Donepezil (Aricept) - acetyl-cholinesterase inhibitor
takes 6-12 months to know if effective

SSRI (Paroxetine)
Takes 8-12 weeks to take effects

-pril ACE-I

HIV
IF initial OR CHANGING , CD4 every 2-8 weeks
IF STABLE, CD4 Every 3-6 months

Thyroid
TSH slightly high in medicated pt

THE ART OF EFFECTIVE TEST TAKING Test-taking ability can be divided into three categories:  mastery of basic knowledge and information; awareness of test-taking techniques and strategies; and, finally, freedom from anxiety that, if present at a high level, will interfere will application of both of the other categories. Understanding the Question The question is called the stem, and the answer choices are called distractors.  The purpose of distractors is to distract you from identifying and choosing the correct answer.  Thus, in the process of taking a multiple-choice test, all of your knowledge, expertise, and judgment are utilized. In effective test construction, the stem is direct and to the point.  This means that the question is asking for one particular response and that you should notread other information into the question.  Often, you will find questions that are asking for "common sense" answers.  Reading into these questions or searching for subtle hidden meanings is not advised.  Principle:  Do not read extra meaning into the question; assume it is direct and to the point.  Your first action then, upon being presented with the question, is to ask yourself " What is this question asking?"  Look for key words or phrases to help you understand.  It is important to have the central point clearly in your mind before going on to consider the distractors. Make very sure you read the stem correctly.  Notice particularly the way the question is phrased.  Is it asking for the right or wrong response?  One of the most important principles in test taking is understanding what the question is asking.  Principle:  Understand exactly what the stem is asking before considering the distractors. Another technique for assessing the stem and interpreting the question correctly is to rephrase the question so that it is very clear in your own mind.  For example, consider the following statement:  "The one treatment that is not required in cardiogenic shock is..."  Rephrase it to read:  "They are asking me to identify a treatment that is not required in cardiogenic shock, but may be required in other shock conditions."  Rephrasing in your own language can assist you to read the question correctly and, in turn, choose the appropriate response.  This is particularly important when you are faced with a difficult and/or confusing question.  Principle:  Rephrase the question in your own words so that it is clear in your mind.  If possible, think of the correct answer before considering the distractors.  If you do not know the answer, the following cues to working with distractors may prove helpful. Distractors are various alternatives chosen to be as close as possible to the right answer.  In good test construction, all distractors should be feasible and reasonable and should apply directly to the stem.  There should be a commonality in all of the distractors.  If one distractor is off base and not plausible, then you can safely assume the person writing the test question ran out of reasonable distractors.  Principle:  When analyzing the distractors, isolate what is important in the answer alternatives from what is not important, relative to the question.  In other words, all distractors may be correct but not the right choice for the specific question that is asked.  One method of helping you choose the correct answer is to ask yourself whether each possible alternative is true or false in relation to the stem.  Asking yourself which distractor is true or false is a shortcut method of answering the question.  It forces you to keep looking at the stem.  Otherwise, you are trying to judge all of the choices at once.  After you have completed the true-false process, remember to go back to the stem and ask yourself if your choice is, in fact, answering the question. An answer alternative may be correct as it stands by itself, but wrong in terms of what the question is asking.  Many, many students fail to recheck the answer with the stem, and they answer the question incorrectly.  An effective strategy in assessing test questions is to judge all four alternative choices against the stem, not against each other.  Read the stem, then check Alternative A against the stem, then check Alternative B against the stem, and so on.  This process will eliminate choosing an alternative that does not fit the question.  Principle:  After choosing the correct answer alternative and separating it form the distractors, go back to the stem and make sure your choice does, in fact, answer the question. If you are answering a test question in which one distractor is considerably different from the others, it is probably not the correct choice.  Often, students tend to pick this alternative just because it is different.  Principle:  Look for similarities in two or three of the choices remembering that the purpose of distractors is to divert you from the one right answer. The multiple-variable question is one in which each possible answer to the question includes several variables.  An effective technique for handling multiple variables is to use the process of elimination.  First, study the question and ask yourself what variable fits with this condition, or, after examining the distractors, underline the variable that you know is correct.  Now ask yourself what variable is not present with this condition.  Again, examine the distractors and cross out those variables which are incorrect.  By this process, you probably will have eliminated at least two distractors even without taking the time to consider the other two.  Principle:  When a question contains multiple variables as alternative choices, use the elimination-of-variable technique. Source: http://www.fireprep.com/the_art_of_effective_test_taki.html

The clinician should remember this axiom in dermatology: “There are more errors made by not looking than by not knowing.”

Key minerals to help control blood pressure

It's usually best to get calcium, magnesium, and potassium from food. Are you getting enough?
A healthy, balanced diet plays a major role in blood pressure control. And you should consume some specific minerals on a regular basis for good blood pressure management: calcium, magnesium, and potassium. But do most of us get enough of these? "If you're eating a healthy diet, you probably have nothing to worry about. But people eating a diet of processed and canned foods might need to be concerned, as well as people taking certain medications," says Dr. Randall Zusman, director of the Division of Hypertension at the Massachusetts General Hospital Heart Center.

Images: Thinkstock 1/2 cup canned white beans: 595 milligrams (mg) of potassium, 67 mg of magnesium, and 96 mg calcium.

3 ounces of cooked halibut: 490 mg of potassium, and 91 mg of magnesium.

1/2 cup cooked spinach: 419 mg potassium, 78 mg of magnesium, and 146 mg of calcium.

1 Potassium
Normal body levels of potassium are important for muscle function, including relaxing the walls of the blood vessels. This lowers blood pressure and protects against muscle cramping. Normal potassium levels also are important for the conduction of electrical signals in the nervous system and in the heart. This protects against an irregular heartbeat.
Potassium is found naturally in many foods, such as prunes, apricots, sweet potatoes, and lima beans. But food may not be enough to keep up your potassium levels if you take a diuretic for high blood pressure such as hydrochlorothiazide (Esidrix, HydroDiuril). These drugs cause potassium to leave your body in the urine, thereby lowering your body's potassium levels. "I'd say at least a third of patients on diuretics for heart failure or high blood pressure or edema don't get enough potassium from their diets. In those cases, we do use supplements," says Dr. Zusman. Don't try a supplement on your own. Too much potassium, like too little, can lead to dangerous irregular heart rhythms.
The Recommended Dietary Allowance (RDA) of potassium is 4.7 grams per day for both men and women ages 51 and older.

2 Magnesium

Magnesium helps regulate hundreds of body systems, including blood pressure, blood sugar, and muscle and nerve function. We need magnesium to help blood vessels relax, and for energy production, bone development, and transporting calcium and potassium. Just like potassium, too much magnesium can be lost in urine due to diuretic use, leading to low magnesium levels.
The National Institutes of Health (NIH) reports that most older adults in the U.S. don't get the proper amount of magnesium in their diets, although extreme magnesium deficiency is very rare. It's best to get the mineral from food, especially dark, leafy green vegetables, unrefined grains, and legumes. The RDA of magnesium is 420 milligrams (mg) per day for men ages 50 and older; 320 mg/day for women ages 50 and older.
Too much magnesium from a supplement or from magnesium-containing drugs such as laxatives may cause diarrhea. There are no known adverse affects of magnesium intake from food.

3 Calcium

Calcium is important for healthy blood pressure because it helps blood vessels tighten and relax when they need to. It's also crucial for healthy bones and the release of hormones and enzymes we need for most body functions. We consume it naturally in dairy products, fish with bones (such as canned salmon and sardines), and dark, leafy greens.
The RDA of calcium for men ages 51 and older is between 1,000 and 1,200 mg per day. For women ages 51 and older it's 1,200 mg per day. Unfortunately, most people get about 700 mg of calcium in their daily diet. So should you take a supplement to make up the difference?
That's tricky business. As we reported in June 2013, some evidence shows calcium supplements increase the risk of death from heart disease. "It's been controversial, so most of us advise our patients to get their calcium from food rather than from supplement pills," says Dr. Zusman. If it's not possible to get enough calcium from food, you can use a low-dose calcium supplement to reach your daily RDA.