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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 post-distribution digoxin concentration, which indicates significant toxicity
B) A concentration within the desirable range
C) Reflects the effect of furosemide on the renal excretion of digoxin
D) A pre-distribution digoxin concentration, which may be misinterpreted

2. A 75-year-old man with a medical history significant for hypertension, diabetes mellitus, and erectile dysfunction returns for follow-up. He currently takes benazepril, glipizide, and sildenafil as needed. He is in the clinic today with symptoms of depression. The physician wants to start an antidepressant that will have a minimal effect on the patient's erectile dysfunction. Which of the following agents would be the best recommendation?

A) Venlafaxine
B) Desipramine
C) Bupropion
D) Fluoxetine

3. A patient presents at a physician's office with gait unsteadiness and clumsiness. The patient has a history of type 2 diabetes mellitus, hypertension, and chronic numbness and tingling of the feet and fingertips.
Examination reveals mild distal wasting, glove-and-stocking sensory impairment, absent ankle jerks, brisk knee jerks, and bilateral Babinski reflexes. Gait is slightly ataxic.
CBC reveals a hemoglobin of 10.1 g/dL, WBC of 4,500 cells/mL, MCV 120 fL, and platelets
163,000 cells/ul.
Which of the following is the most important laboratory test for assisting in diagnosis?

A) Ferritin
B) Folic acid
C) Erythrocyte sedimentation rate
D) Serum vitamin B12

4. For a 34-year-old Woman with a history of ethanol abuse, cirrhosis, ascites, and jaundice, which of the following is the most important factor predisposing her to hepatorenal syndrome?

A) Metabolic acidosis
B) Hypocalcaemia
C) Hypokalemia
D) Volume depletion

5. A drug use evaluation (DUE) of an institution's ACLS medication administration records yields the following data:
* Rate of amiodarone use in patients with asystole = 30%
* Rate of amiodarone use in patients with ventricular fibrillation = 90%
* Rate of epinephrine use in patients with pulseless electrical activity (PEA) = 98%
* Rate of vasopressin use in patients with pulseless ventricular tachycardia = 50% Which of the following treatments should be targeted for intervention?

A) Pulseless electrical activity
B) Ventricular fibrillation
C) Pulseless ventricular tachycardia
D) Asystole

Solutions: