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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:
1. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?
A) A concentration within the desirable range
B) A post-distribution digoxin concentration, which indicates significant toxicity
C) A pre-distribution digoxin concentration, which may be misinterpreted
D) Reflects the effect of furosemide on the renal excretion of digoxin
2. A 45-year-old patient develops neutropenia, fever, headache, meningismus, and lethargy after induction chemotherapy for acute lymphocytic leukemia. A lumbar puncture reveals 1,000 total nucleated cells with elevated CSF protein with gram stain showing Gram-positive rods. Which of the following is the best initial empiric therapy for this patient?
A) Ceftazidime and gentamicin
B) Ampicillin
C) Ceftriaxone
D) Ampicillin and cefotaxime
3. Which of the following disease states has been associated with stress-related mucosal bleeding and is an indication for initiation of stress ulcer prophylaxis?
A) Ulcerative Colitis
B) Gastric carcinoma
C) Coagulopathy
D) Diabetes mellitus
4. A 49-year-old man presents to his physician with a 3-day acute attack of gout in four joints of the right foot. The patient has a history of at least three previous gout attacks; in one, a joint aspirate was positive for urate crystals. His history also includes type 2 diabetes mellitus and two calcium oxalate kidney stones.
Laboratory values include creatinine 3.1 mg/dL, uric acid 11.7 mg/dL, and A1C 6.8%. The patient is allergic to aspirin. Vital signs are BP135/82mm Hg and HR 90 bpm and regular.
Current medications are glipizide 10 mg daily and enalapril 20 mg daily.
Which short-term regimen is most appropriate for treating this patient's gout?
A) Prednisone 40 mg daily
B) Celecoxib 200 mg daily
C) Colchicine 0.6 mg hourly
D) Indomethacin 50 mg three times daily
5. A 40-year-old transplant recipient who is receiving cyclosporine develops seizures requiring anticonvulsant therapy. Because a drug interaction is likely to occur between cyclosporine and phenytoin, the pharmacotherapy specialist suggests that the resident do which of the following?
A) Increase the cyclosporine dose.
B) Decrease the cyclosporine dose.
C) Decrease the phenytoin dose.
D) Increase the phenytoin dose.
Solutions:
Question # 1 Answer: D | Question # 2 Answer: C | Question # 3 Answer: B | Question # 4 Answer: A | Question # 5 Answer: A |