 lbs over 1 year.
BP taking Belviq. Has lost 9 lbs over 1 year.
CM taking Contrave. Weighed 270 lbs. Has lost 14 lbs.
DT taking Qsymia. Has lost 10 lbs over 1 year. D

9. Which of these agents may interact with Belviq?
Levofloxacin
Tramadol
Guaifenasin
ibuprofen B

10. Short Bowel Syndrome

11. In which section of the intestines is B12 absorbed?
Duodenum
Jejunum
Ileum
Colon C

12. Which of these is a function of the ileocecal valve?
Sodium and glucose uptake
Recycles bile salts
Regulates rate of gastric emptying
Prevents bacterial overgrowth D

13. Where does the majority of fluid and electrolyte absorption occur?
Duodenum
Jejunum
Ileum
colon D

14. What is the biggest concern in the first 2 weeks of small bowel syndrome?
Bowel atrophy
Fluid and electrolyte loss
Weight loss
Biliary sludging B

15. What is the most important intervention in stage 2 of SBS?
Fluid replacement
Water soluble vitamin replacement
Enteral nutrition
Pancreatic enzyme supplementation C

16. Which of the following agents could be helpful for a patient on chronic PN showing signs of cholestasis?
Rifaximin
Ursodiol
IV lipids (soybean oil formulation)
cholecystokinin B

17. What is more common in SBS?
Metabolic alkalosis
Metabolic acidosis B

18. Childhood Obesity

19. At what age does childhood obesity begin to show a correlation with adult obesity?
1 yo
2 yo
3 yo
4 yo D

20. Which of the following drugs is approved for weight loss in children?
Metformin
Octreotide
Topiramate
orlistat D

21. Match the drug with the MOA.
Orlistat
Metformin
Octreotide
Liraglutide
Enhances insulin sensitivity
Suppresses pancreatic insulin secretion
GLP-1 analog, stimulates insulin release
Gastric and pancreatic lipase inhibitor
A-4
B-1
C-2
D-3

22. Inflammatory Bowel Disease

23. What is the hallmark feature of ulcerative colitis?
Abdominal pain
Diarrhea
Bloody diarrhea
Weight loss C

24. Which of these statements about sulfasalazine is false?
Sulfasalazine acts topically in the colon.
Sulfasalazine’s toxicity is due to the aminosalicylic component.
The active form of sulfasalazine is 5-ASA.
Sulfasalazine should be started at lower doses (~500 mg BID). B

25. Which of these statements is true about infliximab?
Patients should be screened for TB before beginning infliximab.
Induction doses should be given three times, on week 0, 4, and 8.
Infliximab is given SQ.
Infliximab is safe in patients with hepatic disease. A

26. Tips for Pancreatitis Know your risk factors
Early and aggressive IV fluids
Antibiotics

27. Tips for Hepatitis Hepatitis A prevention
How to interpret Hepatitis B serology
Hepatitis B treatment drugs
Hepatitis B post-exposure prophylaxis
Ribavirin-hemolytic anemia
New agents: Harvoni, Viekira Pak