Jeremiah Parve
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Final Exam Pharmacotherapeutics Quiz on Pharmacotherapeutics (Accumlative Exam), created by Jeremiah Parve on 09/12/2015.

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Jeremiah Parve
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Pharmacotherapeutics (Accumlative Exam)

Question 1 of 154

1

Which of the following factors may influence the volume of distribution of a drug?

Select one of the following:

  • Plasma protein binding

  • Obesity

  • Presence of edema

  • All of the above

Explanation

Question 2 of 154

1

Which of the following medication dose forms will not bypass the first pass effect?

Select one of the following:

  • Fentanyl transdermal patch

  • Conjugated estrogens 0.625 oral tablet

  • Oxymetazoline nasal spray

  • Sublingual nitrogylcerin tablet

Explanation

Question 3 of 154

1

A receptor antagonist...

Select one of the following:

  • potentiates the activity of the receptor.

  • is less likely to elicit an adverse drug effect than a receptor agonist.

  • interacts with the receptor and does not allow other substances to bind with it, thus blocking the receptor.

  • has a stronger receptor affinity than a receptor agonist.

Explanation

Question 4 of 154

1

The Cytochrome P450 enzymes:

Select one of the following:

  • are responsible for oxidative metabolism.

  • are often the mechanism behind drug-drug interactions.

  • are predominantly found in the intestine.

  • A and B

Explanation

Question 5 of 154

1

If an oral dose form (tablet) has F=0.9, we can state that...

Select one of the following:

  • it has low bioavailability.

  • it has a greater bioavailability than the intravenous (IV) form of the drug.

  • a high fraction of the drug will reach the bloodstream.

  • None of the above is correct.

Explanation

Question 6 of 154

1

An adverse event to a medication is...

Select one of the following:

  • Any noxious or unintended reaction to a drug that is administered at standard doses by the proper route for the purposes of prophylaxis, diagnosis, or treatment.

  • Very uncommon in everyday medical practice.

  • The action of a drug on the effectiveness or toxicity of another drug.

  • Always severe and life-threatening.

Explanation

Question 7 of 154

1

Which of the following statements defines pharmacodynamics?

Select one of the following:

  • Study of absorption, distribution, metabolism, and excretion of a drug.

  • Study of the biochemical and physiologic effects of drugs on the function of living organisms and their component parts.

  • Study of how much of the drug is administered reaches its site of action.

  • Study of how much and how fast the drug leaves its site of administration.

Explanation

Question 8 of 154

1

Which of the following is NOT a best practice when prescribing medications for elderly patients?

Select one of the following:

  • The medication indication should be clearly documented in the medical record.

  • The patient should be provided with a medication list only if they are taking greater than 5 medications.

  • The patient's medication regimen should be routinely reviewed for potential problems such as inappropriate dosing and drug interactions.

  • The provider should review the medication list at each visit and assess whether proper monitoring is occurring for each of the patient's medications.

Explanation

Question 9 of 154

1

A medication that has a half-life (t 1/2 ) of 10 hours would reach a steady state concentration in about (assuming linear kinetics with no patient variables):

Select one of the following:

  • 5 hours

  • 10 hours

  • 20 hours

  • 40 hours

Explanation

Question 10 of 154

1

Which of the following is true regarding pharmacokinetic differences in pediatric patients?

Select one of the following:

  • Infants and young children have a thin stratum and larger body surface in relation to size, so they may absorb topical agents more readily than adults.

  • Newborns have a much lower percentage of total body water, which may impact the volume of distribution, Vd.

  • Newborns and infants less than 6 months old have a higher rate of renal excretion than adults.

  • All of the hepatic metabolic pathways are fully developed and functional at the time of birth.

Explanation

Question 11 of 154

1

PM is a 67yo white female with hypertension who presents to clinic with new complaints of edema. She is currently on lisinopril 40mg PO daily and amlodipine 5mg PO daily. Ger blood pressure today is 147/94 mmHg. What is the BEST plan for her drug therapy today?

Select one of the following:

  • Discontinue amlodipine, begin hydrochlorothiazide 12.5mg PO daily

  • Discontinue amlodipine, begin nifedipine immediate-release 10mg PO TID

  • Discontinue amlodipine, begin valsartan 40mg PO daily

  • Discontinue lisinopril, increase amlodipine to 10mg PO daily

Explanation

Question 12 of 154

1

Which of the following HMG-CoA redectase inhibitors ("statins") has the lest amount of CYP450 mediated drug-drug interactions?

Select one of the following:

  • Atorvastatin

  • Pravastatin

  • Simvastatin

  • Rosuvastatin

Explanation

Question 13 of 154

1

Aldosterone antagonists used for the treatment of heart failure:

Select one of the following:

  • Are recommended to be used in combination with an angiotensin converting enzyme inhibitor and angiotensin receptor blocker

  • Should be avoided in patients with chronic liver failure

  • Should only be given to patients with severe heart failure (NYHA functional class IV)

  • Should not be used in patients with a potassium level ≥ 5.0 mEq/L

Explanation

Question 14 of 154

1

AB is a 74yo woman who presents to our clinic today complaining of new-onset mild muscle pain. She began simvastatin 20mg PO daily 6 months ago for the treatment of her blood cholesterol. Which of the following would be BEST to include in your plan today?

Select one of the following:

  • Check thyroid function and vitamin D level

  • Hold simvastatin, and check a fasting lipid panel

  • Hold simvastatin, and check thyroid function and vitamin D level

  • Lower the simvastatin dose to 10mg PO daily

Explanation

Question 15 of 154

1

Thiazide-type diuretics:

Select one of the following:

  • Are recommended as initial or add-on therapy in hypertensive patients with chronic kidney disease

  • Can increase serum phosphorus levels

  • Inhibit re absorption of sodium and chloride in the ascending loop of Henle and distal renal tubule

  • May lose efficacy in a patient who uses a lot of salt in their diet

Explanation

Question 16 of 154

1

Which of the following is true regarding aspirin therapy for vascular disorders?

Select one of the following:

  • Aspirin is often used with other antiplatelet or anticoagulant medications and concomitant use does not increase the risk for bleeding.

  • Increasing the dose of aspirin from 81mg to 325mg will improve outcomes for all vascular disorders.

  • NSAIDs (ibuprofen, naproxen, ketoprofen, etc) may limit aspirin's cardioprotective effects; therefore, concomitant use of aspirin and NSAIDs is contraindicated regardless of the timing of administration.

  • Using the lowest dose of aspirin shown to be effective for an indication will help reduce the risk of adverse events such as bleeding.

Explanation

Question 17 of 154

1

All of the following medications decrease mortality in heart failure patients, EXCEPT:

Select one of the following:

  • Aldosterone antagonists

  • Angiotensin converting enzyme inhibitors

  • Beta-blockers (bisoprolol, carvedilol, extended-release metoprolol succinate)

  • Digoxin

Explanation

Question 18 of 154

1

PH is a 55yo man with Type 2 diabetes and a history of MI. Which therapy option is BEST for initial treatment of his elevated blood cholesterol?

Select one of the following:

  • Atorvastatin 80mg PO daily (High-dose statin intensity)

  • Life-style modifications only

  • Niacin 1500mg PO daily

  • Pravastatin 10mg PO daily (Low-dose statin intensity)

Explanation

Question 19 of 154

1

LF is a 28 year-old woman, weight= 85kg, who was diagnosed with a deep vein thrombosis (DVT) of the left lower extremity 10 days ago. She comes for a clinic visit one week following her hospital discharge and is currently on enoxaparin 1mg/kg SQ every 12 hours. Her current estimated creatinine clearance is 80 mL/min. You decide to:

Select one of the following:

  • Continue the current dose of enoxaparin therapy.

  • Decrease the current dose of enoxaparin to 1mg/kg SQ every 24 hours due to her poor renal function.

  • Decrease the current dose of enoxaparin to 40mg SQ daily to be used for DVT prophylaxis.

  • Increase the current dose of enoxaparin to 1.5mg/kg SQ every 12 hours due to her weight.

Explanation

Question 20 of 154

1

Which of the following statements is true regarding currently available oral anticoagulant medications?

Select one of the following:

  • All oral anticoagulants cost about the same price.

  • All oral anticoagulants have an acute reversal agent.

  • All oral anticoagulants may be used for stroke prophylaxis for non-valvular atrial fibrillation.

  • All oral anticoagulants require INR monitoring for safety and efficacy.

Explanation

Question 21 of 154

1

Cough Variant Asthma is commonly seen in small children. The primary symptom is cough in the evening with essentially normal presentation during daytime examination. Which of the following oral agents has been shown to be effective in this type of asthma?

Select one of the following:

  • Methylprednisolone

  • Theophylline

  • Levocetirizine

  • Singulair®

Explanation

Question 22 of 154

1

Smoking cessation therapy has changed greatly over the past 10 years. OTC products can be purchased which contain _______________________. The drug Zyban (bupropion) allowed the patient to use an oral agent and remove nicotine earlier in the treatment process. The latest medication _______________________ allows the patient to smoke for the 1st week, but comes with a Black Box warning about suicide.

Select one of the following:

  • Nicotine, Wellbutrin

  • Menthol, Chantix® (varenicline tartrate)

  • Nicotine, Chantix® (varenicline tartrate)

  • Nicotine, Clonidine

Explanation

Question 23 of 154

1

We are beginning the cold and flu season in Wisconsin. Patients who are diagnosed with Asthma and COPD should be reminded and encouraged to get a seasonal flu vaccine every year, True or False?

Select one of the following:

  • True
  • False

Explanation

Question 24 of 154

1

Inhaled Corticosteroids in either the aerosol (MDI) form or the micro particle form (DISKUS) cause a common local side effect:

Select one of the following:

  • Reduction of renal function

  • Frog in the throat

  • Candidiasis

  • Group A Streptococcus

Explanation

Question 25 of 154

1

Albuterol (Proventil, Ventolin, ProAir) is the most commonly prescribed beta-2 receptor agonist. Systemic concentration via inhaler is low because only 5% of the oral dose is needed to achieve the desired effect.

Select one of the following:

  • True
  • False

Explanation

Question 26 of 154

1

The Expert Panel Recommends chronic oral steroids as long term control for:

Select one of the following:

  • Exercise or Seasonal asthma

  • Mild, intermittent asthma

  • Severe, persistent asthma

  • Post nasal drip

Explanation

Question 27 of 154

1

Atrovent® and Spiriva® are anticholinergics that stimulate muscarinic cholinergic receptors and reduce vagal tone?

Select one of the following:

  • True
  • False

Explanation

Question 28 of 154

1

The main component of asthma is _________________________ and the primary treatment for that component is ________________________________.

Select one of the following:

  • Inflammation, Inhaled corticosteroids

  • Bronchospasm, SABA

  • Dry Cough, Accolate®

  • Shortness of Breath, Albuterol

Explanation

Question 29 of 154

1

If a smoking patient is taking theophylline or a patient is using nicotine replacement therapy, theophylline level monitoring is essential because:

Select one of the following:

  • Smoking reduces theophylline clearance

  • Theophylline creates an increased urge to smoke or increase use nicotine replacement

  • Smoking increases the theophylline clearance

  • The statement is FALSE, no monitoring is required

Explanation

Question 30 of 154

1

Short acting Beta Agonists (SABA) include:

Select one of the following:

  • Albuterol

  • Duoneb®

  • Xopenex®

  • A & C

Explanation

Question 31 of 154

1

Which of the following would be an appropriate treatment regimen for a patient that you did a viral PCR panel that was positive for influenza A (H1N1)? (Assume your patient has no contraindications to any of the antiviral therapies)

Select one of the following:

  • Oseltamivir

  • Zanamivir

  • rimantidine

  • A & B are both correct

Explanation

Question 32 of 154

1

Which of the following antimicrobial classes are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency?

Select one of the following:

  • Sulfonamides

  • Macrolides

  • Tetracyclines

  • Penicillins

Explanation

Question 33 of 154

1

CC is a 58 year old woman who presents to clinic with sign/symptoms of recurrent urinary tract infection. Medication allergies/intolerances = ciprofloxacin (hives) and nitrofurantoin (neuropathy). Her medication list is as follows: Multivitamin 1 PO daily, aspirin 81mg PO daily, lisinopril 20mg PO daily, Diltiazem ER 240mg PO daily, calcium carbonate 500mg TID, and warfarin 4mg daily for atrial fibrillation (last INR = 2.8 drawn 2 weeks ago). CC’s urinalysis reveals many WBCs, is positive for leukocyte esterase, and shows many bacteria. A culture is ordered but results are not yet known. Which of the following actions is most appropriate?

Select one of the following:

  • Prescribe levofloxacin 500mg PO daily x 7 days, recheck INR in 2 days.

  • Prescribe trimethoprim/sulfamethoxazole DS 1 tab PO BID x 7 days, recheck INR in 2 days.

  • Prescribe trimethoprim/sulfamethoxazole DS 1 tab PO BID x 7 days, no need to check INR since it is a short course of antibiotics.

  • Based on CC’s presentation and urinalysis, no antibiotic prescription is required.

Explanation

Question 34 of 154

1

Which of the following is true about prescribing oseltamivir to pediatric patients age 1 year and older?

Select one of the following:

  • It is contraindicated in this patient population.

  • The pediatric treatment regimen is half as long as the adult treatment regimen.

  • It should not be used for influenza prophylaxis in pediatric patients.

  • They should be monitored closely for neuropsychiatric symptoms while on therapy.

Explanation

Question 35 of 154

1

You prescribed doxycycline for a patient 5 days ago. She calls the clinic stating she still does not feel any better. Her other medications include hydrochlorothiazide 25 mg PO daily, lisinopril 5mg PO daily, Aspirin 81mg daily, and Calcium Carbonate 500mg PO BID. What potential drug interaction is noted?

Select one of the following:

  • Hydrochlorothiazide is increasing the clearance of the doxycycline.

  • Calcium carbonate is inhibiting the absorption of doxycycline.

  • Lisinopril is interfering with the metabolism of doxycycline.

  • Aspirin is inhibiting the absorption of doxycycline.

Explanation

Question 36 of 154

1

Which of the following antimicrobial medication classes should not be administered to children under 8 years old due to binding activity to calcium which may cause tooth enamel dysplasia?

Select one of the following:

  • Macrolides

  • Penicillin beta-lactams

  • Fluoroquinolones

  • Tetracyclines

Explanation

Question 37 of 154

1

Which of the following is FALSE about linezolid?

Select one of the following:

  • It has the potential to interact with serotonergic agents resulting in serotonin syndrome.

  • Patients should adhere to a low-tyramine diet while taking linezolid.

  • Myelosuppression may occur, especially with a prolonged treatment course (>14 days).

  • It is the treatment of choice for methicillin susceptible Staphylococcus aureus (MSSA).

Explanation

Question 38 of 154

1

Patients with moderate to severe PCN allergy can safely be prescribed which of the following, without having to be concerned with cross-hypersensitivity?

Select one of the following:

  • clarithromycin

  • cephalexin

  • cefpodoxime

  • augmentin

Explanation

Question 39 of 154

1

Which of the following statements is TRUE regarding nitrofurantoin?

Select one of the following:

  • It is primarily eliminated from the body through hepatic metabolism.

  • It achieves high concentration in skin and soft tissue.

  • It should not be prescribed to patients with renal impairment, CrCl <50ml/min.

  • It interferes with bacterial DNA gyrase.

Explanation

Question 40 of 154

1

Ciprofloxacin:

Select one of the following:

  • administration should be separated from oral divalent cation administration (i.e. calcium, iron, etc.) by at least two hours.

  • does not require dose adjustment in severe renal dysfunction.

  • is a macrolide antibiotic.

  • is poorly absorbed when given orally compared to the intravenous route (i.e. low bioavailability).

Explanation

Question 41 of 154

1

Which of the following patients may not receive the intranasal live-attenuated influenza vaccine?

Select one of the following:

  • A 32 year old pregnant woman

  • A 45 year old nurse who works on an orthopedic surgery floor

  • A 4 year old boy

  • All of the above patients may receive the intranasal live-attenuated influenza vaccine.

Explanation

Question 42 of 154

1

LK is a 20 year old woman that you have diagnosed with uncomplicated UTI. You prescribe
Trimethoprim/Sulfamethoxazole to treat her infection. She asks you if there is anything she can take to help with the horrible pain until the antibiotic kicks in. You tell her to take phenazopyradine. Which of the following is a FALSE statement regarding phenazopyradine?

Select one of the following:

  • It is a urinary analgesic.

  • If her urinary pain is not gone at the end of her trimethoprim/sulfamethoxazole course, LK should just continue to take phenazopyradine until her symptoms are better.

  • It may turn the urine a red-orange color and the patient should not be alarmed.

  • It should help relieve her symptoms within 24 hours.

Explanation

Question 43 of 154

1

According to the American Heart Association, which of the following regimens is an appropriate prescription for bacterial endocarditis prophylaxis for appropriate dental procedures?

Select one of the following:

  • Ampicillin 2 grams PO TID x 24 hours prior to procedure

  • Clindamycin 600mg PO x 1 dose taken 4 hours prior to procedure

  • Amoxicillin 2 grams PO x 1 dose taken 1 hour prior to procedure

  • B and C are both correct

Explanation

Question 44 of 154

1

Which of the following is true regarding the timing of administration of influenza vaccine?

Select one of the following:

  • It should not be administered to hospitalized patients as they are unable to mount an adequate immune response.

  • Community influenza vaccine campaigns should begin annually in mid-October.

  • Patients should no longer be vaccinated after December 1st as the vaccine will not have enough time to induce an immune response.

  • Most adults have antibody protection against influenza virus 2 to 3 days after receiving the vaccine.

Explanation

Question 45 of 154

1

MZ is a 69 year old man who presents to your clinic to establish care with you as his new provider. In taking his vaccine history, you note that MZ has never received a pneumococcal vaccine. Which of the following is the best action plan for MZ? He is in good health and has no other medical problems.

Select one of the following:

  • MZ is not a candidate for a pneumococcal vaccine at this visit. Do not immunize.

  • Recommend that MZ receive 23-valent pneumococcal polysaccharide vaccine today and again in 6-12 months

  • Recommend that MZ receive the 13-valent pneumococcal conjugate vaccine today and again in 6-12 months

  • Recommend that MZ receive the 13-valent pneumococcal conjugate vaccine today and receive the 23-valent pneumococcal polysaccharide vaccine in 6 months

Explanation

Question 46 of 154

1

TR is a 21 year-old college athlete who presents to clinic febrile and complaining of a painful “spider bite” on his left thigh. Upon examination you find an erythematous abscess that is draining slightly. TR tells you that it looks a lot like the spider bites that a couple of his teammates have. He has no known medication allergies and takes no medications. Which of the following is the best action to take?

Select one of the following:

  • Tell TR to be alert and try to identify the spider. Prescribe cephalexin 500mg TID x 5 days.

  • Drain the abscess and send TR home.

  • Drain the abscess & send for culture. Tell TR that his teammates should see their providers for evaluation for community-associated MRSA infection. Prescribe doxycycline 100mg PO BID x 7 days.

  • Drain the abscess & send for culture. Tell TR that his teammates should see their providers for evaluation for community-associated MRSA

Explanation

Question 47 of 154

1

The American Heart Association would recommend prescribing antibiotics for bacterial endocarditis prophylaxis in:

Select one of the following:

  • A 62 year old man with a prosthetic heart valve who will be undergoing a minor genitourinary procedure.

  • A 12 year old boy with congenital heart disease who will be seeing an orthodontist for placement of braces.

  • A 47 year old woman with history of bacterial endocarditis 2 years ago, who will be seeing a periodontist for gingival grafting.

  • None of the patients above require prophylaxis.

Explanation

Question 48 of 154

1

Which of the following patients should initially receive two doses of influenza vaccine, 4 weeks apart?

Select one of the following:

  • A 5 year old child receiving the flu vaccine for the first time.

  • A 3 month old infant.

  • A 12 year old child receiving the flu vaccine for the first time.

  • None of the above patients should receive two doses of vaccine.

Explanation

Question 49 of 154

1

The drug of choice to treat group A streptococcal pharyngitis in a patient with no known drug allergies is

Select one of the following:

  • Penicillin

  • Levofloxacin

  • Oseltamivir

  • Linezolid

Explanation

Question 50 of 154

1

Which of the following vaccines is a live vaccine?

Select one of the following:

  • Injectable influenza vaccine

  • Measles-Mumps-Rubella (MMR)

  • Pneumonia vaccine

  • Tetanus toxoid

Explanation

Question 51 of 154

1

MM is a 66 year old post-menopausal woman who complains of loss of urinary control when she laughs. She has tried non-pharmacologic interventions for the past 3 months. Physical exam shows slight urogenital atrophy. The best pharmacologic therapy you can prescribe is:

Select one of the following:

  • Finasteride

  • Oxybutinin

  • Tolterodine

  • An estrogen preparation

Explanation

Question 52 of 154

1

When prescribing taldalafil to a patient, you need to counsel the patient on potential side effects and adverse reactions, which include:

Select one of the following:

  • Headache

  • Priapism

  • Visual changes

  • All of the above

Explanation

Question 53 of 154

1

According to the CDC, there are ________________million new sexually transmitted infections in the world each year.

Select one of the following:

  • 9 million

  • 19 million

  • 29 million

  • 19 thousand

Explanation

Question 54 of 154

1

Which of the following statements is FALSE about the Intravaginal contraceptive, Nuvaring®?

Select one of the following:

  • It contains both Estrogen and Progesterone.

  • It must be inserted by a healthcare professional.

  • It is inserted once each month.

  • None of the above is FALSE.

Explanation

Question 55 of 154

1

According to the Office of Dietary Supplements, the recommended daily dose of calcium from all sources for women 51y/o and older is _______________________ mg/day.

Select one of the following:

  • 1300 mg

  • 1200 mg

  • 1250 mg

  • 1100 mg

Explanation

Question 56 of 154

1

Trichomonas single dose treatment is 2 grams of:

Select one of the following:

  • Metronidazole

  • Azithromycin

  • Doxycycline

  • A and C

Explanation

Question 57 of 154

1

According to the textbook, NICE (2008a), recommends Fosamax (alendronate) as Primary Prevention for:

Select one of the following:

  • Women over 70 y/o who have an independent risk for fracture.

  • Women over 75 y/o with 2 or more risk factors.

  • Women over 65 y/o with confirmed osteoporosis.

  • All of the above.

Explanation

Question 58 of 154

1

The antibiotic combination of Cefixime 400mg PO x 1 dose PLUS Azithromycin 1gm PO x 1 dose is a treatment for:

Select one of the following:

  • Syphilis

  • Gonorrhea with probable Chlamydia

  • Trichomonas

  • Chlamydia

Explanation

Question 59 of 154

1

Which of the following statements is TRUE regarding progestin-only oral contraceptive medications?

Select one of the following:

  • Progestin-only oral contraceptives have a higher failure rate than estrogen-based contraceptives when taken exactly as prescribed.

  • They have a higher risk of clotting associated with them versus those containing both estrogen and progestin.

  • There are no progestin-only oral contraceptive products on the market.

  • All of the above are true.

Explanation

Question 60 of 154

1

Treatment for syphilis in penicillin allergic patients includes:

Select one of the following:

  • Doxycycline 100mg BID x 14 days

  • Ceftriaxone 1gm IV daily x 14 days

  • Doxycycline 100mg BID x 28 days

  • Both A and B are appropriate treatment

Explanation

Question 61 of 154

1

AG is an obese woman (BMI=42) with type 2 DM. She presents to clinica today for follow up of her elevated blood glucose readings on her home meter. Her most recent glucometer download shows an average blood glucose = 295, with range of 215-475mg/dl. Her current insulin regimen is insulin glargine 100 units SQ every morning, lispro 30 units SQ before breakfast and lunch, and lispro 40 units SQ before supper. Which of the following would be the most appropriate insulin dose adjustment for JS given her glucometer readings?

Select one of the following:

  • Increase total daily insulin dose by 10 units

  • Increase total daily insulin dose by 20 units

  • Increase total daily insulin dose by 40 units

  • Increase total daily insulin dose by 60 units

Explanation

Question 62 of 154

1

Which of the following is a correct pairing?

Select one of the following:

  • Glipizide: Hold for 48 hours prior to contrast dye procedures (i.e. cardiac catheterizations)

  • Repaglinide: Decreases post-prandial glucose

  • Metformin: Highest incidence of hypoglycemia with this oral agent

  • Pioglitazone: Undergoes primarily renal elimination with no hepatic metabolism

Explanation

Question 63 of 154

1

Which of the following medications act primarily by improving insulin secretion?

Select one of the following:

  • Pioglitazone

  • Metformin

  • Glipizide

  • Acarbose

Explanation

Question 64 of 154

1

Which of the following patients with Type 2 DM should NOT receive metformin as part of their treatment regimen?

Select one of the following:

  • A 60 y.o. female, weight 80kg, SCr = 1.4 mg/dl

  • A 42 y.o. male, weight 120kg, SCr = 0.9 mg/dl

  • A 64 y.o. female, weight 68kg, SCr = 1.1 mg/dl

  • A 56 y.o. male, weight 92kg, SCr = 1.4 mg/dl

Explanation

Question 65 of 154

1

Which of the following is true regarding levothyroxine?

Select one of the following:

  • It is a drug of choice for the treatment of hyperthyroidism.

  • It is a synthetic derivative of T3.

  • It has a half-life of approximately a week, and therefore should be titrated slowly in order to make sure a full dose-response has been realized.

  • Its use is contraindicated in pregnancy.

Explanation

Question 66 of 154

1

Which of the following is FALSE regarding H2-Receptor antagonists?

Select one of the following:

  • The class includes agents such as ranitidine and famotidine.

  • They are considered superior to the proton-pump inhibitor class for treating erosive esophagitis.

  • They are available as over-the-counter (OTC) preparations.

  • Most require dose adjustment in severe renal dysfunction.

Explanation

Question 67 of 154

1

JW is a 37 year old obese male with newly diagnosed type 2 DM. He is 68 inches tall and weighs 120kg. His hemoglobin A1c is 14%. You plan to start him on an intensive insulin regimen. What would be an appropriate starting dose?

Select one of the following:

  • 50 units per day; half of the dose should be a long-acting analog and the other half a short-acting analog

  • 100 units per day; 2/3 of the dose should be a long-acting analog and 1/3 should be a short-acting analog

  • 90 units per day; half of the dose should be a long-acting analog and the other half a short-acting analog

  • 150 units per day; 2/3 of the dose should be a long-acting analog and 1/3 should be a short-acting analog

Explanation

Question 68 of 154

1

Which of the following is a correct pairing of drug : drug type?

Select one of the following:

  • Bisacodyl: stool softener

  • Lactulose: Adsorbant antidiarrheal

  • Psyllium: stimulant laxative

  • Senna: stimulant laxative

Explanation

Question 69 of 154

1

Which of the following medications would be the best choice for treating an anxious 26 year old female with IBS that is predominately bothered with painful constipation?

Select one of the following:

  • Alosetron

  • Loperamide

  • Vicodin prn pain

  • Selective Serotonin Reuptake Inhibitor (SSRI)

Explanation

Question 70 of 154

1

Which of the following lists the different insulin formulations in correct order of half-life, shortest to longest?

Select one of the following:

  • Insulin aspart, regular insulin, NPH insulin, insulin glargine

  • Regular insulin, insulin aspart, insulin glargine, NPH insulin

  • Insulin aspart, insulin glargine, regular insulin, NPH insulin

  • Insulin aspart, insulin glargine, NPH insulin, regular insulin

Explanation

Question 71 of 154

1

Ocular decongestants like oxymetazoline...

Select one of the following:

  • can result in rebound ocular congestion if used for greater than 5 days.

  • cause vasodilation and increased blood flow to the eye.

  • should be used for at least a week to achieve maximum efficacy.

  • A & B are correct.

Explanation

Question 72 of 154

1

Which of the following monitoring parameters is required for ALL patients after initiation of clozapine (Clozaril®)?

Select one of the following:

  • Absolute neutrophil count

  • Electrocardiogram

  • Electroencephalogram

  • Serum clozapine level

Explanation

Question 73 of 154

1

Of the following antidepressants, which one is considered safest to use in a pregnant patient?

Select one of the following:

  • Imipramine (Tofranil®)

  • Paroxetine (Paxil®)

  • Phenelzine (Nardil®)

  • Sertraline (Zoloft®)

Explanation

Question 74 of 154

1

Which of the following is true about topical vehicles?

Select one of the following:

  • Creams are oil-based preparations.

  • Those that contain alcohol can be drying and irritating to the skin.

  • Ointments are the best delivery system in terms of drug penetration.

  • B and C

Explanation

Question 75 of 154

1

You are evaluating a 30-year-old female in clinic who was recently prescribed an antipsychotic medication for schizophrenia. While you are trying to evaluate her, she keeps getting out of her chair to pace around the room and tap her feet. She apologizes for the behavior and says, “I just feel so restless.” Which of the following medications would be the BEST medication to treat the type of movement disorder this patient is likely experiencing?

Select one of the following:

  • Amantadine (Symmetrel®)

  • Benztropine (Cogentin®)

  • Diphenhydramine (Benadryl®)

  • Propranolol (Inderal®)

Explanation

Question 76 of 154

1

MG presents to your clinic with newly diagnosed depression. He is a truck driver and works various hours throughout the day and night. He must remain focused and alert while driving so he doesn’t cause an accident and specifically requests a medication that will help manage his depression but will not cause sedation. Which of the following medications is the BEST option for this patient?

Select one of the following:

  • Fluoxetine (Prozac®)

  • Mirtazapine (Remeron®)

  • Paroxetine (Paxil®)

  • Phenelzine (Nardil®)

Explanation

Question 77 of 154

1

What is the minimum washout period you should recommend between discontinuing a monoamine oxidase inhibitor (MAOI) and starting a selective serotonin reuptake inhibitor (SSRI)?

Select one of the following:

  • 1 week

  • 2 weeks

  • 4 weeks

  • 6 weeks

Explanation

Question 78 of 154

1

Therapeutic effect of an antidepressant is typically seen in

Select one of the following:

  • 2-8 hours

  • 2-8 days

  • 2-8 weeks

  • 2-8 months

Explanation

Question 79 of 154

1

Which of the following antipsychotics is MOST appropriate to initiate in a patient with a past medical history significant for obesity and diabetes?

Select one of the following:

  • Aripiprazole (Abilify®)

  • Clozapine (Clozaril®)

  • Olanzapine (Zyprexa®)

  • Quetiapine (Seroquel®)

Explanation

Question 80 of 154

1

You would like to prescribe an initial antidepressant for your patient that works on dopamine and has little to no impact on serotonin because you are worried about the potential for sexual dysfunction and gastrointestinal side effects. Which of the following medications BEST matches this description?

Select one of the following:

  • Bupropion (Wellbutrin®)

  • Duloxetine (Cymbalta®)

  • Fluoxetine (Prozac®)

  • Vortioxetine (Brintellix®)

Explanation

Question 81 of 154

1

Which statement is False about Acute pain according to the lecture?

Select one of the following:

  • The pain lasts from hours to days.

  • The pain has minimal effects on the patients social and work activities.

  • Anxiety and depression are associated with the pain in a majority of patients.

  • Treatment often consists of short term analgesic medication.

Explanation

Question 82 of 154

1

Which of the following is NOT a reported anticholinergic adverse event with tricyclic antidepressants?

Select one of the following:

  • Shortness of breath

  • Constipation

  • Dry mouth

  • Postural hypertension

Explanation

Question 83 of 154

1

True or False: According to the lecture and week 9 update notes, Ultram® (Tramadol) is a Class III (Schedule III) controlled substance in many states. In Wisconsin, it has not been placed as a Class III medication.

Select one of the following:

  • True
  • False

Explanation

Question 84 of 154

1

A fentanyl transdermal patch:

Select one of the following:

  • should be applied to the same location on the body with each new application

  • will have decreased bioavailability/concentration if heat is applied over the patch

  • is a long-acting opioid medication delivery system

  • A and C

Explanation

Question 85 of 154

1

Preventive migraine therapy includes:

Select one of the following:

  • Medication taken Daily

  • Medication taken only if needed

  • Medication to treat an acute attack

  • Medication is only taken at the onset of any headache

Explanation

Question 86 of 154

1

Hirsutism is likely to be a side effect of which of the following medications?

Select one of the following:

  • carbamazepine

  • valproic acid

  • phenytoin

  • lamotrigine

Explanation

Question 87 of 154

1

Treximet ® is a medication used for acute migraine treatment and contains 2 medications

Select one of the following:

  • Naproxen and Nexium®

  • Aspirin and acetaminophen

  • Butalbital and Acetaminophen

  • Sumatriptan and naproxen

Explanation

Question 88 of 154

1

Cox-2 inhibitors no longer available in the United States include:

Select one of the following:

  • Celecoxib (Celebrex®)

  • Valdecoxib (Bextra®)

  • Meloxicam (Mobic®)

  • A and C

Explanation

Question 89 of 154

1

Which of the following anti-epileptic medications has the potential to interact with oral contraceptives rendering this form of birth control less effective?

Select one of the following:

  • Oxcarbazepine

  • Phenytoin

  • Levitiracetam

  • A and B

  • B and C

Explanation

Question 90 of 154

1

Carbamazepine:

Select one of the following:

  • is used only to treat epilepsy

  • levels may increase if patients drink significant amounts of grapefruit juice

  • has sedation as one of it’s more common side effects

  • B and C

Explanation

Question 91 of 154

1

Which of the following is FALSE about the seasonal intranasal influenza vaccine?

Select one of the following:

  • It is a live vaccine.

  • A patient who recently underwent bone marrow transplantation is a good candidate for the intranasal vaccine.

  • It is a quadrivalent vacccine.

  • It is contraindicated in patients with anaphylactic egg allergy.

Explanation

Question 92 of 154

1

Which of the following sexually transmitted infection : treatment medication pairings is correct?

Select one of the following:

  • Primary syphilis : Injectable benzathine penicillin 2.4 million units IM

  • Chlamydia: Azithromycin 1g PO x 1 dose

  • Trichomoniasis : Metronidazole 2g PO x 1 dose

  • All of the above are correct

Explanation

Question 93 of 154

1

Beers list advises to avoid prescribing agents with anticholinergic effects to elderly patients. Which of the following is NOT an anticholinergic effect?

Select one of the following:

  • Dry mouth

  • Urinary retention

  • Insomnia

  • Blurred vision

Explanation

Question 94 of 154

1

Which of the following medication classes is contraindicated in pregnancy?

Select one of the following:

  • Angiotensin converting enzyme inhibitors

  • Beta-blockers

  • Thiazide diuretics

  • None of the above

Explanation

Question 95 of 154

1

Which of the following is a true statement about thimerosal?

Select one of the following:

  • It is the preservative used in the intranasal live-attenuated influenza vaccine.

  • It is the preservative used in multi-dose vials of influenza vaccine.

  • There are no influenza vaccine preparations available that are thimerosal-free.

  • A & B are correct

Explanation

Question 96 of 154

1

MM is a 17 year old young man who is currently on low dose inhaled steroids (i.e. step 2 in the stepwise approach) to control his asthma. He returns to clinic because he is still has symptoms, several days a week. His inhaler technique is good and he describes appropriate daily use of his inhalers. He has had to use his albuterol rescue inhaler every day, often more than once per day. Which of the following is the best next step to help MM manage his symptoms and gain better control?

Select one of the following:

  • Keep MM on low-dose inhaled steroids and add salmeterol to the regimen.

  • Start MM on prednisone 5mg PO daily.

  • Discontinue the low dose steroid inhaler and replace it with salmeterol.

  • Add a second inhaled steroid agent to CH’s regimen.

Explanation

Question 97 of 154

1

Which of the following is true regarding inspiratory drive and inhaled medications?

Select one of the following:

  • For dry powder inhalers, even patients with very low inspiratory drive can achieve optimal medication delivery to the lungs.

  • If a patient has a poor inspiratory drive, a nebulizer will be an ineffective way to deliver medication.

  • For patients with poor inspiratory drive, the use of a spacer will worsen medication delivery to the lungs.

  • None of the above is true.

Explanation

Question 98 of 154

1

Which of the following is true regarding pharmacokinetic differences in pediatric patients?

Select one of the following:

  • Infants and young children have a thicker stratum and larger body surface in relation to size, so topical absorption is more difficult than in adults.

  • Newborns and infants less than 6 months old have a higher rate of renal excretion than adults.

  • Newborns have a much higher percentage of total body water, which may impact the volume of distribution, Vd.

  • All of the hepatic metabolic pathways are fully developed and functional at the time of birth.

Explanation

Question 99 of 154

1

Which of the following is true regarding aspirin therapy for vascular disorders?

Select one of the following:

  • Aspirin is often used with other antiplatelet or anticoagulant medications and concomitant use does not increase the risk for bleeding.

  • Increasing the dose of aspirin from 81mg to 325mg will improve outcomes for all vascular disorders.

  • NSAIDs (ibuprofen, naproxen, ketoprofen, etc) may limit aspirin's cardioprotective effects; therefore, concomitant use of aspirin and NSAIDs is contraindicated regardless of the timing of administration.

  • Using the lowest dose of aspirin shown to be effective for an indication will help reduce the risk of adverse events such as bleeding.

Explanation

Question 100 of 154

1

Which of the following statements about using systemic (PO) glucocorticoids is TRUE for a COPD patient?

Select one of the following:

  • All COPD patients should be maintained on daily, low-dose oral steroids.

  • If systemic steroid use is necessary to control an exacerbation, at least 6 weeks of oral steroid should be prescribed.

  • Chronic use of systemic steroids has been associated with an unfavorable risk to benefit ratio in COPD patients.

  • None of the above is true.

Explanation

Question 101 of 154

1

RS is a 55yo African-American man with hypertension, diabetes and chronic kidney disease. He is currently on felodipine 10mg PO daily and enalapril 20mg PO daily. His blood pressure today is 125/81 mmHg, and he complains of a dry cough. What is the BEST plan for his drug therapy today?

Select one of the following:

  • Decrease felodipine to 5mg PO daily and increase enalapril to 20mg PO twice daily

  • Decrease enalapril to 10mg PO daily and increase felodipine to 20mg PO daily

  • Discontinue enalapril and begin losartan 50mg PO daily

  • Refer to RS to a hypertension specialist

Explanation

Question 102 of 154

1

Telithromycin

Select one of the following:

  • is a firstline agent for treating community acquired pneumonia.

  • is structurally related to macrolide antibiotics.

  • is rarely prescribed due to concern for hepatotoxicity.

  • B & C

Explanation

Question 103 of 154

1

Which of the following antimicrobial agents should not be administered to children under 8 years old unless risk outweighs benefit due to binding activity to calcium which may cause tooth enamel dysplasia?

Select one of the following:

  • azithromycin

  • doxycycline

  • amoxicillin

  • ciprofloxacin

Explanation

Question 104 of 154

1

Ciprofloxacin:

Select one of the following:

  • does not require dose adjustment in severe renal dysfunction.

  • is a beta lactam antibiotic.

  • administration should be separated from oral divalent cation administration (i.e. calcium, iron, etc.) by at least two hours.

  • is poorly absorbed when given orally compared to the intravenous route (i.e. low bioavailability).

Explanation

Question 105 of 154

1

There are two types of pneumococcal vaccines available, the 23-valent and the 7-valent conjugate vaccine. Which of the following statements is a correct statement about the appropriate pneumococcal vaccine?

Select one of the following:

  • A 65 year-old man should receive the 23-valent conjugate vaccine.

  • A 1 year-old patient should receive the 23-valent vaccine.

  • The 7-valent vaccine has superior immunogenicity in elderly patients and is the vaccine of choice for this population.

  • The vaccines are interchangeable and can be given to any age group.

Explanation

Question 106 of 154

1

Which of the following medications is contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency?

Select one of the following:

  • cephalexin

  • azithromycin

  • trimethoprim/sulfamethoxazole

  • ciprofloxacin

Explanation

Question 107 of 154

1

Which of the following medication dose forms will NOT bypass the first pass effect?

Select one of the following:

  • Clonidine 0.1 mg/24-hour patch

  • Metoprolol 2.5mg IV push

  • Nifedipine XL 60mg tablet

  • Nitroglycerin 0.4mg sublingual tablet

Explanation

Question 108 of 154

1

Which of the following does not influence RATE of absorption of a medication?

Select one of the following:

  • Steady state concentration of drug

  • Route of administration (i.e. oral, buccal, rectal, etc.)

  • Gastric pH for certain oral medications

  • Presence of food in the gut for certain oral medications

Explanation

Question 109 of 154

1

Which of the following patients may not receive the intranasal live-attenuated influenza vaccine?

Select one of the following:

  • A 32 year old pregnant woman

  • A 45 year old nurse who works on an orthopedic surgery floor

  • A 9 year old boy

  • All of the above patients may receive the intranasal live-attenuated influenza vaccine.

Explanation

Question 110 of 154

1

A medication that has a half-life (t 1/2 ) of 6 hours would reach an initial steady state concentration in about (assuming linear kinetics with no patient variables):

Select one of the following:

  • 3 hours

  • 6 hours

  • 24 hours

  • 72 hours

Explanation

Question 111 of 154

1

Bupropion would be a good choice for smoking cessation in which of the following patients?

Select one of the following:

  • A 24 year old woman with history of an eating disorder

  • A 36 year old man who is also taking phenytoin for seizure control

  • A 48 year old man with depression

  • A 32 year old pregnant woman who is making her first quit attempt

Explanation

Question 112 of 154

1

According to the American Heart Association, which of the following regimens is an appropriate prescription for bacterial endocarditis prophylaxis for appropriate dental procedures?

Select one of the following:

  • Ampicillin 2 grams PO TID x 24 hours prior to procedure

  • Clindamycin 600mg PO x 1 dose taken 4 hours prior to procedure

  • Amoxicillin 2 grams PO x 1 dose taken 1 hour prior to procedure

  • B & C are both correct

Explanation

Question 113 of 154

1

Which of the following statements is TRUE regarding theophylline?

Select one of the following:

  • Therapeutic drug monitoring (obtaining drug levels) is usually unnecessary.

  • The provider needs to screen the patient’s regimen for CYP450 mediated drug-drug interactions if prescribing theophylline.

  • Theophylline monotherapy is a recommended first line treatment for asthma in adults.

  • The therapeutic range is 20 – 25 mg/L (or mcg/ml).

Explanation

Question 114 of 154

1

The propensity of a drug to bind or attach itself to a given receptor site describes which of the following?

Select one of the following:

  • Plasma concentration

  • Adverse drug reaction

  • Receptor affinity

  • Nonlinear kinetics

Explanation

Question 115 of 154

1

PH is a 55yo man with Type 2 diabetes and a history of MI. Which therapy option is BEST for initial treatment of his elevated blood cholesterol?

Select one of the following:

  • Atorvastatin 80mg PO daily (High-dose statin intensity)

  • Life-style modifications only

  • Niacin 1500mg PO daily

  • Pravastatin 10mg PO daily (Low-dose statin intensity)

Explanation

Question 116 of 154

1

Which of the following classes of medication would be the BEST choice for initial therapy to treat hypertension in a nonblack patient with normal kidney function?

Select one of the following:

  • Aldosterone antagonists

  • Angiotensin converting enzyme inhibitors

  • Beta-blockers

  • Loop diuretics

Explanation

Question 117 of 154

1

Which of the following is FALSE about injectable influenza vaccine?

Select one of the following:

  • It is an inactivated vaccine.

  • It should only be administered via the subcutaneous route.

  • It is contraindicated in patients with anaphylactic egg allergy.

  • It vaccinates against selected annual strains of influenza A and B.

Explanation

Question 118 of 154

1

A 22 year-old patient comes to your clinic complaining of runny nose and cough for the past 2 days. She has not had fevers or chills, or any other outstanding symptoms. Which of the following choices would be the most appropriate action to take?

Select one of the following:

  • Prescribe amoxicillin 500mg orally three times daily.

  • Explain that since her symptoms have only been going on for 2 days, she may have a viral illness and does not yet require an antibiotic prescription – she should call you if she is not better at 7 days.

  • Obtain a chest x-ray.

  • Prescribe azithromycin, 500mg PO x 1, then 250mg daily x 4 days.

Explanation

Question 119 of 154

1

Which of the following respiratory drug: side effect pairings is most appropriate?

Select one of the following:

  • albuterol inhaler: oral candidiasis

  • theophylline: bradycardia

  • ipratropium: hypersalivation

  • montelukast: headache

Explanation

Question 120 of 154

1

Vaccine Information Statements (VIS):

Select one of the following:

  • must, by law, be given to a patient or parent/guardian prior to the provider administering a vaccination.

  • are available in multiple languages on the CDC website.

  • contain information regarding possible adverse effects the patient may experience from the vaccine.

  • All of the above are true about vaccine information statements.

Explanation

Question 121 of 154

1

Which of the following is not recommended with regards to use of these specific antiplatelet agents?

Select one of the following:

  • Clopidogrel use in a patient with active peptic ulcer disease.

  • Prasugrel use in a patient ≥ 75 years old.

  • Ticagrelor use with concomitant aspirin 325mg PO daily.

  • All of the above

Explanation

Question 122 of 154

1

Sulfonamide antibiotics

Select one of the following:

  • should not be prescribed in the third trimester of pregnancy.

  • are bacteriostatic.

  • prevent bacteria that synthesize folic acid from reproducing.

  • All of the above are true.

Explanation

Question 123 of 154

1

Which of the following is true about nicotine gum?

Select one of the following:

  • It should be chewed in the same fashion as one would use a piece of chewing gum.

  • A new piece should be used every 5 minutes.

  • It cannot be used as monotherapy for smoking cessation.

  • It is associated with gastrointestinal side effects such as nausea and stomach ache.

Explanation

Question 124 of 154

1

Which of the following HMG-CoA reductase inhibitors ("statins") has the least amount of CYP450 meditated drug-drug interactions?

Select one of the following:

  • Atorvastatin

  • Pravastatin

  • Simvastatin

  • Rosuvastatin

Explanation

Question 125 of 154

1

Which of the following is FALSE regarding the nicotine transdermal patch?

Select one of the following:

  • It is available by prescription only.

  • A common side effect is anxiety or feeling jittery.

  • It should be avoided in patients with severe skin conditions, such as eczema or psoriasis.

  • Patients should rotate the site of patch placement.

Explanation

Question 126 of 154

1

Which of the following is true regarding polypharmacy?

Select one of the following:

  • It occurs only in elderly patients.

  • An example is prescribing a new drug to treat a side effect caused by another drug the patient is taking.

  • It results in cost-savings for many patients.

  • It usually reduces the number of adverse drug reactions that a patient will experience.

Explanation

Question 127 of 154

1

Which of the following agents for smoking cessation requires dose adjustment for patients with renal dysfunction?

Select one of the following:

  • Varenicline

  • Nicotine patch

  • Nicotine nasal spray

  • Nicotine lozenge

Explanation

Question 128 of 154

1

Which of the following is FALSE regarding short-course of oral steroids (i.e. “steroid burst”)?

Select one of the following:

  • It allows for fast control of symptoms

  • The patient should continue to use scheduled inhalers while on a steroid burst

  • A steroid taper is required for a short (5 to 7 days) course of oral steroids

  • None of the above is false

Explanation

Question 129 of 154

1

Clindamycin:

Select one of the following:

  • inhibits protein synthesis in susceptible organisms.

  • has poor penetration into abscess fluid.

  • has very minimal GI side effects when compared to other antibiotic classes.

  • lacks activity against anaerobes.

Explanation

Question 130 of 154

1

Which of the following patients should initially receive two doses of influenza vaccine, 4 weeks apart?

Select one of the following:

  • A 5 year old child receiving the flu vaccine for the first time.

  • A 3 month old infant.

  • A 12 year old child receiving the flu vaccine for the first time.

  • None of the above patients should receive two doses of vaccine.

Explanation

Question 131 of 154

1

Which of the following is a true statement about the corresponding pregnancy category?

Select one of the following:

  • Category A: Studies have failed to show risk to the fetus if the drug is given during pregnancy.

  • Category B: These drugs should never be given in pregnancy.

  • Category X: These drugs are contraindicated only in the first trimester of pregnancy.

  • Category D: Studies have shown these drugs to be safe throughout pregnancy.

Explanation

Question 132 of 154

1

Salmeterol

Select one of the following:

  • is dosed four times daily due to its short half-life.

  • is appropriate to use as monotherapy in asthma patients.

  • is the treatment of choice for an acute asthma exacerbation.

  • is an agonist at beta-2 receptors and increases cAMP.

Explanation

Question 133 of 154

1

Which of the following medication regimens is appropriate for a patient with intermittent asthma?

Select one of the following:

  • Medium-potency inhaled steroid + albuterol MDI for rescue

  • Albuterol inhaler use PRN

  • Monotherapy with leukotriene receptor antagonist

  • Low-potency inhaled steroid + albuterol MDI for rescue

Explanation

Question 134 of 154

1

Which of the following statements is a TRUE statement about antivirals used to treat herpes virus infection?

Select one of the following:

  • Valacyclovir is a prodrug of acyclovir.

  • If used correctly, the antivirals will eradicate the virus from the body and cure the patient’s
    infection.

  • Acyclovir does not require dose adjustment for severe renal dysfunction.

  • Topical antivirals are the treatment of choice for genital herpes infection outbreaks

Explanation

Question 135 of 154

1

Which of the following vaccines is a live vaccine?

Select one of the following:

  • Injectable influenza vaccine

  • Injectable polio vaccine

  • Varicella vaccine

  • Tetanus toxoid

Explanation

Question 136 of 154

1

Which of the following is NOT an example of a significant allergic reaction to a medication?

Select one of the following:

  • Anaphylaxis

  • Local irritation at site of injection of medication

  • Hives

  • Angioedema

Explanation

Question 137 of 154

1

AL is a 16 year-old patient with asthma for whom you have prescribed a beclomethasone inhaler.Which of the following counseling points is INAPPROPRIATE?

Select one of the following:

  • AL should rinse her mouth after using this inhaler.

  • AL should bring her inhaler with her to every visit so you can assess her technique.

  • AL should use the beclomethasone as her rescue inhaler.

  • AL may use a spacer with this inhaler in order to improve technique and delivery to the lungs.

Explanation

Question 138 of 154

1

Which of the following is the best choice for adjunctive therapy for treating heart failure in African-American patients?

Select one of the following:

  • Amlodipine

  • Hydralazine plus isosorbide dinitrate

  • Hydralazine plus lisinopril

  • Hydrochlorothiazide

Explanation

Question 139 of 154

1

Which of the following is an INCORRECT statement regarding pharmacodynamic changes in elderly patients?

Select one of the following:

  • Elderly patients have an increased baroreceptor response.

  • Elderly patients have decreased sensitivity to medications affecting the central nervous system.

  • Beta agonists and antagonists usually have an increased effect in elderly patients.

  • All of the above statements are incorrect.

Explanation

Question 140 of 154

1

Which of the following is FALSE about metronidazole?

Select one of the following:

  • It is used primarily for its activity against aerobic bacteria.

  • Patients who drink alcohol need to be counseled for potential disulfuram reaction.

  • It has coverage against some anaerobic gram positive organisms.

  • It interferes with bacterial DNA synthesis.

Explanation

Question 141 of 154

1

Which of the following antimicrobials would be the best choice for a patient with history of baseline QT interval prolongation? (Assume all drugs listed below would be therapeutically appropriate for the antibiotic indication)

Select one of the following:

  • Cefpodoxime

  • Moxifloxacin

  • Levofloxacin

  • Clarithromycin

Explanation

Question 142 of 154

1

Patients with severe PCN allergy can safely be prescribed which of the following, without having to be concerned with cross-hypersensitivity?

Select one of the following:

  • cephalexin

  • cefpodoxime

  • doxycycline

  • dicloxacillin

Explanation

Question 143 of 154

1

If a drug is highly protein bound,

Select one of the following:

  • there is a high percentage of free drug in the body

  • it always has a narrow therapeutic index

  • it will likely undergo first-pass metabolism

  • free drug concentration may be increased in patients with low albumin

Explanation

Question 144 of 154

1

Which of the following treatment regimens would be appropriate for a patient who has tested positive for novel influenza A(H1N1)? Your patient does not have any comorbid conditions or contraindications to medications.

Select one of the following:

  • Rimantadine

  • Oseltamivir

  • Zanamivir

  • B and C

Explanation

Question 145 of 154

1

AB is a 74yo woman who presents to your clinic today complaining of new-onset mile muscle pain. She began simvastatin 20mg PO daily 6 months ago for the treatment of her blood cholesterol. Which of the following would be BEST to include in your plan today?

Select one of the following:

  • Check thyroid function and vitamin D level

  • Hold simvastatin, and check a fasting lipid panel

  • Hold simvastatin, and check thyroid function and vitamin D level

  • Lower the simvastatin dose to 10mg PO daily

Explanation

Question 146 of 154

1

Which of the following is true regarding the impact that steroids have on linear growth in children?

Select one of the following:

  • The potential risk appears to be independent of the steroid dose.

  • For severe persistent asthma, high dose inhaled steroids are likely to have less impact on growth than oral steroids.

  • Studies have consistently shown that low dose inhaled steroids are associated with significant growth delay.

  • Children should not be prescribed inhaled corticosteroids due to the risk of growth delay.

Explanation

Question 147 of 154

1

Albuterol

Select one of the following:

  • is a short-acting beta-2 receptor agonist.

  • should be prescribed as rescue therapy for asthmatic patients.

  • has a higher risk of systemic side effects compared to inhaled epinephrine.

  • A and B

Explanation

Question 148 of 154

1

Which of the following would be used to provide passive immunity to a patient?

Select one of the following:

  • Varicella vaccine

  • Injectable polio vaccine

  • Rabies immune globulin

  • MMR vaccine

Explanation

Question 149 of 154

1

When prescribing an azole antifungal agent to your patient, it is important to consider that

Select one of the following:

  • all of the azole antifungal are renally eliminated and will require dose adjustment in renal dysfunction

  • the patient's medication list should be screened to evaluate for potential CYP450 mediated drug interactions

  • most infections can be treated with a single dose

  • None of the above need to be considered

Explanation

Question 150 of 154

1

Which of the following is true regarding the use of digoxin for the treatment of heart failure?

Select one of the following:

  • Desired digoxin levels are between 0.5-2 ng/mL

  • Digoxin has a negative inotropic effect in heart failure

  • Patients with digoxin toxicity may present with visual disturbances or bradycardia

  • All of the above

Explanation

Question 151 of 154

1

Which of the following antimicrobials should not be used for managing community-associated MRSA skin infection, since it not cover the pathogen? Assume outpatient management.

Select one of the following:

  • Linezolid

  • Trimethoprim/sulfamethoxazole

  • Cephalexin

  • A & C are correct

Explanation

Question 152 of 154

1

Which of the following patients are most at risk for potential side effects from statin medications?

Select one of the following:

  • Patients taking high dose statin therapy

  • Patients taking concomitant fibrate therapy

  • Patients with baseline liver disease

  • All of the above

Explanation

Question 153 of 154

1

Which of the following is the BEST reason for overlapping low molecular weight heparin (LMWH) therapy with warfarin therapy (i.e. "bridging") when treating venous thromboembolism (VTE)?

Select one of the following:

  • Because they are administered by injection, LMWHs are more effective for treating VTE than warfarin; therefore they should be used when anticoagulant therapy is initiated.

  • Patients may tolerate LMWHs and warfarin differently. It's important to see which agent the patient tolerates best before choosing a single agent to treat VTE.

  • The initial protein C and S deficiency that occurs with initiation of warfarin therapy results in a temporary hypercoaguable state, and the LMWH provides anticoagulation coverage during this time.

  • Warfarin inhibits vitamin K dependent clotting factors which all have very short half-lives which delays the onset of warfarin's anticoagulation effect so LMWH is required at the initiation of therapy.

Explanation

Question 154 of 154

1

Which of the following is/are inappropriate prescriptions scenarios?

Select one of the following:

  • An 87 year-old man prescribed ibuprofen 800 mg PO TID for muscle aches.

  • Diazepam 10 mg PO BID for a 76 year-old woman with anxiety.

  • Discontinuing aspirin 81 mg PO daily with intention of reducing GI bleeding risk in a 67 year-old woman who had an MI 5 years ago.

  • All of the above are inappropriate scenarios.

Explanation

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