DHA Clinical Practice & Guidelines 4 — Questions and Answers
Question 1: According to DHA guidelines, what is the recommended first-line treatment for uncomplicated community-acquired pneumonia in a healthy adult without comorbidities?
- Amoxicillin 500mg TID for 5 days (Correct answer)
- Azithromycin 500mg once daily for 3 days
- Levofloxacin 750mg once daily for 5 days
- Ceftriaxone 1g IV once daily for 7 days
Correct answer: Amoxicillin 500mg TID for 5 days
Amoxicillin is the preferred first-line agent for uncomplicated CAP in otherwise healthy adults per DHA antimicrobial stewardship guidelines.
Question 2: A patient presents with a blood pressure of 160/100 mmHg on two separate occasions. Per DHA hypertension guidelines, which classification does this represent?
- Elevated blood pressure
- Stage 1 hypertension
- Stage 2 hypertension (Correct answer)
- Hypertensive urgency
Correct answer: Stage 2 hypertension
A sustained BP ≥140/90 mmHg qualifies as Stage 2 hypertension under DHA/JNC classification, requiring prompt pharmacologic intervention.
Question 3: Under DHA clinical guidelines, which screening interval is recommended for colorectal cancer using fecal immunochemical testing (FIT) in average-risk adults aged 50–74?
- Every 6 months
- Annually (Correct answer)
- Every 2 years
- Every 3 years
Correct answer: Annually
Annual FIT is the recommended non-invasive colorectal cancer screening strategy for average-risk adults per DHA cancer screening protocols.
Question 4: When managing a patient with type 2 diabetes and established cardiovascular disease, DHA guidelines recommend which medication class as a preferred add-on to metformin?
- Sulfonylureas
- DPP-4 inhibitors
- SGLT-2 inhibitors (Correct answer)
- Alpha-glucosidase inhibitors
Correct answer: SGLT-2 inhibitors
SGLT-2 inhibitors (e.g., empagliflozin) have demonstrated cardiovascular mortality benefit and are preferred in T2DM patients with established CVD per DHA/ADA-aligned guidelines.
Question 5: A pregnant woman at 28 weeks gestation tests positive on the 50g glucose challenge test (GCT) with a value of 155 mg/dL. What is the appropriate next step per DHA antenatal guidelines?
- Diagnose gestational diabetes and initiate dietary management
- Repeat the 50g GCT in 2 weeks
- Perform a 75g oral glucose tolerance test (OGTT) (Correct answer)
- Initiate insulin therapy immediately
Correct answer: Perform a 75g oral glucose tolerance test (OGTT)
A GCT value between 140–199 mg/dL is a positive screen requiring confirmatory 75g OGTT (or 100g 3-hour OGTT) to diagnose gestational diabetes.
Question 6: Per DHA sepsis management guidelines (Sepsis-3), which combination of interventions must be completed within the first hour of sepsis recognition (Hour-1 Bundle)?
- Blood cultures, broad-spectrum antibiotics, 30 mL/kg IV crystalloid, and vasopressors if MAP <65 mmHg
- Blood cultures, urine culture, lactate measurement, and broad-spectrum antibiotics
- Lactate measurement, blood cultures, broad-spectrum antibiotics, and 30 mL/kg IV crystalloid (Correct answer)
- CBC, BMP, chest X-ray, and empiric antibiotics
Correct answer: Lactate measurement, blood cultures, broad-spectrum antibiotics, and 30 mL/kg IV crystalloid
The SEP-1 Hour-1 Bundle requires measuring lactate, obtaining blood cultures, administering broad-spectrum antibiotics, and giving 30 mL/kg IV crystalloid for hypotension or lactate ≥4 mmol/L.
Question 7: According to DHA stroke guidelines, what is the maximum time window for administering IV alteplase (tPA) in eligible acute ischemic stroke patients from symptom onset?
- 1 hour
- 3 hours
- 4.5 hours (Correct answer)
- 6 hours
Correct answer: 4.5 hours
IV alteplase can be administered up to 4.5 hours from confirmed symptom onset in eligible ischemic stroke patients per DHA/AHA guidelines.
DHA Clinical Practice & Guidelines 4
According to DHA guidelines, what is the recommended first-line treatment for uncomplicated community-acquired pneumonia in a healthy adult without comorbidities?