Pharmacotherapeutics (Accumlative Exam)

Jeremiah Parve
Quiz by Jeremiah Parve, updated more than 1 year ago
Jeremiah Parve
Created by Jeremiah Parve over 5 years ago
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Description

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

Resource summary

Question 1

Question
Which of the following factors may influence the volume of distribution of a drug?
Answer
  • Plasma protein binding
  • Obesity
  • Presence of edema
  • All of the above

Question 2

Question
Which of the following medication dose forms will not bypass the first pass effect?
Answer
  • Fentanyl transdermal patch
  • Conjugated estrogens 0.625 oral tablet
  • Oxymetazoline nasal spray
  • Sublingual nitrogylcerin tablet

Question 3

Question
A receptor antagonist...
Answer
  • 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.

Question 4

Question
The Cytochrome P450 enzymes:
Answer
  • are responsible for oxidative metabolism.
  • are often the mechanism behind drug-drug interactions.
  • are predominantly found in the intestine.
  • A and B

Question 5

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

Question 6

Question
An adverse event to a medication is...
Answer
  • 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.

Question 7

Question
Which of the following statements defines pharmacodynamics?
Answer
  • 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.

Question 8

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

Question 9

Question
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):
Answer
  • 5 hours
  • 10 hours
  • 20 hours
  • 40 hours

Question 10

Question
Which of the following is true regarding pharmacokinetic differences in pediatric patients?
Answer
  • 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.

Question 11

Question
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?
Answer
  • 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

Question 12

Question
Which of the following HMG-CoA redectase inhibitors ("statins") has the lest amount of CYP450 mediated drug-drug interactions?
Answer
  • Atorvastatin
  • Pravastatin
  • Simvastatin
  • Rosuvastatin

Question 13

Question
Aldosterone antagonists used for the treatment of heart failure:
Answer
  • 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

Question 14

Question
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?
Answer
  • 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

Question 15

Question
Thiazide-type diuretics:
Answer
  • 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

Question 16

Question
Which of the following is true regarding aspirin therapy for vascular disorders?
Answer
  • 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.

Question 17

Question
All of the following medications decrease mortality in heart failure patients, EXCEPT:
Answer
  • Aldosterone antagonists
  • Angiotensin converting enzyme inhibitors
  • Beta-blockers (bisoprolol, carvedilol, extended-release metoprolol succinate)
  • Digoxin

Question 18

Question
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?
Answer
  • Atorvastatin 80mg PO daily (High-dose statin intensity)
  • Life-style modifications only
  • Niacin 1500mg PO daily
  • Pravastatin 10mg PO daily (Low-dose statin intensity)

Question 19

Question
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:
Answer
  • 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.

Question 20

Question
Which of the following statements is true regarding currently available oral anticoagulant medications?
Answer
  • 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.

Question 21

Question
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?
Answer
  • Methylprednisolone
  • Theophylline
  • Levocetirizine
  • Singulair®

Question 22

Question
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.
Answer
  • Nicotine, Wellbutrin
  • Menthol, Chantix® (varenicline tartrate)
  • Nicotine, Chantix® (varenicline tartrate)
  • Nicotine, Clonidine

Question 23

Question
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?
Answer
  • True
  • False

Question 24

Question
Inhaled Corticosteroids in either the aerosol (MDI) form or the micro particle form (DISKUS) cause a common local side effect:
Answer
  • Reduction of renal function
  • Frog in the throat
  • Candidiasis
  • Group A Streptococcus

Question 25

Question
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.
Answer
  • True
  • False

Question 26

Question
The Expert Panel Recommends chronic oral steroids as long term control for:
Answer
  • Exercise or Seasonal asthma
  • Mild, intermittent asthma
  • Severe, persistent asthma
  • Post nasal drip

Question 27

Question
Atrovent® and Spiriva® are anticholinergics that stimulate muscarinic cholinergic receptors and reduce vagal tone?
Answer
  • True
  • False

Question 28

Question
The main component of asthma is _________________________ and the primary treatment for that component is ________________________________.
Answer
  • Inflammation, Inhaled corticosteroids
  • Bronchospasm, SABA
  • Dry Cough, Accolate®
  • Shortness of Breath, Albuterol

Question 29

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

Question 30

Question
Short acting Beta Agonists (SABA) include:
Answer
  • Albuterol
  • Duoneb®
  • Xopenex®
  • A & C

Question 31

Question
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)
Answer
  • Oseltamivir
  • Zanamivir
  • rimantidine
  • A & B are both correct

Question 32

Question
Which of the following antimicrobial classes are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency?
Answer
  • Sulfonamides
  • Macrolides
  • Tetracyclines
  • Penicillins

Question 33

Question
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?
Answer
  • 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.

Question 34

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

Question 35

Question
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?
Answer
  • 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.

Question 36

Question
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?
Answer
  • Macrolides
  • Penicillin beta-lactams
  • Fluoroquinolones
  • Tetracyclines

Question 37

Question
Which of the following is FALSE about linezolid?
Answer
  • 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).

Question 38

Question
Patients with moderate to severe PCN allergy can safely be prescribed which of the following, without having to be concerned with cross-hypersensitivity?
Answer
  • clarithromycin
  • cephalexin
  • cefpodoxime
  • augmentin

Question 39

Question
Which of the following statements is TRUE regarding nitrofurantoin?
Answer
  • 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.

Question 40

Question
Ciprofloxacin:
Answer
  • 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).

Question 41

Question
Which of the following patients may not receive the intranasal live-attenuated influenza vaccine?
Answer
  • 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.

Question 42

Question
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?
Answer
  • 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.

Question 43

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

Question 44

Question
Which of the following is true regarding the timing of administration of influenza vaccine?
Answer
  • 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.

Question 45

Question
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.
Answer
  • 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

Question 46

Question
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?
Answer
  • 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

Question 47

Question
The American Heart Association would recommend prescribing antibiotics for bacterial endocarditis prophylaxis in:
Answer
  • 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.

Question 48

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

Question 49

Question
The drug of choice to treat group A streptococcal pharyngitis in a patient with no known drug allergies is
Answer
  • Penicillin
  • Levofloxacin
  • Oseltamivir
  • Linezolid

Question 50

Question
Which of the following vaccines is a live vaccine?
Answer
  • Injectable influenza vaccine
  • Measles-Mumps-Rubella (MMR)
  • Pneumonia vaccine
  • Tetanus toxoid

Question 51

Question
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:
Answer
  • Finasteride
  • Oxybutinin
  • Tolterodine
  • An estrogen preparation

Question 52

Question
When prescribing taldalafil to a patient, you need to counsel the patient on potential side effects and adverse reactions, which include:
Answer
  • Headache
  • Priapism
  • Visual changes
  • All of the above

Question 53

Question
According to the CDC, there are ________________million new sexually transmitted infections in the world each year.
Answer
  • 9 million
  • 19 million
  • 29 million
  • 19 thousand

Question 54

Question
Which of the following statements is FALSE about the Intravaginal contraceptive, Nuvaring®?
Answer
  • 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.

Question 55

Question
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.
Answer
  • 1300 mg
  • 1200 mg
  • 1250 mg
  • 1100 mg

Question 56

Question
Trichomonas single dose treatment is 2 grams of:
Answer
  • Metronidazole
  • Azithromycin
  • Doxycycline
  • A and C

Question 57

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

Question 58

Question
The antibiotic combination of Cefixime 400mg PO x 1 dose PLUS Azithromycin 1gm PO x 1 dose is a treatment for:
Answer
  • Syphilis
  • Gonorrhea with probable Chlamydia
  • Trichomonas
  • Chlamydia

Question 59

Question
Which of the following statements is TRUE regarding progestin-only oral contraceptive medications?
Answer
  • 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.

Question 60

Question
Treatment for syphilis in penicillin allergic patients includes:
Answer
  • 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

Question 61

Question
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?
Answer
  • 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

Question 62

Question
Which of the following is a correct pairing?
Answer
  • 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

Question 63

Question
Which of the following medications act primarily by improving insulin secretion?
Answer
  • Pioglitazone
  • Metformin
  • Glipizide
  • Acarbose

Question 64

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

Question 65

Question
Which of the following is true regarding levothyroxine?
Answer
  • 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.

Question 66

Question
Which of the following is FALSE regarding H2-Receptor antagonists?
Answer
  • 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.

Question 67

Question
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?
Answer
  • 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

Question 68

Question
Which of the following is a correct pairing of drug : drug type?
Answer
  • Bisacodyl: stool softener
  • Lactulose: Adsorbant antidiarrheal
  • Psyllium: stimulant laxative
  • Senna: stimulant laxative

Question 69

Question
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?
Answer
  • Alosetron
  • Loperamide
  • Vicodin prn pain
  • Selective Serotonin Reuptake Inhibitor (SSRI)

Question 70

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

Question 71

Question
Ocular decongestants like oxymetazoline...
Answer
  • 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.

Question 72

Question
Which of the following monitoring parameters is required for ALL patients after initiation of clozapine (Clozaril®)?
Answer
  • Absolute neutrophil count
  • Electrocardiogram
  • Electroencephalogram
  • Serum clozapine level

Question 73

Question
Of the following antidepressants, which one is considered safest to use in a pregnant patient?
Answer
  • Imipramine (Tofranil®)
  • Paroxetine (Paxil®)
  • Phenelzine (Nardil®)
  • Sertraline (Zoloft®)

Question 74

Question
Which of the following is true about topical vehicles?
Answer
  • 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

Question 75

Question
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?
Answer
  • Amantadine (Symmetrel®)
  • Benztropine (Cogentin®)
  • Diphenhydramine (Benadryl®)
  • Propranolol (Inderal®)

Question 76

Question
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?
Answer
  • Fluoxetine (Prozac®)
  • Mirtazapine (Remeron®)
  • Paroxetine (Paxil®)
  • Phenelzine (Nardil®)

Question 77

Question
What is the minimum washout period you should recommend between discontinuing a monoamine oxidase inhibitor (MAOI) and starting a selective serotonin reuptake inhibitor (SSRI)?
Answer
  • 1 week
  • 2 weeks
  • 4 weeks
  • 6 weeks

Question 78

Question
Therapeutic effect of an antidepressant is typically seen in
Answer
  • 2-8 hours
  • 2-8 days
  • 2-8 weeks
  • 2-8 months

Question 79

Question
Which of the following antipsychotics is MOST appropriate to initiate in a patient with a past medical history significant for obesity and diabetes?
Answer
  • Aripiprazole (Abilify®)
  • Clozapine (Clozaril®)
  • Olanzapine (Zyprexa®)
  • Quetiapine (Seroquel®)

Question 80

Question
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?
Answer
  • Bupropion (Wellbutrin®)
  • Duloxetine (Cymbalta®)
  • Fluoxetine (Prozac®)
  • Vortioxetine (Brintellix®)

Question 81

Question
Which statement is False about Acute pain according to the lecture?
Answer
  • 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.

Question 82

Question
Which of the following is NOT a reported anticholinergic adverse event with tricyclic antidepressants?
Answer
  • Shortness of breath
  • Constipation
  • Dry mouth
  • Postural hypertension

Question 83

Question
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.
Answer
  • True
  • False

Question 84

Question
A fentanyl transdermal patch:
Answer
  • 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

Question 85

Question
Preventive migraine therapy includes:
Answer
  • Medication taken Daily
  • Medication taken only if needed
  • Medication to treat an acute attack
  • Medication is only taken at the onset of any headache

Question 86

Question
Hirsutism is likely to be a side effect of which of the following medications?
Answer
  • carbamazepine
  • valproic acid
  • phenytoin
  • lamotrigine

Question 87

Question
Treximet ® is a medication used for acute migraine treatment and contains 2 medications
Answer
  • Naproxen and Nexium®
  • Aspirin and acetaminophen
  • Butalbital and Acetaminophen
  • Sumatriptan and naproxen

Question 88

Question
Cox-2 inhibitors no longer available in the United States include:
Answer
  • Celecoxib (Celebrex®)
  • Valdecoxib (Bextra®)
  • Meloxicam (Mobic®)
  • A and C

Question 89

Question
Which of the following anti-epileptic medications has the potential to interact with oral contraceptives rendering this form of birth control less effective?
Answer
  • Oxcarbazepine
  • Phenytoin
  • Levitiracetam
  • A and B
  • B and C

Question 90

Question
Carbamazepine:
Answer
  • 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

Question 91

Question
Which of the following is FALSE about the seasonal intranasal influenza vaccine?
Answer
  • 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.

Question 92

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

Question 93

Question
Beers list advises to avoid prescribing agents with anticholinergic effects to elderly patients. Which of the following is NOT an anticholinergic effect?
Answer
  • Dry mouth
  • Urinary retention
  • Insomnia
  • Blurred vision

Question 94

Question
Which of the following medication classes is contraindicated in pregnancy?
Answer
  • Angiotensin converting enzyme inhibitors
  • Beta-blockers
  • Thiazide diuretics
  • None of the above

Question 95

Question
Which of the following is a true statement about thimerosal?
Answer
  • 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

Question 96

Question
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?
Answer
  • 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.

Question 97

Question
Which of the following is true regarding inspiratory drive and inhaled medications?
Answer
  • 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.

Question 98

Question
Which of the following is true regarding pharmacokinetic differences in pediatric patients?
Answer
  • 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.

Question 99

Question
Which of the following is true regarding aspirin therapy for vascular disorders?
Answer
  • 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.

Question 100

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

Question 101

Question
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?
Answer
  • 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

Question 102

Question
Telithromycin
Answer
  • 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

Question 103

Question
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?
Answer
  • azithromycin
  • doxycycline
  • amoxicillin
  • ciprofloxacin

Question 104

Question
Ciprofloxacin:
Answer
  • 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).

Question 105

Question
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?
Answer
  • 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.

Question 106

Question
Which of the following medications is contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency?
Answer
  • cephalexin
  • azithromycin
  • trimethoprim/sulfamethoxazole
  • ciprofloxacin

Question 107

Question
Which of the following medication dose forms will NOT bypass the first pass effect?
Answer
  • Clonidine 0.1 mg/24-hour patch
  • Metoprolol 2.5mg IV push
  • Nifedipine XL 60mg tablet
  • Nitroglycerin 0.4mg sublingual tablet

Question 108

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

Question 109

Question
Which of the following patients may not receive the intranasal live-attenuated influenza vaccine?
Answer
  • 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.

Question 110

Question
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):
Answer
  • 3 hours
  • 6 hours
  • 24 hours
  • 72 hours

Question 111

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

Question 112

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

Question 113

Question
Which of the following statements is TRUE regarding theophylline?
Answer
  • 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).

Question 114

Question
The propensity of a drug to bind or attach itself to a given receptor site describes which of the following?
Answer
  • Plasma concentration
  • Adverse drug reaction
  • Receptor affinity
  • Nonlinear kinetics

Question 115

Question
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?
Answer
  • Atorvastatin 80mg PO daily (High-dose statin intensity)
  • Life-style modifications only
  • Niacin 1500mg PO daily
  • Pravastatin 10mg PO daily (Low-dose statin intensity)

Question 116

Question
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?
Answer
  • Aldosterone antagonists
  • Angiotensin converting enzyme inhibitors
  • Beta-blockers
  • Loop diuretics

Question 117

Question
Which of the following is FALSE about injectable influenza vaccine?
Answer
  • 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.

Question 118

Question
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?
Answer
  • 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.

Question 119

Question
Which of the following respiratory drug: side effect pairings is most appropriate?
Answer
  • albuterol inhaler: oral candidiasis
  • theophylline: bradycardia
  • ipratropium: hypersalivation
  • montelukast: headache

Question 120

Question
Vaccine Information Statements (VIS):
Answer
  • 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.

Question 121

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

Question 122

Question
Sulfonamide antibiotics
Answer
  • 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.

Question 123

Question
Which of the following is true about nicotine gum?
Answer
  • 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.

Question 124

Question
Which of the following HMG-CoA reductase inhibitors ("statins") has the least amount of CYP450 meditated drug-drug interactions?
Answer
  • Atorvastatin
  • Pravastatin
  • Simvastatin
  • Rosuvastatin

Question 125

Question
Which of the following is FALSE regarding the nicotine transdermal patch?
Answer
  • 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.

Question 126

Question
Which of the following is true regarding polypharmacy?
Answer
  • 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.

Question 127

Question
Which of the following agents for smoking cessation requires dose adjustment for patients with renal dysfunction?
Answer
  • Varenicline
  • Nicotine patch
  • Nicotine nasal spray
  • Nicotine lozenge

Question 128

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

Question 129

Question
Clindamycin:
Answer
  • 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.

Question 130

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

Question 131

Question
Which of the following is a true statement about the corresponding pregnancy category?
Answer
  • 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.

Question 132

Question
Salmeterol
Answer
  • 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.

Question 133

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

Question 134

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

Question 135

Question
Which of the following vaccines is a live vaccine?
Answer
  • Injectable influenza vaccine
  • Injectable polio vaccine
  • Varicella vaccine
  • Tetanus toxoid

Question 136

Question
Which of the following is NOT an example of a significant allergic reaction to a medication?
Answer
  • Anaphylaxis
  • Local irritation at site of injection of medication
  • Hives
  • Angioedema

Question 137

Question
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?
Answer
  • 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.

Question 138

Question
Which of the following is the best choice for adjunctive therapy for treating heart failure in African-American patients?
Answer
  • Amlodipine
  • Hydralazine plus isosorbide dinitrate
  • Hydralazine plus lisinopril
  • Hydrochlorothiazide

Question 139

Question
Which of the following is an INCORRECT statement regarding pharmacodynamic changes in elderly patients?
Answer
  • 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.

Question 140

Question
Which of the following is FALSE about metronidazole?
Answer
  • 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.

Question 141

Question
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)
Answer
  • Cefpodoxime
  • Moxifloxacin
  • Levofloxacin
  • Clarithromycin

Question 142

Question
Patients with severe PCN allergy can safely be prescribed which of the following, without having to be concerned with cross-hypersensitivity?
Answer
  • cephalexin
  • cefpodoxime
  • doxycycline
  • dicloxacillin

Question 143

Question
If a drug is highly protein bound,
Answer
  • 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

Question 144

Question
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.
Answer
  • Rimantadine
  • Oseltamivir
  • Zanamivir
  • B and C

Question 145

Question
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?
Answer
  • 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

Question 146

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

Question 147

Question
Albuterol
Answer
  • 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

Question 148

Question
Which of the following would be used to provide passive immunity to a patient?
Answer
  • Varicella vaccine
  • Injectable polio vaccine
  • Rabies immune globulin
  • MMR vaccine

Question 149

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

Question 150

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

Question 151

Question
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.
Answer
  • Linezolid
  • Trimethoprim/sulfamethoxazole
  • Cephalexin
  • A & C are correct

Question 152

Question
Which of the following patients are most at risk for potential side effects from statin medications?
Answer
  • Patients taking high dose statin therapy
  • Patients taking concomitant fibrate therapy
  • Patients with baseline liver disease
  • All of the above

Question 153

Question
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)?
Answer
  • 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.

Question 154

Question
Which of the following is/are inappropriate prescriptions scenarios?
Answer
  • 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.
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