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Section 1.1 Part 5

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

SS is a 55-year-old African American woman newly diagnosed with acute lymphoblastic leukemia (ALL). Her physician has recommended she receive part A hyper-CVAD regimen (cyclophosphamide, vincristine, doxorubicin, and dexamethasone). What baseline examination should she receive prior to initiating doxorubicin on day 4?

a)

CT scan to assess distant site involvement

b)

Lumbar puncture to determine CNS disease

c)

24-Hour urine collection to determine renal function

d)

MUGA scan to determine left ventricular ejection fraction (LVEF)

2.

Which of the following is the major pathologic cell type found in 95% of prostate cancers?

a)

A. Adenocarcinoma

b)

B. Melanoma

c)

C. Sarcoma

d)

D. Carcinoma

3.

VN is a 77-year-old man who has been experiencing increased dyspnea for the last month. He was diagnosed with COPD 3 years ago and has been taking albuterol via a metered-dose inhaler on an as needed (prn) basis. His most recent spirometry results are: FEV1/FVC ratio of 0.65 and FEV1 65% of predicted. Select the best choice for treating his COPD and increased symptoms.

a)

Add scheduled tiotropium and continue prn albuterol

b)

Add scheduled fluticasone and continue prn albuterol

c)

Add prn salmeterol and continue prn albuterol

d)

Add scheduled theophylline and continue prn albuterol

4.

LR is a patient with end-stage COPD. COPD medications include as-needed albuterol, scheduled ipratropium, flunisolide, salmeterol and theophylline. Theophylline was added three months ago and has improved clinical symptoms modestly as reported by the patient. However, LR has had difficulty obtaining a target level of theophylline. What is the target theophylline level for initial treatment of LR's COPD?

a)

10 mg/L

b)

20 mg/L

c)

30 mg/L

d)

40 mg/L

5.

Select the statement that accurately describes breast cancer.

a)

The lifetime risk for US women developing breast cancer is 1 in 8.

b)

In the United States, the death rate from breast cancer has decreased since the widespread implementation of screening mammography guidelines.

c)

Breast cancer is the second leading cause of death from cancer in US women.

d)

Pharmacotherapy for metastatic breast cancer is palliative rather than curative.

e)

All of the above.

6.

Select the gram-negative bacterial pathogen that is a common cause of lower respiratory tract infections.

a)

Haemophilus influenzae

b)

Influenza

c)

Parainfluenza

d)

Staphylococcus aureus

7.

RT is a 35-year-old pharmaceutical representative. His territory is the Southeastern United States. He has a past medical history of partial epilepsy and allergic rhinitis. Medications include carbamazepine and cetirizine. RT travels a lot for his job (air and land travel). His seizures have been well controlled until recently. He cannot identify any risk factors for the increase in seizures and states that he has been 100% adherent with medicine. The past few weeks has been unseasonal as it has been 100 degrees F and very humid. His provider has evaluated RT for treatable causes of his increase in seizures. All labs and evaluation have been within normal limits. RT's carbamazepine level was 8.1 mcg/ml. The provider orders a pharmacotherapy consult for evaluation. Select the potential reason for the increase in seizure activity for RT.

a)

RT has partial epilepsy and carbamazepine is not effective for partial seizures.

b)

There is a drug interaction between cetirizine and carbamazepine leading to subtherapeutic levels of carbamazepine.

c)

RT has a supratherapeutic carbamazepine level. Supratherapeutic AED levels may cause a seizure.

d)

Storing carbamazepine tablets in humid conditions can cause concretion of the tablets, resulting in poor bioavailability and therapeutic failure.

8.

Which of the following accurately describes influenza?

a)

A. A bacterial illness caused by Haemophilus influenzae

b)

B. A viral illness caused by respiratory syncytial virus (RSV)

c)

C. A viral illness caused by rhinovirus.

d)

D. A viral illness caused by influenza A and B.

e)

E. A bacterial illness caused by Streptococcus pneumoniae.

9.

Which of the following laboratory values is of value in differentiating HF from other disease states that cause similar symptoms?

a)

Sodium

b)

Creatinine

c)

B-type natriuretic peptide (BNP)

d)

Norepinephrine

10.

Which of the following acid-base disturbances would you expect to see in an acute asthma exacerbation?

a)

Respiratory acidosis

b)

Respiratory alkalosis

c)

Metabolic acidosis with respiratory compensation

d)

Metabolic alkalosis with respiratory compensation

11.

BD is a 59-year-old woman who has suffered from migraines for many years. Her frovatriptan 2.5 mg works well to abort her headaches when they occur. Over the past few months, her headaches have increased in frequency to one every 2 weeks. She also complains of difficulty sleeping. Her vital signs today upon physical examination are Ht 5 ft 6 in, Wt 140 lb, BP 120/80 mm Hg, and HR 60 bpm. Her physician would like to start her on prophylactic drug therapy.

a)

Propranolol

b)

Botulinum toxin type A

c)

Nortriptyline

d)

Phenelzine

12.

The presence of gram-negative diplococci on Gram stain is suggestive of which organism?

a)

Treponema pallidum

b)

Trichomonas vaginalis

c)

Herpes simplex virus-2

d)

Neisseria gonorrhoeae

13.

TLS is characterized by the following:

a)

Hypocalcemia, hypouricemia, hyperkalemia

b)

Hyperphosphatemia, hyperkalemia, hyperuricemia

c)

Hypercalcemia, hyperkalemia, hypomagnesium

d)

Hypokalemia, hyperphosphatemia, hypouricemia

14.

A patient reports that he has been taking his finasteride daily for the last 6 months for BPH. His last PSA was 2.6 ng/mL. Today it is 1.3 ng/mL. This can be best explained by which of the following?

a)

Finasteride stops the prostate from producing PSA.

b)

Finasteride can cause erroneous results in laboratory testing for PSA.

c)

PSA levels are often significantly decreased in patients taking 5ARI.

d)

Both a and b.

e)

All of the above.

15.

Which of the following factors predicts a favorable chance to respond to erlotinib?

a)

A. Adenocarcinoma histology

b)

B. Squamous histology

c)

C. EGFR mutations present

d)

D. K-ras mutations present

16.

ZM is a 44-year-old, 170 lb man that was found unresponsive in the middle of a city street and brought to the emergency department by ambulance. He is noted to have a blood pressure of 115/60 mm Hg, a heart rate of 61 beats/min, a respiratory rate of 6 breaths/min, his ECG reveals a normal sinus rhythm, he is afebrile, has no apparent trauma, and is noted to have an odor of alcohol on his breath. Prescription bottles for methadone and clonazepam were found in his shirt pocket. The attending physician requests recommendations on the administration of flumazenil, naloxone, thiamine, and dextrose. Which of these agents would not be appropriate with ZM's history?

a)

Flumazenil

b)

Naloxone

c)

Thiamine

d)

Dextrose

17.

TT is a 52-year-old African American man concerned about colorectal cancer screening. He inquires about screening recommendations for someone of his age. What information should the pharmacist discuss with the patient?

a)

CT/PET of chest, abdomen, and pelvis

b)

Digital rectal examination

c)

Flexible sigmoidoscopy

d)

Colonoscopy

e)

CEA blood test

18.

FR is a 29-year-old woman with a chief complaint of dysuria. The physician orders a urinalysis and a urine culture. What is the most likely cause of the UTI?

a)

Acinetobacter baumannii

b)

Escherichia coli

c)

Pseudomonas aeruginosa

d)

Staphylococcus saprophyticus

19.

IE is a patient with non-hodgkins lymphoma (NHL) and presents to the oncology clinic for a follow-up evaluation. IE's labs reveal a low mean corpuscular volume and low serum ferritin. What type of anemia does IE have?

a)

Low mean corpuscular volume and serum ferritin are not associated with anemia

b)

Iron deficiency anemia

c)

Vitamin B12 deficiency anemia

d)

Anemia of chronic disease

e)

Aplastic anemia

20.

The administration of which of the following agents would be indicated in the setting of tricyclic antidepressant overdose associated with seizures or QRS interval >115 ms?

a)

Sodium bicarbonate

b)

Flumazenil

c)

Physostigmine

d)

Procainamide

e)

Both a and c