Pharmacy Prep
Evaluating Exam
Review and Guide
Q&A
MUST PASS July 2016
Pharmacy Prep
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Foreword by
Misbah Biabani, Ph.D
Coordinator/Director, Pharmacy Prep
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc
4789 Yonge St. Suites 417
Toronto ON M2N 5M5, Canada
Content
Abbreviations
PHARMACY PREP
HUMAN ANATOMY
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PharmacyPREP.com Human anatomy
Ans. D
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PharmacyPrep.Com Gastrointestinal System
PHARMACY PREP
GASTROINTESTINAL SYSTEM
1. A person with Vitamin B12 deficiency due to intrinsic factors. Should take?
A. Vitamin B 12 supplements
B. Vitamin B 12 IM inj.
C. Vitamin B 12 oral
D. Vitamin B 12 inj. and folic acid
Ans. B
3. Which of the following may increase excessive acid secretion in patient with?
A. high carbohydrate diet
B. high protein diet
C. High liquid diet
D. High salt diet
E. All of the above
Ans. b
6. Epigastric pain is a symptom of Ulcer. (less likely GERD), GERD is heartburn, this could be
regurgitation of acid into esophagus to throat.
2-1
PharmacyPrep.Com Gastrointestinal System
A. Ulcer
B. GERD
C. Appendicitis
D. Angina
E. All of the above
Ans. A
Tips: Epigastric pain is a symptom of Ulcer. (less likely GERD), GERD is heartburn, this could be
regurgitation of acid into esophagus to throat.
10. What is the most sensitive and specific means to diagnose the cause of dyspepsia?
A. Endoscopy
B. CT scan
C. Magnetic resonance imaging
D. Urea Breath Test
E. Esophagogastroduodenoscopy
Ans. A
2-2
PharmacyPrep.Com Gastrointestinal System
11. Which of the following bacteria can cause chronic peptic ulcer disease?
A. E. coli
B. H. pylori
C. S. aureus
D. S. pneumonia
E. Candida infections
Ans. B
12. What is the laboratory test confirm the peptic ulcer disease caused by H. pylori?
A. Endoscopy
B. CT scan
C. Magnetic resonance imaging
D. Urea Breath Test
E. Esophagogastroduodenoscopy
Ans. D
2-3
PharmacyPrep.Com Gastrointestinal System
17. A patient of your pharmacy, recently had gastrectomy and ileum was removed. Which of
the following can be deficient?
A. Iron deficient anemia
B. Calcium deficient due to deficiency of vitamin D
C. Vitamin B 12 deficiency due to deficiency of intrinsic factor
D. Vitamin K deficiency due to deficiency if GI bacteria
E. All of the above
Ans. C
2-4
PharmacyPrep.Com Nervous System
PHARMACY PREP
Nervous System
1. Which part of brain that controls important cognitive skills in humans, such as emotional
expression, problem solving, memory, language?
A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Parietal lobe E. Brainstem
Ans. A
4. Which part of brain that controls important cognitive skills in humans, such as emotional
expression, problem solving, memory, language?
A. Frontal lobe
B. Occipital lobe
C. Temporal lobe
D. Parietal lobe
E. Brainstem
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PharmacyPrep.com Cardiovascular System
PHARMACY PREP
CARDIOVASCULAR SYSTEM
1. Which of the following cardiovascular disease is the most commonly associated with
atherosclerotic plaques?
A. Angina
B. Myocardial infarction
C. Deep vein thrombosis
D. Ischemic stroke
E. All of the above
Ans. e
Tips: if stable plaque than commonly cause angina, if plaque is ruptured than cause
inflammation can lead to MI.
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www.Pharmacyprep.com Endocrine System
PHARMACY PREP.
ENDOCRINE SYSTEM
2. A diabetic patient mistakenly taken double dose of insulin. Which of the following is
NOT effect of excessive insulin administration?
A) Sweating
B. palpitation
C. Confusion
D. Diarrhea
E. Fatigue
Ans. D
5. MK is 30 year old female taking insulin for type 1 DM. Which of the following
conditions decrease requirement of insulin dose?
A) Pregnancy
B) Infection
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C) Physical activities
D) Heavy meals
E) Acute illness
Ans . C
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PHARMACY PREP
RENAL DISORDERS
4. A man with history of severe diarrhea, the loss of HCO 3 - from GI tract causes a
decrease in blood [HCO 3 -], and increase CO 2 his values are thus this man has? pH = 7.25,
pCO 2 = 24 mmHg, [HCO 3 -] = 10 mEq/L
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. Normal acid base status
Ans. B
6. A regular customer of your pharmacy, age 55 yo, medication profile include Ramipril
10 mg, valsartan 5 mg, and recently doctor added spironolactone. Patient diet include
excessive intake of bananas. All of the following are pharmacist concern, except?
A. Ramipril
B. Valsartan
C. Spironolactone
D. Age 55 yo
E. Bananas
Ans. D
9.A patient eGFR declined significantly and doctor suspect chronic kidney diseases. All of
the following are associated with chronic kidney disease, except?
A. Intravenous radiographic contrast
B. NSAIDs or COX-II inhibitors
C. Volume depletion
D. Strict blood pressure or blood glucose control
E. Aminoglycosides
Ans. D
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PharmacyPrep.Com Liver Function and Diseases
PHARMACY PREP
5. Liver cirrhosis is a type of end stage chronic liver disease (liver cirrhosis)? What clinical
laboratory tests is used to diagnose ?
A) ALT
B) AST
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C) Bilirubin
D) Albumin
E) LDH
Ans. C
Tips. The liver cirrhosis diagnosis can be confirmed by a liver biopsy (removal of a tissue
sample for examination under microscope). CT scan and ultrasound may show that liver
is shrunken or abnormalities.
Alcoholic liver disease can result into liver cirrhosis. Trans aminases AST to ALT ratio
>2:1 strongly suggest alcohol abuse.
6. MK is a 50 year old man diagnosed for ascites. Which of the following are causes of
ascites, except
A) Tuberculosis
B) Abdominal surgeries
C) Congestive heart failure
D) Stroke
E) Liver cirrhosis
Ans. D
Tips. Stroke is cerebrovascular conditions and not associated with chronic liver disease
ascites.
8. Liver enzymes like cytochrome CYP450 cause drug metabolism in liver. What is NOT
related to drugs that are metabolized in liver?
A) metabolism effects by tissue binding
B) metabolism changes with liver blood circulation
C) metabolism changes with intrinsic activity
D) metabolism effected by chronic liver diseases
E) oxidative metabolism is catalyzed by cytochrome CYP450.
Ans: C
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Ans. C
Tips: oral secretion contact can cause hepatitis A.
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PharmacyPrep.Com Respiratory System
PHARMACY PREP.
RESPIRATORY COMPLICATIONS
1) Emphysema is?
A) COPD
B) Fibrosis
C) Bronchitis
D) Airway disease
E) None of the above
Ans. A
2. Dyspnea means
A. Painful muscle spasms
B. Pain in the heart
C. Pain in extremities
D. Painful breathing
E. Painful menstruation
Ans. D
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Ans. A
6. All are correct concerning the action of corticosteroids in asthma status, EXCEPT:
A. Suppress the inflammatory response
B. Decrease production of inflammatory mediators
C. Decrease airway responsiveness to inflammation
D. Relieve brochocontriction
E. Increase β-agonist receptors response
Ans. E
8. Peak flow meter is test to determine asthma severity for patient at home. This test
measures?
A) The highest forced expiratory flow
B) Volume that has been exhaled at the end of the first second (FEV 1 ).
C) Total lung capacity
D) Expiration rate
E) Inspiration rate
Ans. A
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www.pharmacyprep.com Urinary System
Pharmacy Prep
Urinary System
E. Trimethoprim
Ans.c
11. Which of the following medical conditions cause difficulty to urination in stream?
A. Urinary tract infections
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www.pharmacyprep.com Urinary System
B. Prostatitis
C. Benign prostatic hyperplasia
D. Urinary incontinence
E. Cystitis
Ans: C
13. Hypertrophy
A. Increased in cell size
B. Increased in cell numbers
C. Decreased in cell size
D. Decreased in cell numbers
E. Increase cell size and numbers
Ans. A
15. KP is a 37 year old women. Presents to doctor with symptoms of frequent urination at
work place. Doctor has diagnosed with urinary incontinence. Her social history, denies
taking alcohol and smoking. She is mother of 2 children and gave a birth to her 3rd child
recently a month ago. What type of incontinence?
A) Urge incontinence
B) Overflow incontinence
C) Stress incontinence
D) Urinary tract infection
16. What drugs are least likely used in patient with urinary incontinence?
A. oxybutynin
B. diuretics
C. amitriptyline
D. All of the above
ans. B
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www.pharmacyprep.com Urinary System
17. Urinary incontinence in children is defined as repeated daytime or night time voiding
urine into the bed or cloths. It is termed as?
A. Bed sores
B. Bed wetting
C. Wetting Phenomenon
D. All of the above
Ans. B
19. Tamsulosin is used to treat benign prostatic hyperplasia symptoms. It blocks alpha 1a
receptors and facilitates urine flow?
A) coronary arteries
B) bladder arteries
C) prostate arteries
D) cerebral arteries
E) all of the above
Ans. B
21. Which of the following is least likely associated with UNCOMPLICATED urinary
tract infections?
A. dysurea
B. urinary urgency
C. fever
D. turbid urine
E. urinary frequency
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Ans. d
Ans.D
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PHARMACY PREP
The Eye
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Ans: A
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Ans. B
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Ans. c
B. clindamycin
C. azithromycin
D. clarithromycin
E. cephalexin
ans. a
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PharmacyPrep.Com Blood and Anemia
PHARMACY PREP
18) In microcytic anemia (iron deficient), all of the following decrease, except?
A) Mean cell volume (MCV)
B) Hematocrit (Hct)
C) Hemoglobin
D) Serum ferritin
E) Total iron binding capacity (TIBC)
Ans. E
Tips. In microcytic anemia total iron binding capacity increase. Hematocrit is actual volume of
RBCs in a unit volume of whole blood).
8. Which of the following is screening test is used to confirm iron deficient anemia?
A. MCV
B. Serum folate levels
C. Serum ferritin levels
D. RBC levels
E. Transferrin level
Ans. C
Tips. The screening test for iron deficient anemia is a ferritin level. Iron deficient anemia is
typically defined as ferritin level <30 ng/mL. However infections, inflammation and obesity
can influence ferritin level, in these situations definition changes to <50 ng/mL.
3. Hematocrit is?
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PharmacyPrep.Com Blood and Anemia
4. Which of the following iron supplements have the highest elemental iron?
A. Ferrous sulfate
B. Ferrous gluconate
C. Ferrous fumarate
D. Combination of iron supplements
E. All of the above
Ans.C
Tips. Ferrous fumarate 33%, Ferrous sulfate 20%, Ferrous gluconate 12%.
5. A 59 yo lady comes to pharmacy to buy some iron supplements. She currently using
ibuprofen 400 mg qid for her joint pains. She feels like she is very week and fainting. She
observed occult blood in stool, however she is NOT sure? What is appropriate to do?
A. Recommend ferrous fumerate because high elemental iron
B. Recommend ferrous glucose because it is light on stomach
C. Refer her to doctor to determine cause of bleeding
D. Ask her to stop taking ibuprofen
E. Ask her to take low dose of ibuprofen
Ans: C
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9. Blood hemoglobin transport oxygen in systemic circulation. The form of iron present in
hemoglobin is?
A. Ferrous Fe3+
B. Ferric Fe2+
C. oxidized form
D. oxyhemoglobin
E. Methemoglobin
Ans. B
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PharmacyPREP.COM Biochemistry
PHARMACY PREP
BIOCHEMISTRY
5. Gluconeogenesis is?
8. The protein three dimensional structure and linked with disulphide bonds is?
A. primary
B. secondary
C. tertiary
D. quaternary
Ans. C
9.Which of the following protein structure describes more than one amino acid chain?
A. primary
B. secondary
C. tertiary
D. quaternary
Ans. D
D) Phenyl alanin
E) Acetyl CoA
Ans. C
11. Heme containing enzymes are formed from protoporphyrin. What are the
examples of heme containing enzymes or proteins?
A) hemoglobin
B) myoglobin
C) cytochrome oxidase
D) all of the above
Ans. D
12. Which of the following is the rate limiting step in atherosclerosis formation?
A. HMG-COA to mevalonate formation
B. Mevalonate to cholesterol formation
C. Low density lipoprotein formation'
D. Lipid synthesis
Ans. A
PHARMACY PREP
NUTRITION
5. A breast fed infant should recieved which of the following vitamin drops?
A. Vitamin A drops
B.Vitamin B 12
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C.Vitamin C
D.Vitamin D drops
E. Vitamin E drops
Ans. D
8. What is the closes option to breast milk for infant at age of 3 mo?
A. Formula milk
B. Cow based formula milk
C. Soy based formula milk
D. Lactose free formula milk
E. Cow milk
Ans. B
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PharmacyPrep.Com Microbiology
PHARMACY PREP
MICROBIOLOGY
1. Colon is large intestine which contains which of the following type of bacteria:
A. 95% to100% anaerobic
B. 95% to 100% aerobic
C. 30 to 50% anaerobic
D. 30 to 50% aerobic
E. There is no bacteria in lower gut
Ans . A
2. The most common causative organism of community acquired pneumonia (CAP) is:
A. S. pneumonia
B. M. pneumonia
C. H. influenza
D. S. aureus
E. E. coli
Ans. A
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PharmacyPrep.Com Microbiology
9. MK is a 27 year old man presents with persistent ear pain for last 2 days and
associated with drainage. Pharmacist refer patient to physician because?
A. otitis externa caused by P. aeruginosa and S. aureus
B. Because it is associated with drainage
C. Because ruptured tympanic membrane
D. because ear pain with drainage could be perforation of tympanic membrane or
drainage from middle ear.
E. Because it can cause hearing loss
Ans.D
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PHARMACY PREP
2. Translation occurs:
A) Before transcription
B) After transcription
C) Same time as transcription
D) in mitochondria
E) in chromosomes
Ans. A
4. A woman carrying hemophilia and has a child from a man with hemophilia. Which of
the following is NOT her child?
A. A girl with hemophilia
B. A boy with hemophilia
C. A girl having no gene of hemophilia
D. A girl having the gene of hemophilia
E. A boy having no hemophilia
Ans. C
m X Y
w
X xx xy
X xx xy
XX = Women with hemophilia
XY = Man with hemophilia
XY = Man with NO hemophilia
XX = Women with hemophilia carrier
5. What is cDNA?
A. DNA template produced by mRNA, is complementary DNA (cDNA)
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8. Centrosomes?
A) Centrosomes contains acid hydrolyzing enzyme
B) Centrosomes are main organizing microtubule centre
C) Centrosomes contain protein (rough) and lipid (smooth) synthesis
d) Centrosomes are primary site for biological protein synthesis.
E) Centrosomes are enzymes that produces and decomposes hydrogen peroxides.
peroxisomes breakdown long chain fatty acids
Ans. B
Tips. Centrosomes are organizing microtubule centre Lysosome contains acid
hydrolyzing enzyme. Endoplasmic reticulum contain protein (rough) and lipid (smooth)
synthesis. Ribosomes are primary site for biological protein synthesis. Peroxisomes
contains enzymes that produces and decomposes hydrogen peroxides. Peroxisomes
breakdown long chain fatty acids.
9 Antisense RNA targets specific viral or microbial nucleic acid sequences that interferes
with normal replication and expression. The antisense technology targets?
A. Tcell
B. B Cell
C. DNA
D. mRNA
E. cDNA
Ans. D
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PHARMACY PREP
PHARMACOGENETICS
2. What is SNP?
A. Single nucleotide polymorph
B. Single nucleotide pharmacogenetic
C. Single genetic markup
D. Single genetic variation
E. Single nucleotide product
Ans. A
Tips. The SNP is single nucleotide polymorphism (SNP). It occurs when one base pair of
nucleotide replaces another. A single base differences that exist between individual. This is
the most common genetic variation in DNA.
3. If you know person genetics mark up, and target a medicine is defined as?
A. pharmaceutics
B. biotechnology
C. Nanotechnology
D. Pharmacogenetics
E. Molecular biology
Ans. D
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PHARMACY PREP.
IMMUNOLOGY and Immunizations
3. A 70 yo elderly patient is treated with antibiotics for 7 days. However, still have signs
of symptoms of infections such as fever. The patient neutrophil count is still increased
over 70%. What kind of infections patient have?
A. parasitic
B. viral
C. fungal
D. inflammation
E. bacterial
Ans. E
5. A HIV patient currently has CD 4 T cell count is 300. What treatment doctor may target
for prophylaxis?
A. M. Tuberculosis
B. Cytomegalvoirus
C. Pneumocytisis pneumonia jerovicii or carinii
D. Non-Hodgkins lymphoma
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E. Kaposis sarcoma
Ans. A
9.All of the following are NOT recommended for flu vaccine, except?
A) Child under 6 months age
B) A person allergy to eggs
C) Person with currently acute bronchitis symptoms
D) Pregnant
E) Person with current symptoms of pneumonia
Ans. D
10. Which of the following populations is LEAST considered high risk for influenza so
that vaccination with influenza vaccine is not necessary?
A) Person age > 5 yrs to 50 yrs
B. Residents of long-term care facilities (e.g., nursing homes)
C. Patients with diabetes mellitus
D. Patients over the age of < 65 yo
E. Patients with COPD or asthma
Ans. A
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PHARMACY PREP
BIOTECHNOLOGY
1. Herceptin (Trastuzumab), is
A. Treatment of HER2-overexpressing metastatic breast cancer
B. Tumor necrosis factor alpha inhibitor
C. Glycoprotein inhibitor
D. Interleukin
E. Interferon's
Ans: A
7. Filgrastim is?
A. Colony stimulating factor
B. Erythropoietin's
C. Interferon's
D. Human growth hormones
E. Monoclonal antibodies
Ans: A
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8) Operlaveukin is?
A) Interleukin 11
B) Colony stimulating factor
C) Interleukin 3
D) Interleukin 2
E) Epoeitin
Ans. A
HAMA is?
A) Human antigen and Mouse antibody
B) Human antimouse antibody
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Murine antibody
C)
D) Humanized antibody
E) Human antibody
Ans. B
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PHARMACY PREP
TOXICOLOGY
Ans. B
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47. B
BIBLIOGRAPHIC REFERENCE
4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS -
2003/2004
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6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.
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PHARMACY PREP.
PHARMACOKINETICS
PHARMACOKINETIC FORMULAS
Vd = D/Cp
Cp = D/Vd
D = Vd x Cp
V d = CL T /K el
t 1/2 = 0.693 /K el
K el = 0.693/t 1/2
1) A dose of 240 mg was given to a patient, his total body clearance is 3.5 L/min and
the drug excreted unchanged in the urine is 80 mg. What is his non-renal clearance?
a) 240 ml/min
b) 2.3 L/min
c) 3.3 L/min
d) 1.16 L/min
e) 160 ml/min
Ans. B
Renal clearance is drug excreted unchanged or metabolized in urine.
CL T = CL R +CL NR
CL NR = CL T - CL R
240 mg................3.5 L
80 mg....................?
=1.16 L
= 3.5 - 1.16 = 2.3L
or
3.5/240 mg = ?/80 mg
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Ans. B
3.A dose was given, the plasma concentration was 64 mg, t 1/2 =0.7 hrs. After 7 hours
from the initial dose, what is the drug's concentration?
a) 0.0mg
b) 1mg
c) 2mg
d) 3mg
e) 4mg
Ans. A
or
C = C o . e-kt
K = 0.693/t 1/2
K = 0.693/0.7 = 0.999
C = 64 x e(-0.999x7) = 0.06
or
ln C = -kt + ln C o
How to use calculator (Sharp EL-510RN)
Enter 64
Multiply
Enter 2ndF
Enter ex
Enter (
Enter (-)
Enter
Enter )
Enter =
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4. A 40 year old patient who weighs 70 kg, needs intravenous infusion of amoxicillin. The
desired C ss of drug is 15mg/dL. The physician ordered antibiotic infused for 10 hours.
Amoxicillin has t 1/2 = 1 hour and Vd = 9L.
What rate of iv is recommended for this patient? (no loading dose was given);
A. 135 mg/hr
B.936 mg/hr
C. 1000 mg/hr
D. 333 mg/hr
E. 400 mg/hr
Ans. B
Tips:
C ss = R___
K x Vd
R = Rate of infusion
K = first order elimination constant
V d = volume of distribution
R = C ss x k x V d
R = 15 0.693 x 9000 =
100 1 hour
= 935.54 mg/hr
5) If the rate of infusion of the drug is 500 mg q8h and clearance is 7.3 L/hr. Find steady
state concentration
a) 85.6 mg/L
b) 856 mg/L
c) 8.56 g/L
d) 8.56 mg/L
e) 68.4 mg/L
C ss = rate of infusion/clearance
Css = R/CL
CL = R/Css
R = Css x CL
CL = K x Vd A patient parameter include elimination rate contant 0.17 h-1 and
volume of distribution 11.8 L. What is clearance? 2.02 L/h
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Ans. D
7. A drug was found to have zero order kinetic 100 mg after 6 days 99 mg. How
long it will take to eliminate the entire drug from the body?
a) 100 days
b) 200 days
c) 300 days
d) 600 days
e) 900 days
Ans. d
8. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and
follows zero order kinetics. After 5 min how much drug will be absorbed?
A. 10 mg
B. 50 mg
C. 75 mg
D. 100 mg
Ans. b
9. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and
follows zero order kinetics. How long it takes to absorb all the drug?
A. 10 min
B. 50 min
C. 75 min
D. 100 min
Ans. A
10. Ampicillin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026
h. What is the shelf life of ampicillin?
a) 4 hr
b) 8hr
c) 2hr
d) 16hr
e) 12hr
Tips. T 90 = 0.105/K
T 90 = 0.105/0.026 = 4hrs
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11. Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal
dosage schedule for cloxacillin is 125 mg q6h, a patient with renal function 20% of
normal should receive?
a) 25 mg q6h
b) 31.25 mg q6h
c) 62.5 mg q6h
d) 75 mg q6h
e) 125 mg q12h
Tips:d
62.5 mg 62.5 mg
12.5 mg 62.5 mg
or
50-20 = 30%
50% .............125
30%................?
12. Drug which dose is 1500 mg is given every 24 hours. The renal clearance of this
drug is 1.2 mg/dL. Calculate the clearance in ml/min.
a) 98.6 ml/min
b) 76.8 ml/min
c) 86.8 ml/min
d) 66.8 ml/min
e) 43.6 ml/min
Ans. C
Tips
1.2 mg...........100 mL
1500 mg..........?
125,000............1440 min
? mL.........................min
= 86.8 ml/min
or
1.2 mg --------100 ml 125000 mls--------1440 min (60 min x 24 hrs)
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or
13. If a drug is 50% metabolized and half life drugs is 1 hr . What is the percentage of
blood concentration after 4hrs?
a) 50%
b) 25%
c) 12.5%
d) 6.25%
e) 3.12%
Ans. D
Tips: 100 50% --> 25 -->12.5 --> 6.25%-->
or
Drug concentration = 100%
t 1/2 (decrease the drug by half) = 50%
2 t1/2 t1/2 t1/2 = 6.25%
14. A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus
injection to a 32 years old female who weighed 75Kg. The antifungal has an
elimination half life of 2 hours and apparent volume of distribution of 0.28L/Kg.
What is the initial plasma drug concentration in this patient?
a) 36 mg/L
b) 1.8 mg/L
c) 17.8 mg/L
d) 1.79 mg/L
e) 19 mg/L
Ans. C C p = D o C p = 5 mg/Kg = 17.8mg/L
Vd 0.28L/kg
15. Following the anterior information, calculate the predicted plasma concentration at
8 hours after the dose:
a) 15mg/L
b) 111mg/L
c) 11.1mg/L
d) 1.11mg/L
e) 2.64mg/L
Ans. D Cp initial = 17.9mg/L and elimination t 1/2 is 2hours
Cp = 17.9 after 2 hours = 8.95
Cp = 8.95 after 2 hours = 4.47
Cp = 4.47 after 2 hours = 2.23
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16. Following the same anterior information, calculate how much drug remains in the
patient body, 8 hours after the administrated dose:
a) 23mg
b) 112mg
c) 100mg
d) 15.3mg
e) 84.4mg
17. Following the anterior information, how long after the dose is exactly 75%
eliminated from the patient body?
a) 2 hours
b) 4 hours
c) 6 hours
d) 8 hours
e) 10 hours
Ans. B Initial dose = 375mg and elimination t1/2 is 2hours
Cp = 375mg after rs
a er rs
4 hours → 75%
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20. Still following the information of the anterior questions, calculate the corresponding
loading dose:
a) 98mg
b) 160mg
c) 48mg
d) 24mg
e) 100mg
16- A LD = V ss
21. Drug A bind to 28% with protein, when given at dose 150 mg/day. If given to 300
mg/day, what % of drug A bind with protein. Mol.wt of protein is more than drug A.
A-56% B-28% C-14% D-80% E-60%
Ans-B
22. Two drugs that metabolized by the kidney and liver. Which one has first pass
metabolism?
drug x drug y
CL t 1100 460
CL r 110 20
Vd 3.3 2
ProteinBinding 85% 90%
A) Drug x = oral
B) drug y = oral
C) drug y = rectal
D. drug x = rectal
Ans. B
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23. Mr. Florence Backs is a 72-year-old patient weighing 71.8 kg who is taking
aminophylline 250mg by i.v. at stat. and then was given immediately by i.v. drip at a rate
of 40mg/hour. Theophylline level at stat = 7.5mg/ml and V d of theophylline is 0.5L/kg.
What is the expected serum concentration after the initial dose?
a. 5.55mcg/ml
b. 13.1mcg/ml
c. 7.5mcg/ml
d. 6.8mcg/ml
Ans-B
Co = Dose x F x S
Vd
= 250 x 1 x 0.8 = 5.55 ug/ml
(0.5) (71.8 kg)
Ans: D
27. What is the F value for an experimental drug tablet based on the following data?
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Drug Dose
Form Dose AUC (µg/ml/mL/h)
Tablet 100 mg po 20
Solution (control) 100 mg po 30
Injection (control) 50 mg IV push 40
a) 0.25
b) 0.38
c) 0.50
d) 0.66
e) 0.90
Ans. A
29. Using the above data the absolute bioavailability of Company B tablets is best
estimated to be
a) 25%
b) 40%
c) 44%
d) 68%
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e) 87%
Ans. C
Tips: The best measure of absolute bioavailability is considered to be AUC of iv. Because
AUC iv is not available for this drug, the next best comparison will be the cumulative
drug amount found in the urine.
Because iv dose was 10 mg, whereas the oral tablet dose was 20mg, a correction factor
of 2 x is needed.
Cumulative amount is 20 mg injected.
9.4 x 2 = 18.8
8.2/18.8 = 0.44 or 44%
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PHARMACY PREP.
RATES AND ORDERS OF REACTIONS
2. The time it takes to infused drug to reach plasma steady state concentration (Css)
depends on:
I-Elimination half-life of drug.
II-Fraction of free excreted in urine
III-Plasma concentration curve
A. I only B. III only C. I and II only D. II and III only E. All of the above
Ans. a
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6.A drug completely renally eliminated. The patient has renal failure. This drug is hepatic
metabolized. What will happen to drug?
A. Drug metabolite accumulates in blood
B. Drug is completely in metabolized in liver
C. Drug is completely eliminate renally
D. Drug is completely protein bound
E. Drug have linear kinetic
Ans. A
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PHARMACY PREP
PHARMACODYNAMICS
27-1
Pharmacyprep.com Medicinal Chemistry
PHARMACY PREP.
MEDICAL CHEMISTRY
Terfinadine Fexofenadine
A) 1 B) 2 C-3 D) 4 E) None
Ans.B
4. If a drug chemical structure has 3 chiral carbons. How many optical isomers are
possible?
A) 2 B) 4 C) 8 D) 9 E) 12
Ans. C
2n = 22 =2x2=4
n= number of chiral centers
23 = 2 x 2 x 2 = 8
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Pharmacyprep.com Medicinal Chemistry
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PharmacyPREP.Com Medicinal Chemistry of autonomic nervous system
Pharmacy Prep
NH2
HO Dopamine
OH
OH H OH H H
NH2 CH3 N CH3 N CH3 N CH3
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PharmacyPREP.Com Medicinal Chemistry of autonomic nervous system
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PharmacyPrep.Com Medicinal Chemistry of autocoids and analgesics
PHARMACY PREP
2. Ecosonides are?
A. Leukotrienes
B. Prostaglandins
C. serotonins
D.Histamines
Ans. b
3.Ondansetron is?
A. Serotonin type 1 antagonist
B. Serotonin type 2 antagonist
C. Serotonin type 3 antagonist
D. Serotonin type 3 agonist
Ans. C
5.Glutathione is?
A. cysteine, glycine and lysine
B. cysteine, glycine and tryptophan
C. cysteine, glycine and glutamate
D. Cysteine, glycine and isoleucine
Ans. C
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PharmacyPrep.Com Medicinal Chemistry of autocoids and analgesics
11
HO
A) Prostaglandin E
B) Prostaglandin F
C) Prostaglandin G
D) Prostaglandin H
E) Prostaglandin I
Ans. A
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PHARMACY PREP.
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF CARDIOVASCULAR SYSTEM
4.. Imidazoline is a molecular structure that contains a heterocyclic ring and belongs the
molecular structure of:
A. Prazosin
B. Nifedipine
C. Atropine
D. Clonidine
E. Allopurinol
Ans. D
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7) What functional group is responsible for metallic taste or taste changes in captopril?
A) Sulfonamide
B) Sulfide
C) Sulfhydril group
D) Proline ring
E) Carbamate group
Ans. A
10 ce a a e a car n c an rase re c an r c r a e a a e
diuretic have an identical molecular group very important in their structure knows as:
A. Sulfonamide group
B. Pyrimidine group
C. Purine group
D. Pyrrolidine group
E. Ether group
Ans. A
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O
HS - H2C
N
CH3
CO2H
A) Diuretics
B) Angiotensin converting enzyme (ACE) Inhibitors
C) Calcium channel blockers
D) Selective Serotonin Receptor Inhibitors
E) Angiotensin Receptor Blockers (ARBs)
Ans. B
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Tetrazole ring OH
N N
N
N
H
Losartan
A) Tetrahydropyrazole ring
B) On position 2 ethyl alcohol on imidazole ring
C) Two ring structure
D) Alkyl long chain on imidazole ring
E) AT 1 receptors
Ans. B
16) HMG Co A reductase inhibitor like statins effective lowers LDL. What is incorrect?
-dihydroxycarboxylate is essential for SARs
B) Myopathy SE is e ass c a e s a ns s s n re -MM
C) Initial SEs include stomach upset like diarrhea
a ns ncrease er en es s n r s
E) Statins combined with niacin decrease the risk of myopathy
Ans: E
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A. Leukotriene antagonists
B. Beta blockers
C. Coumarins
D. Calcium channel blockers
E. Benzodiazepines
Ans: D
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PHARMACY PREP
4. Which of the following SSRI least likely associated with withdrawal symptoms?
A. Trazodone B. Amitriptyline C. Phenelzine D. Fluoxetine E. Mirtazapine
Ans. d
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6.MP is 20 yo man using lithium carbonate 400 mg QID for the treatment of manic depression.
Patient presents with tremors. All of the following drugs increase lithium toxicity by
increasing lithium serum concentration, except
A. Ramipril
B. Naproxen
C. Caffeine
D. Hydrochlorothiazide
Ans. C
7. Which of the following drug combination least likely cause serotonin syndrome?
A. Phenelzine and fluoxetine
B. Phenelzine and amitriptyline
C. Phenelzine and Tranylcypromine
d. Bupropion and trazodone
E. Selegiline and tramadol
Ans. e
Tips. bupropion and trazodone have weak affect on serotonins, thereby less likely serotonin
syndrome. The most likely are combination with MAOi like C.
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10. Which of the following is correct about dibenzazepine drugs like clozapine and
quetiapine?
A. Act more effectively on D 2 receptors than 5HT 2
B. Acts more effective on 5HT 2 than D 2 receptors
C. Acts more effective on 5HT 2 and M 1
D. Acts more effectively on D 2 and 5HT 2 , H 1 , M 1 and alpha1
E. acts on D 2 receptors only
Ans. B
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PHARMACY PREP
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF ENDOCRINE SYSTEM
28-1
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PHARMACY PREP
2. An asthma patient using salbutamol PRN but her asthma is not controlled. What drug is
added next?
A. Salmeterol
B. Fluticasone inhaler
C. Prednisone oral
D. Montelukast
E. Theophylline
Ans. b
3. A patient using salbutamol for the past 6 months, but asthma is not controlled. Which drug is
added next?
a. Increase salbutamol dose
B. Inhaled corticosteroids
C. Formterol
D. Oral prednisone
Ans. b
29-1
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6. COPD patient currently using salbutamol PRN, ipratropium PRN, tiotropium daily,
theophylline bid and Formoterol daily.
Which of the following drug is the pharmacist concern?
A) salbutamol B) ipratropium C) tiotropium D) formoterol
E) theophylline
ans. E
Tips. Theophylline can cause tachycardia, tremors, nervousness, insomnia, abdominal cramps,
Nausea and vomiting.
7.A 50 yr old COPD patient exacerbations, which of the following antibiotics is least likely used?
a. amoxicillin B. cotrimoxazole C. azithromycin D. doxycycline E. ciprofloxacin
Ans. E
Tips. ciprofloxacin is least likely used for respiratory tract infections. However respiratory tract
fluroquinolones levofloxacin and moxifloxacin can be used.
29-2
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PHARMACY PREP
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF MUSCULOSKELETAL DRUGS
What analgesics drugs are NOT used to treat acute gout attacks?
A) allopurinol
B) acetaminophen
C) colchicine
D) dexamethasone
E) indomethacin
Ans. b
Prednisone used in treatment of gout arthritis (intra articular inj.) and severe asthma
(oral). What is correct?
A) gout patient may have more systemic SEs
B) asthma patient may have more systemic SEs of steroid
C) Asthma & gout patient have same SEs
D) Only gout patient have prednisone SEs
E) None of the above
B. Murine MAB
C. Mice MAB
D. Chimeric MAB
D. Human MAB
Ans.d
Q. Bisphosphonates are?
A. osteoclasts
B. Osteoblast
C. Pyrophosphate
D. Phosphoric acids
E. calcium phosphate
Ans. c
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Pharmacy Prep
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF ANTIMICROBIALS
MP is 49-year-old women using calcium carbonate 500 mg QD and bring a new prescription of
ciprofloxacin 500 mg BID for 3 days to treat UTI. What is appropriate?
a) Skip calcium supplements for 3 days and take ciprofloxacin
b) Take ciprofloxacin morning and supper time and take calcium 2 tab morning.
C) take ciprofloxacin morning 2 tab and calcium 2 tab at supper time
D) Take ciprofloxacin morning and supper and calcium 2 tab at noon.
Ans. D
All of the following drug can cause serotonin syndrome when combined with MAOi, except?
A. St. John wart
B. Linezolid
C. Fluoxetine
D. Amitriptyline
E. Amoxicillin
Ans. E
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PHARMACY PREP.
METABOLISM
Q. What is the common metabolic reaction of acetyl salicylic acid?
A. glucuronidation
b. glutathione conjugation
C. Glycine conjugation
D. Hydroxylation
E. oxidative deamination
Ans. C
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PHARMACY PREP
BIOPHARMACEUTICS
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Ans. A
3. Determine the F value for a capsule AUC 20 mg/dL/hour with 100 mg dose when i.v
of same drug AUC is 25 mg/dL/hour with 100 mg dose.
A. 20%
B. 60%
C. 40%
D. 80%
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E. 100%
Ans. D
AUC po x 100 = 80%
AUC iv
4. Determine the F value for a capsule AUC 20 mg/dL/hour with 50 mg dose when i.v of
same drug AUC is 25 mg/dL/hour with 100 mg dose.
A-20% B-60% C-40% D-80% E-160%
Ans. E
AUC po x 100
AUC iv
AUC po = 20 x 2 = 40 mg = 1.6 x 100 = 160%
25 mg
Ans- C We need to multiply the IV dose by 5 to find the same dosage so:
IV Push---------------50mg---------------AUC 250
Physiochemical factors affecting the rate and extent of drug distribution includes?
a) plasma protein binding
b) types of surfactant in preparation
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PharmacyPREP.Com Physical Pharmacy
PHARMACY PREP.
PHYSICAL PHARMACY
1. Which of the following equations can be used to easily calculate the pH. of a buffer
solutions constituted of a weak acid and its salts.
A. Hixson-Crowell equation
B. Arrhenius equation
C. Stokes equations
D. Henderson-Hasselbalch equation
E. Noyes-Whitney equation
Ans. D
Tips: Henderson-Hasselbalch equations used to mathematically calculate the pH of a
buffer solution.
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PharmacyPREP.Com Physical Pharmacy
5. Lyophylization method
A. sublimation of dry powder to vapor
B. drying wet drug to dry powder
C. powder sterilization methods
D. gaseous sterilization
Ans. B
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PharmacyPrep.Com Pharmaceutical Excipients
PHARMACY PREP
PHARMACEUTICAL EXCIPIENTS
Q. Ascorbic acid?
I. Acidifying agent
II. water soluble antioxidant
III. Water soluble vitamin
A. I only B. III only C. I and II D. II and III E. I, II,II
Ans.E
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PHARMACY PREP
RHEOLOGY
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PHARMACY PREP
PHARMACEUTICAL DOSAGE FORMS
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PHARMACY PREP.
DRUG DELIVERY SYSTEMS
1. What is incorrect about transdermal drug delivery systems?
A. Drugs with long half life are preferred
B. Transdermal drugs after topical application on skin surface have systemic absorption
C. Transdermal drugs are absorbed by diffusion method
D. Systemic absorption is maintained throughout the dosing interval
E. Transdermal patches is essential to contact with skin
Ans. A
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PHARMACY PREP.
PHARMACEUTICAL ANALYSIS
6. All of the following detector are used in High Performance Liquid Chromatography
(HPLC): EXCEPT:
A. Diode Array Detector
B. UV detector
C. Refractive Index detector
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D. Gamma Rays
E. Radioactive detector
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C. Increase in conductivity
D. Lowering of freezing point
E. Magnitude of vapor pressure
18. Atoms with the same number of protons are known as:
A. I only B. III only C. I and II only D. II and III only E. All are correct
20. Instrument used to measure quantity of two liquids with equal volume:
A. Picnometer
B. Hydrometer
C. Thermometer
D. Thermostat
E. Tensiometer
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22. Kind of solvent where acids and bases are produced, react and dissociates producing
such anion or cation species is called:
A. Amphiprotic solvent
B. Protophilic solvent
C. Aprotic solvent
D. Protogenic solvent
E. Inert solvent
25. Considerations that should be taken in selecting a solvent for an assay analysis:
A. Nature and solubility of the sample under investigation
B. Side reactions should not occur between the sample in analysis and the solvent
C. The solvent should be pure, low toxic and inexpensive
D. Solvent should have a high dielectric constant
E. If the sample is a weak acid the solvent should also be a weak acid
27. Dimethyl formamide is a solvent used in the assay of which of the following drugs?
A. Adrenaline B. Sulfonamides C. Cimetidine
D. Chlortalidone E. Levodopa
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PHARMACEUTICAL ANALYSIS
ANSWERS
1. Ans: C
Tips: Salting out is characterized when the addition of a solute in a solution cause the
decrease of solution solubility, when the addition of a solute cause the increase of
solubility is called salting in.
2. Ans: E
Tips: Amphiprotic is a type of solvent where acids and bases are produced. It reacts and
dissociates producing such anion and/or cation species.
3. Ans: B
Tips: M+ molecular ion is detected by mass spectroscopy that determines the molecular
weight of the sample.
4. Ans: D
Tips: Gas chromatography is a chromatographic method used to separate volatile
organic compounds as alcohol, hydrocarbons and aerosols.
5. Ans: D
Tips: Mass spectroscopy may be used as adjunct in gas chromatography.
6. Ans: D
Tips: X-rays are not used as detectors in HPLC
7. Ans: C
Tips: TLC-Thin Layer Chromatography is a very fast and simple chromatographic method
that separates organic compounds, progress of organic reactions, and tests the purity of
products by capillary theory.
8. Ans: B
Tips: Freeze dryer is used for the conversion of wet powders to dry powders.
9. Ans: D
Tips: Radiation is the most appropriated sterilization method for hormones; the only
exception is testosterone that is normally sterilized by dry heat sterilization.
10. Ans: C
Tips: Ethylene oxide sterilization is a very effective technique that combines heat and
moisture having a very high penetration power to sealed containers.
11. Ans: A
Tips: Amphetamines can be extracted from plasma by ether.
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12. Ans: E
Tips: HPLC- High Performance Liquid Chromatography is a method that utilizes high-
pressure pumps to increase efficiency in the separation. The mobile phase is normally
an aqueous solution and the particles size of the stationary phase definitely alters the
effect of resolution.
13. Ans: C
Tips: Colligative properties in physical chemistry, depending on the number of molecules
present in a given space, rather than on their size, molecular weight or chemical
constitution. The colligative properties of solutions are osmotic pressure, boiling point
elevation, freezing point depression, and vapor pressure lowering.
14. Ans: A
Tips: Colligative properties in physical chemistry of a solution, depending on the number
of molecules present in a given space, rather than on their size, molecular weight or
chemical constitution.
15. Ans: B
Tips: 15- Colligative proprieties are important in determining the tonicity of the
solution. The colligative properties of solutions are osmotic pressure, boiling point
elevation, freezing point depression, and vapor pressure lowering
16. Ans: C
Tips: The only function of plates in TLC is support the mobile phase that moves by
capillary mechanism through the stationary phase (plates).
17. Ans: A
Tips: Buffers are added to the solutions exactly to avoid the change in the solution’s pH,
therefore if added to the solution will not affect the reaction.
18. Ans: B
Tips: In physical chemistry, isotopes are atoms with the same number of protons.
Isotones with the same number of neutrons and isobaros with the same number of
mass.
19. Ans: B
Tips: Hydrometer is an instrument used to measure specific gravity by floating in a
liquid: Hydrometer (SWIM in water)
20. Ans: A
Tips: Picnometer is an instrument used to measure quantity of two liquids with equal
volume
21. Ans: E
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22. Ans: A
Tips: Amphiprotic solvent as water, acetic acid, methanol and ethanol are kind of
solvents where acids and bases are produced, react and dissociates producing such
anion or cation species.
23. Ans: C
Tips: Titration is a determination of a given component in a solution by addition of a
liquid reagent of known strength until a given endpoint is reached. Non-aqueous
titration can be used in the assay of some materials that cannot be easily titrated in
aqueous system.
24. Ans: A
Tips: The end point of a titration analysis is characterized by change in color.
Commonly used indicators include triphenyl methane group corants and azo group
corants.
26. Ans: D
Tips: Formic acid is a solvent used in non-aqueous titration in the assay of levodopa and
methyldopa
27. Ans: B
Tips: Dimethyl formamide is a solvent used in non-aqueous titration in the assay of
sulfonamides, allopurinol and acetazolamide.
28. Ans: C
Tips: mass spectroscopy methods
29. Ans: B
30. Ans: A
31. Ans: A
32. Ans: B
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BIBLIOGRAPHIC REFERENCE
4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS -
2003/2004
6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.
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PharmacyPrep.Com Canadian Healthcare System
PHARMACY PREP
2. A pharmacist is?
A. primary health care member
B. secondary health care member
C. tertiary health care member
D. Community health Centre
E. Public health care system
Ans. A
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PHARMACY PREP
1. All of the following are regulated as schedule 2 drug in harmonized drug schedule,
except?
A. Lactulose B. Vitamin B 12 inj. C. Dukoral D. Mupirocin E. Ferrous gluconate
Ans.d
3. Which of the following drug comply with the requirements of the Narcotic
Regulations?
A. Alprazolam
B. Tylenol # 1
C. Ketamine
D. Amphetamine
E. Methylphenidate
Ans. C
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6.A women, she recently moved into your pharmacy area from other neighborhood. She
comes with request to transfer her son prescription of methylphenidate from her
previous pharmacy. What is appropriate action?
A. Call other pharmacy get prescription transferred
B. Ask her to get a new prescription because it cannot be transferred
C. Give her part fill of methylphenidate
D. Tell her to call other pharmacy to request for Rx transfer
E. Talk to her and ask the reason for moving in this area
Ans. B
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PharmacyPrep.Com Social, Behavioral Aspects of Pharmacy Profession
PHARMACY PREP
1. A staff pharmacist reports about a pharmacy manager billing, excessive fee to long term
care. What is termed as?
A. conflict of interest
B. integrity
C. whistle blowing
D. revenge
Ans. c
2. A pharmacy owned by two partners. One of the partner billing excessively to long term
care. The partner was caught by college of wrong doing. The other partner claim he is not
aware of the fraud?
A. two partner are responsible for crime
B. the person who committed crime is responsible
C. two of them are not responsible
D. college of pharmacy is responsible
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PHARMACY PREP
PHARMACY MANAGEMENT
1. Pharmacy ABC has sales of prescription medication for the year 2013 to 2014. In
order to find out profit of pharmacy ABC, which of the following financial statement
may be useful:
I-Balance sheet II-Retain earning statement III-Income statement
A. I only B. III only C. I and II only D. II and III only E. I, II, and III
4) Cost of goods for a drug is $10 and mark up is 30%. What is retail price? Prescription
fee is $10. What is the total amount customer pay?
A) $13 B) $10 C) $23 D) $22 E) $33
5. A financial statement that is used to determine the total value of Rxs drug sales for a
pharmacy during the course of a year is known as:
A. Income statement B. Profit statement C. Retained statement D. Net
income E. Balance sheet
6. Delegation includes:
I) Delegating a project to technician
II) Supervising technician in project
III) Monitoring completion of project
A. I only B. III only C. I and II only D. II and III only E. I, II, III
8. The manager of the pharmacy made a list of work that should be done by his
employees in order of priority, this is called
A. Delegation B. Job analysis C. Job description D. Negligence E. None of the
above
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10. A senior pharmacy technician has a worked in a community pharmacy for 10 years.
He is well trained and welcomes new learning opportunities. His manager now wanting
to delegate a new technical project to him, should:
I) Discuss suggested steps to accomplish the project
II) Negotiate a time schedule for completion of the project
III) Provide support and follow up as required
A. I only B. III only C. I and II only D. II and III only E. I, II, and III
11. Which of the following is the most important component of business plan:
A. Location analysis B. Market area analysis C. Site analysis D. Product
analysis E-None of the above
13. Computer software and hardware program very useful in pharmacies that combines
and track all the business information as product information, cash register, inventory,
stocks and so on.
A. Pharmacare system B. Health Watch system C. Point of sale (POS)
D. Universal Pharmacy system E. Business update computer system
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17. Total sales of prescription drugs are $210,000 and cost of good sold is 180,000.
What is gross profit?
A. 71% B. 14% C. 50% D. 20% E. 25%
20. Which of the following is the most important in pharmacy location analysis:
A. Trading area
B. Market area analysis
C. Site consideration
D. Region
E. Geographical area
21. Which of the following is the most important in pharmacy site consideration:
A. Sales per square feet
B. Convenience and distance
C. Parking space
D. Physical characteristics of space
E. Use of ratios
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23. Pharmacy ABC have sales of prescription medication for the year 2004 to 2005. In
order to find out profit of pharmacy ABC, which of the following financial statement
may be useful:
I-Balance sheet
II-Retain earning statement
III-income statement or profit & loss statement
A. I only B. III only C. I and II only D. II and III only E. I, II, and III
26. The style of management in which owner of pharmacy store emphasizes the
development of detailed policies and written procedure for employees to observe at all
times is referred as:
A. bureaucratic work procedure are described in details policies and written
procedure.
B. autocratic Implementing personal opinion without consultations.
C. assertive
D. consultative with consultation
E. benevolent generous and kind
28) The cost of goods sold is $150,000, at start of year $25,000 at the end of
year 50,000 the inventory capital. What is the turnover rate?
A) 4 B) 3 C) 2 D) 1 E) 5
29. The previous turnover rate was 6 and this year cost of good sold is $150,000, at start
of year $25,000 at the end of year 50,000 the inventory capital. What is the difference
of turn over rate this year from previous year?
A. 4 B) 3 C) 2 D. 1 E. 5
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E. Merchandising problems
32. In a market there is only one seller and there are many buyers. This competition
described as?
A. Monopoly B. Monopolistic competition C. Oligopoly
D. Oligopolistic competition
34. If you open a pharmacy in multicultural area, what you should do increase your
sales?
A. you have signs of multicultural
B. Hire technician from same cultures
C. Develop literature with different language
D. Offer help in different languages
35. Which of the following structure of pharmacies is difficult open and operate?
A. Sole ownership B. Franchise C. Banner pharmacy D. Partnership
36. If pharmacy manager for 16 year he is doing all the job by himself, without taking
any idea and skills from other, what is that called?
A. Beaurocratic B-Autocratic C-Independent D-Assertive E-Submissive
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40. All of the following are important fundamental principles of marketing EXCEPT:
A. Product B. Price C. Profession D. Promotion E. Place
41. If a pharmacy has an inventory turnover rate of 4 that means that the “days of
inventory on hand” is:
a) 73 b) 102 c) 24 d) 91 E. 265
42. Drug identification number is given to each drug that is sold in Canada. This is
assigned by the?
A. Pharmacy Manager
B. Manufacturer
C. Health Canada
D. Pharmacy owner
E. None of the above
44. When pharmacy manager describes the position in pharmacy. The qualifications
required and the duties required in the position are called?
A. Job analysis
B. Job posting
C. Position allocation
D. Job description
E. Job finding
46. A person brings prescription for 6 months of medical supplies, before he travels.
However, his insurance covers only 3 months. What is appropriate?
A. Insurance may cover for 3 months, rest a customer should pay
B. Call insurance, to verify if customer is covered for vacation supply
C. Do not dispense for 6 months
D. None of the above
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D. placing advertisement
E. responsible for narcotics
50. It is one type of cost sharing plan in which patient has to pay a specified amount
during a specific period of time. Before benefits are paid by third party.
A. Co-payment B. Co-insurance C. Deductible D. Discount E. Bankruptcy
54. All the following is/are true with respect to the balance sheet, EXCEPT
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1. Ans: B
2. Ans: D
3. Ans: D
Tips: Net income is the financial statement that is total income minus expenses.
4. Ans: C
Sales price = cost + [cost x %markup]
= $10 + [$10 x 0.3] = $13
= $13 + $10 = $23
5. Ans: A
Tips: Income statement is the financial statement used to determine the total value of
RXs drug sales for a pharmacy during the course of a year.
6. Ans: E
7. Ans: C
8. Ans: C
Tips: Job description is a description of all the work that should be done by the
employers in order of priority. The manager normally does it.
9. Ans: D
Tips: The pharmacist should always interact with the patient providing clear verbal
information such as explaining how to take the medication, side effects and therapy,
and completing the concealing with extra writing or sheet information.
10. Ans: E
Tips: Delegation of a job should include the suggested steps to accomplish the project; a
negotiation of time schedule for completion of the project and the person doing the
delegation should provide support and follow up as required.
11. Ans: B
12. Ans: C
13. Ans: C
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Tips: POS-Point of sale is a computer software and hardware program very useful in
pharmacies that combines and track all the business information such as product
information, cash register, inventory, stocks and so on.
14. Ans: C
15. Ans: C
Tips: Leasing (Renting) is not a form of enterprise.
16. Ans: E
17. Ans: B
Tips: [Sales - COGS/Sales] x 100
COGS = Cost of goods sold
Total sales $210,00 is 100%
Cost of goods sold is 180,000 is 85.5%
100%-85.5% = 14.5%
18. Ans: C
19. Ans: C
Tips: Leasing (Renting) is not a form of enterprise
20. Ans: B
21. Ans: E
Tips: use of ratios is frequently used rule of thumb in site considerations, this include
sales per square feet, number of prescription per patient, and average price for
prescription.
22. Ans: D
23. Ans: B
24. Ans: D
25. Ans: B
26. Ans: A
27. Ans: C
28. Ans: A
Tips: Turnover rate = COGS/average inventory
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29. Ans: C
Tips: Average inventory = (beginning inventory + closing inventory)/2
$150000/[$50,000 + $25000]/2 = 4
this year TOR is 4, so previous year was 6.
30. Ans: C
31. Ans: B
32. Ans: A
33. Ans: E
Tips: there are 4 Ps; Place, Product, Price and promotion
34. Ans: C
35. Ans: A
36. Ans: C
37. Ans: B
Average inventory = $200,000+$220,000/2 = $210,000
Turnover rate = 500,000/210,000 =2.3
38. Ans: C
Tips: Net worth = Total assets – total liabilities
($150,000+$40,000) - $75,000 = $115,000
39. Ans: B
40. Ans: C
Tips: There are 4 “P” of marketing = Product, Price, Promotion and place.
41. Ans: D
42. Ans: C
43. Ans: D
44. Ans: D
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45. Ans: D
46. Ans: B
47. Ans: E
48. Ans: B
49. Ans: A
Tips: Merchandising is visual display of products.
50. Ans: C
51. Ans: D
Associate franchise Banner Franchise
No capital investment Capital investment
Central distribution No central distribution
Example: Shopper drug mart Example: IDA
52. Ans: B
Tips: An individual or corporation must own 5 or more stores to be considered a chain.
53. Ans: E
Tips: 3-5 year plan is required.
54. Ans: C
Tips: At year end, every business must have a balance sheet prepared.
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PHARMACY PREP
PHARMACOECONOMICS
2. Pharmacoeconomics means:
A. Analyses of cost and benefit of the drug therapy to the healthcare system and society
B. Cost of pharmaceutical dispensing fee
C. Cost of products sold in a pharmacy
D. Analyses of cost and benefit for the pharmacy business
E. Prices determined by the provincial authorities to be followed by the pharmacy
3. What is QALY?
A. Quantity Adjusted Life Year
B. Quality Adjusted Life Year
C. Quantity of Available for Long Year
D.Health related quantity of life
E. Quality of as per life year
4. What is HRQOL?
A. Health Related Quality Of Life
B. Health Related Quantity Of Life
C. Health Related Quantity Of Year
D. None of the above
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7. Pharmacy manager wants to increase salary of staff pharmacy, do you consider all
except?
A. other pharmacist available to do his job
B. budget
C. pharmacist asking a raise
D. consider his experience
E. Life allowance
12. Pharmacy manager wants to increase salary of staff pharmacy, do you consider all
except?
A. other pharmacist available to do his job
B. budget
C. pharmacist asking a raise
D. consider his experience
E. Life allowance
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14. If two drugs have same effectiveness than selection is based on?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. Professional judgment of prescriber
15. Which attempts to define exactly how much good is achieved for each dollar spent?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. All of the above
16. Clinical parameters and cost effectiveness of two drugs can be compared by?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. All of the above
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Drug A Drug B
Cost
dose $300 $300
Hospitalization $300 $300
Stay require
Total cost $600 $600
Outcome
Extra years of life 2 6
Cost effectiveness ratio: 600/2 600/6
$300 $100
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PHARMACOECONOMICS
ANSWERS:
1. Ans: C
2. Ans: A
Tips: Pharmacoeconomics is the description and analysis of the costs of drug therapy to
health care system and society.
3. Ans: B
4. Ans: A
5. Ans: A
6. Ans: B
7. Ans: E
8. Ans: B
9. Ans: D
10. Ans: A
11. Ans: B
12. Ans: E
13. Ans: A
Tips: Short form 36 (SF-36) most frequently used in pharmacoeconomic general health
status instrument measuring 8 dimensions: physical functions, social functions, role
emotional, role physical, bodily pain, mental health, general health, and vitality.
Cost
14. Ans: C
15. Ans: A
16. A
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PHARMACY PREP
DRUG DISCOVERY AND DEVELOPMENT
2. All of the following are true about Phase III human clinical trial, EXCEPT?
A. Healthy human volunteers are tested
B. Disease human volunteers are tested
C. Larger population than Phase II is tested
D. Drugs are approved for sale after phase III clinical trials.
3. Medications that are prescribed and sold over the counter in Canada are approved by?
A. Canadian Health Act
B. NAPRA
C. Health Canada
D. Federal Government of Canada
E. Provincial governments
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7. Who sets prescription drug prices in Canada?
A. Health Canada
B. Patented medication review board (PMPRB)
C. Pharmacy manager
D. Provincial college of pharmacy
E. Pharmaceutical Manufacturer
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DRUG DISCOVERY AND DEVELOPMENT
ANSWERS:
1.Ans: A
2. Ans: A
3. Ans: C
4. Ans: B
5. Ans: D
6. Ans: A
7. Ans: B
8. Ans: C
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PHARMACY PREP
EPIDEMIOLOGY AND CLINICAL STUDIES
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PHARMACY PREP.
BIOSTATISTICS CALCULATIONS
1.What is incorrect about the relation of confidence interval and sample size
A. There is a relationship between sample size and the width of the confidence interval.
B. The general rule is that the width of the confidence interval will be proportional
to 1/ n, so to halve the interval you need 4 times the sample size.
C. Larger samples give more precise estimates with lower standard error and tighter
confidence intervals.
D. As the sample size increases, the interval and its width decrease, thus providing a
more precise estimate of the population value.
E. The larger the sample size the larger the confidence interval
Ans. E
Tips. The larger the sample size the
2. A study experiment event rate or treatment reduced 10% risk and control reduced
7.5% risk. What is absolute risk reduction?
A. 7.5% B. 2.5% C. 10% D. 15%
Ans. B
ARR = EER-CER or 10-7.5 = 2.5%
NNT = 1/ARR = (1/2.5) x 100 = 40
NNT are always rounded up to the nearest whole number.
3. If a drug reduces the risk of a bad outcome from 50 per cent to 30 per cent. The ARR
is?
A. 50%
B. 30%
C. 20%
D.10%
Ans.
What is NNT?
1/0.2 = 5
4) The results of the trial of vasodilators in patient with congestive heart failure. The
mortality in the ACEi arm was 33% and in hydralazine plus nitrate group it was 39%.
What is absolute risk difference?
A) 0.86 B) 6% C) 14% D) 29% E) 3.3%
Ans. B
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5.In the above case how many patient do you need to treat to benefit one case (NNT)?
A. 10
B. 5
C. 6
D.17
Ans. D
6.A new drug absolute risk reduction is 4% for preventing stroke. Means?
A. Four patient in 100 actually benefit from new drug
B. Four patient of all study group benefit from new drug
c. New drugs four times better than old drug
D. New drugs is 4% better than old drug
ans. a
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Pharmacy Prep
HOSPITAL PHARMACY
4. Listing of drug by their generic name followed by strength, form, toxicology, use &
recommended quantity dispensed
B. Prepared locally by its own clinical staff or P&T committee
C. Each hospital has their own formulary
D. Formulary is federal and all hospital in Canada has the same formulary
Ans. d
5. Which of the following is least likely done by the regulated pharmacy technician?
A. sterile preparation of IV
B. Checking formulary stability reconstituted IV preps
C. Preparing TPN
D. Final check before delivery to wards
E. Counseling to patients
Ans. E
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6. A hospital doctor ordered a drug that is not present in hospital formulary list. What is
appropriate action?
A. Dispense equivalent drug present in formulary
B. Check in non formulary list or order from community pharmacy
C. Call doctor to change the medication from list of formulary
D. Contact other hospital pharmacy to get the medication.
Ans. b
7. Hospital doctor prescribed amoxicillin 500 mg for 8 hourly administration. What is correct?
A. unit dose is dispensed with one dose of amoxicillin 500 mg one capsule
B. unit dose is dispensed with three capsule of amoxicillin 500 mg for an 8 hourly administration
C. unit dose is dispensed with nine capsule of amoxicillin 500 mg for 8 hourly for 3 days
administration
D. Call the doctor to clarify
Ans. b
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PHARMACY PREP.
Basic CALCULATIONS
1.A child weighs 22 lbs, and doctor wants to give a drug 1 mg/kg/day bid, how much you
should give per day?
a. 10 mg/day B. 5 mg/day C. 15 mg/day D. 20 mg/day
Ans. a
2.A child weighs 22 lbs, and doctor wants to give 1 mg/kg/day bid drug, how much you
should give per dose?
a. 10 mg/dose B. 5 mg/dose C. 15 mg/dose D. 20 mg/dose
Ans. b
3.A patient weight 180 lbs has admitted to emergence for congestive heart failure and
severe edema. Patient was give furosemide iv infusion for the past 24 hours. After
discharge the patient weight was 173 lbs. How many kg patient weight is lost?
A. 7 kg B.3.2 kg C. 2.2kg D. 172 kg
4.A prescription order of cisplatin 750 mg/m2/day, IV tid. The patient weighs 75 kg and
is 162 cm tall. Calculate the dosage to administer?
BSA in m2 = c
=
= 3.37
= 1.84 m2
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5.Patient age 60 yo, weight 78 kg and height 184 cm. Doctor prescribed 5-flurouracil
300 mg/m2 se ac a e e se ra a s n body surface area?
BSA = c
1.99 mg/m2
er a
6.A chemotherapy protocol for a pt. body weight 68 kg and height 1.7 m. Chemo drug
leucovorin 400 mg/m2 is recommended what is daily dose?
c
= 1.79 m2
8. Syrup is an 85% w/v solution of sucrose in water. It has a density of 1.313 g/ml. How
an ra s a er s e se a e s r
A. 85 g B. 106 g C. 125 g D. 164 g E. 58 g
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100 ........... 85
125.............?
= 106 g
164-106 = 58 g
9.Ampicillin 1 g drug. Add 6.8 ml sterile water to provide final concentration volume 8
mL. What is concentration of the reconstituted solution in the vial in mg/mL?
A. 8 mg/mL
B. 125 mg/mL
C. 100 mg/mL
D. 150 mg/mL
Unknown Known
125 mg/mL
10.Given ampicillin 1 g vial. If the final concentration has been calculated to 125 mg/1
mL. What is the volume taken if dose of the ampicillin is 500 mg?
A. 8 mL
B. 4 mL
C. 2 mL
D.1 mL
Ans. B
125 mg...........1 mL
500 mg.............?
x/500 mg 1 ml/125 mg
= 4mL
11.A sterile methylprednisone powder vial contain 125 mg drug. Reconstituted by adding
1.8 mL of sterile water to final volume 2 mL. What is final concentration of reconstituted
solution in the per mg/mL?
A. 125 mg/mL
B. 62.5 mg/mL
C. 31.5 mg/mL
D.16.5 mg/mL
ans. B
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2 mL ..................125 mg (known)
1 mL .................? (unknown)
uknown known
x mg/ 1mL 125mg/2mL
x mg = (1 mL x 125 mg) / 2 mL
= 62.5 mg/mL
Xg/1000 mL 1g/100 mL
Xg = (1000 mL x 1g)/100 mL
= 10 g
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Dose Calculations
or
i. 15 mg BID = 30 mg daily
ii. For 20 days: 30 mg x 20 = 600 mg are dispensed
iii. Solution contains 5 mg/ml. 600 mg are contained in 600/5 = 120 mL
Ans: E
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3. A patient is currently taking 220 mg anhydrous zinc sulfate. To receive the equivalent
amount of elemental zinc, how many milligrams of zinc sulfate heptahydrate (.7H 2 O)
would be patient need to take? (MW: zinc 65, ZnSO 4 161, H 2 O 18).
a) 123 mg
b) 220 mg
c) 300 mg
d) 392 mg
e) 545 mg
ZnSO4 = 161
ZnSO4 heptahydrate= (7x18 =126)
161+126 = 287
161..............220 mg
287................?
(220 x 287)/161
= 392
OR
Working:
i. 220 mg ZnSO 4 provides 220/161 = 1.366 mmol Zn (and 1.33 mmol
SO 4 , but this is not relevant)
ii. Each mmol of ZnSO 4 . 7H 2 O also provides 1 mmol Zinc
iii. Calculate the molecular weight of ZnSO 4 . 7H 2 O as follows:
ZnSO 4 = 161
7H2O = (7 X 18) = 126
ZnSO 4 7H2O = 161 + 126 = 287
iv. Therefore, 1.366 mmol of ZnSO 4 . 7H2O (which provides 1.366 mmol
Zinc) are provided by 1.366 x 287 = 392 mg
Ans: D
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Working:
i. 60 g of 0.01% fluocinolone acetonide (required in the Rx) contains
0.01/100 x 60 = 0.006 g fluocinolone acetonide)
ii. You have 0.2% fluocinolone acetonide (0.2 g per 100 g = 0.002 g
fluocinolone per gramme of cream)
iii. Therefore, for the Rx you need 0.006 / 0.002 = 3 g Synalar cream
Ans: D
B is wrong, because 3 g Synalar and 60 g of Dermabase will give 63 g of total cream,
with a concentration of 0.0095% (0.006 / 63 x 100)
5. In the International System of Units (SI), most drugs levels are to be reported in the
units of micromoles/litre (µmols/litre). The therapeutic concentration range for
theophylline (MW 180) is 10-20 µg/mL. the SI equivalent would be:
a) 0.055- 0.11 µmol/L
b) 27-55 µmol/L
c) 55-110 µmol/L
d) 110-220 µmol/L
e) 180-360 µmol/L
Working:
i. Careful!!! Theophylline therapeutic concentration is given in
µmol/mL, while answers are given in µmol/L.
ii. Convert therapeutic concentration to µg/L: 10-20 µmol/mL =
10,000 – 20,000 µg/L
iii. Lower parameter: 10 µg/mol = 10,000 µg/L = 10,000/180 = 55
µmol/L
iv. Upper parameter: 20 µg/mL = 20,000 µg/L = 20,000/180 =
111µmol/L
Ans-C
6. Prednisolone each tablet containing 10mg. Taper 1/2 tablet every week .How tablets
are needed?
7. A family of 1 adults (300 mg/wk) and 8-year-old child (75mg/wk), 14 year old
(225mg/wk) teenager, going for 2 weeks trip to malaria infections area. You have 300
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mg base drug. How many tablets will you give for whole family? (Prophylaxis require 4
weeks before trip, during trip and 2weeks after trip)
A-17 tablets
B-18 tablets
C-16 tablets
D-19 tablets
Ans. C
Total = 8 week therapy
Adult = 8 tablet
14 yo = 6 tablet (225 mg/wk)
8 yo = 2 tablet (75 mg/wk)
Total tablet = 16 tablets
TIPS:
D = M/V
Concentration = Solute x 100
Solute + Solvent
= 250 g x 100
250g+1250 g
= 16% w/w
M=DxV
M = 1.25 x 1000 mL = 1250 g
Then
250 g+1250 g = 1500 g (total volume)
(250g/250 g+1250 g) x100 = 16%
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17. Prednisolone each tablet containing 5mg. Start 35 mg and then taper by 5mg every 1
day. How many tablets are needed?
A-20 tab
B-56 tab
C-14 tab
D-28 tab
Tips: 7+6+5+4+3+2+1 = 28 tab
For above questions, how many days patient takes prednisone? 7days
17. Prednisolone each tablet containing 5mg. Start 35 mg and then taper by 5mg every 2
day. How many tablets are needed?
A-20 tab
B-56 tab
C-14 tab
D-28 tab
7+7+6+6+5+5+4+4+3+3+2+2+1+1 = 56 tab = 14 days
For the above questions. Patient take for how many days? 14 days
18) If three tablets contain 975 mg of ASA, how many grams of ASA would be contained
in 12 tablets?
A) 4g
B)325g
C) 3.9g
D) 39g
E) 390g
19) How many milliliters of a heparin sodium injection containing 200,000 heparin units
in 10 mL should be used to obtain 5,000 heparin units?
A-0.50mL
B-0.25mL
C-0.10mL
D-0.75mL
E-250mL
200,000 ---- 10 ml
5000 ---- ?
20) A physician asks the pharmacist to compound codeine sulfate tablet triturates
containing 10 mg of codeine. The patient need a 5-day supplies and may take 1-2 q4-6h
PRN How much codeine is needed to fill this prescription?
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A. 300 mg
B.400 mg
C-600 mg
D-1200 mg
Ans: c
23) Prednisolone each tablet containing 5 mg. Start 10 mg and then taper by 1/2 tab
every week. How many tablets are needed?
A-21 tab
B-56 tab
C-14 tab
D-28 tab
E-35 tab
Ans.
Tips: 14 tab+10.5tab+7tab+3.5 tab = 35 tab
5 tab x 7 days
26) Dexamethasone 8 mg bid x 7 days then taper by 1 mg twice day every 2nd day until
finish? Available strength 4 mg and 0.5 mg. Calculate how many tablets of both
strengths you will dispense?
A) 112 tablets of 4 mg or 800 tablets of 0.5 mg
B) 126 tablets of 4 mg or 1008 tablets of 0.5 mg
C) 56 tablets of 4 mg and 96 of 0.5 mg
D) 136 tablets of 4 mg or 990 tablets of 0.5 mg
E) Give both 44 of 4 mg and 96 of 0.5 mg tablets
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7 d x 16 mg = 112 mg = 28 tab of 4 mg
2 d x 7 mg bid =14 mg for 2 d 28 mg = 4 of 4 mg & 24 of 0.5 mg
2 d x 6 mg bid 24 mg = 4 of 4 mg and 16 of 0.5 mg
2 d x 5mg bid= 20 mg = 4 of 4 mg and 8 of 0.5 mg
2 d x 4mg bid =16 mg = 4 of 4 mg
2 d x 3 mg bid = 12 mg = 24 of 0.5 mg
2 d x 2 mg bid = 8 mg = 16 of 0.5 mg
2 d x 1 mg bid = 4 mg = 8 of 0.5 mg
Ans.
Tips. If you give both 44 of 4 mg and 96 of 0.5 mg
Total 224 mg
Total therapy 21 days
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Pharmacy prep
1) A prescription for hydrocrotisone cream 0.1%. Pharmacy has 0.25% available in 30 g tube.
How many grams diluents base (vanishing cream) should be added?
A) 30 g B) 45 g C) 50 g D) 75 g E) 25 g
V2 = (C1 x V1)/C2
V2 = (0.25% x 30 g)/0.1%
V2 = 75 g
Ans: B
Step1: determine the volume of final product. Since dexamethasone is 4mg/mL, a 1 ml vial have
4mg of drug
X ml/ 4 mg = 1 ml/1 mg = 4 mL
Step2: subtract the volume of concentrate from the total volume to determine the amount of
diluents needed.
4 ml-1ml = 3 mL
3.If a 600 ml of a 15% (v/v) solution of methyl salicylates in alcohol are diluted to 1500 ml what
will be the percentage strength.
51-1
Pharmacyprep.com Dilutions and Concentrations
C2 = (C1xV1)/V2
C2 = 6%
4) A physician has prescribed 60 g of 0.01% fluocinolone acetonide cream. You have available
the commercially prepared cream containing 0.2% fluocinolone acetonine (Synalar cream) and
cream base (Dermabase ) for dilution. To prepare the Rx you would require:
C1. V1 = C2. V2
0.01% x 60 g = 0.2% . V2
0.5 1.5
2.5 0.5
0.5% of HC............(1.5/2)x60 = 45 g
51-2
Pharmacyprep.com Dilutions and Concentrations
6.Hydrocortisone 1% 60 g.
Your pharmacy has 2.5% hydrocortisone and petrolatum base. What fraction of each
hydrocortisone needed use to prepare above prescription
2.5% 1
1%
0% 1.5
2.5% HC = 24 g
petrolatum base = 36 g
mEq = 92/23
= 4 mEq
8) You are given ZnCl 2 0.7%, phenylephrine 0.1% and boric acid 1.1% with E values 0.16, 0.32
and 0.5 respectively. This solution will be:
A) Hypotonic
B) Hypertonic
C) Isotonic
D) Non isotonic
Solution.
[(0.7 x0.16] + [(0.1 x 0.32] + [ (1.1 x 0.5)]
= 0.9>0.69 = Hypotonic
How much NaCl required making isotonic solution?
0. 9 - 0.69 = 0. 21 or 2 mg
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9) Zinc sulfate is a two-ion electrolyte, dissociating 70% in weak solutions. Calculate its
dissociation factor.
ZnSO 4 Zn + SO 4 + ZnSO 4
70+ 70 +30
170/100 = 1.7
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PHARMACY PREP
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PHARMACY PREP
1.A 65 yo customer at your pharmacy using nitroglycerine patch daily for the prevention
of coronary artery disease. If patient a new prescription. Which of the following Rx is the
pharmacist concern?
A. Nitroglycerine 0.3 mg SL tab
B. Nitroglycerine 0.4 mg SL spray
C. Sildenafil 50 mg as needed
D. Tylenol # 3 for as needed for pain
E. Ritonavir soft gelatin cap 100 mg daily
Ans. c
2.A very frequent customer at your pharmacy, request for 15 days supply of Lipitor 10
mg tablets because customer has no prescription and no refills of Lipitor. In the next few
hours he has to take a flight for vacation. Currently all walk-in-clinics are closed and his
physician is not available for prescription.? According to extended scope of pharmacy
practice pharmacist dispensed 15 days of drugs? This is defined as?
A. Adaptation
B. Advancing a drug
C. Pharmaceutical opinion
D. Professional discretion
E. Professional judgement
Ans.b
3.MP came from the British Columbia, during the journey he lost his medications. He
approaches at your pharmacy with a rough list of medication, he was using. The
pharmacy and doctor clinic is currently closed due to long weekend in BC. What is
appropriate?
A. dispense the list of medication
B. refer him to walk in clinic
C. refuse to dispense any medications
D. write prescription
E. dispense OTC medications
Ans. b
4.A 75 yo patient has been discharged from the hospital. Presents at your pharmacy with
the following discharge report prescription. What is the pharmacist concern?
a. Metformin 1000 mg, PO, evening with dinner and metformin 1000 mg, po, morning
with breakfast
B. Levodopa/carbidopa 25/100 mg, po, four times per day
C. Digoxin 120 mg once daily in the morning
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PHARMACY PREP
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PHARMACY PREP
CLINICAL TOXICOLOGY
1- An adult patient who ingested 30 acetaminophen tablets (325 mg/tab) 6 hours ago
should be treated with/by
A. EDTA infusion
B. Ipecac syrup
C. Activated charcoal
D. N-acetylcysteine
E- Probenecid
4-A patient brings the prescription of amitriptyline 300 mg 3 month’s supply. Patient
medical history includes, major depression and in the past has 2 unsuccessful attempts
to suicide. What is the appropriate, a pharmacist should do?
A-Dispense 3 months supply of amitriptyline and caution about overdose symptoms.
B-Dispense in part fills or small quantities and ask patient pick up in parts every 15 days
C-Refuse the prescription and ask patient to see other doctor
D-Refer patient to other physician for mental assessment.
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7- A grand mother gave 2 tbsp (250 mg/5ml) of amoxicillin suspension instead of 2 tsp
to a child 9 mo age. What is appropriate to do?
A-Monitor diarrhea
B-Refer to doctor
C-Refer to emergency
D-Call poison control center
E-Wait and watch
10- A grand mother gave 2 tbsp of amoxicillin of 500 mg/5ml bid instead of 2 tsp to a 9
month old child. What to do?
A) refer to emergency
B) refer to doctor
C) wait and see
D) recommend to skip next dose
E) contact regional poison control centre
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12) A doctor comes to your pharmacy and write a prescription for oxycontin 100 tablets
for himself? What to do?
A)dispense 50 tablets only
B)dispense 200 tablets only
C)it is illegal dispense narcotics to doctor
D)It is unethical to dispense narcotics for themselves
E)Refer doctor to Centre of addiction and mental health (CAMH)
14- Pharmacy tech received a phone call from your pharmacy customer. She has
swallowed 10 tablets of acetaminophen 500 mg. What is appropriate recommendation?
A) Suggest to take lots of fluids
B) refer to emergence
C) ask to contact poison control centre
D) ask wait and see
E) give N acetyl cysteine
A child admitted to hospital following ingestion of overdose of aspirin and some other
OTC sleeping pills, which contain antihistamines, and anticholinergic drugs. The child is
in coma and flushed and flaccid. Her pupils were fixed and dilated. The lab results
indicated her blood aspirin drug levels are 5.8 H is 6. Her
an symptoms
r ne
also include deep and rapid respiration.
16) The symptoms of deep and rapid respiration may lead to:
A-Hypertension
B-Respiratory acidosis
C-Respiratory alkalosis
D-Increase in temperature
E-Reduction in temperature
Ans-C
Tips:
Respiratory Acidosis. This occurs due inadequate ventilation of CO 2 by lungs.
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Predisposing factor for respiratory acidosis:, Asthma, Beta blockers, Sleep apnea, CNS
depressants, Pulmonary edema or embolism, Cardiac arrest
RESPIRATORY ALKALOSIS. Due to increase in excretion of CO 2 However this condition is
not very common.
18) In order to increase the excretion of aspirin from body, which of the following
should be administered:
A-Probenecid
B-Ammonium chloride
C-charcoal
D-Ipecac
E-Sodium bicarbonate
Ans-E
ANSWERS:
1- D
2. C
3- A
Tips: Stimulants laxative are the drug of choice for the treatment of constipation
associated with opioids use.
4-B
5- B
6- B
7- B
8- E
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9- C
10- E
Tips: serious toxicity is unlikely following large doses of amoxicillin. Acute ingestion of
large doses (250 mg/kg) of amoxicillin may cause nausea, vomiting, diarrhea, abdominal
pain. Acute oliguric failure and hematuria may occur following large doses
Reference: CPS 2009
11- C
Tips: Nystatin suspension have no systemic absorption, so overdose monitor symptoms
so wait and see.
12- D
13- E
14- C
15- E
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PHARMACY PREP
PHARMACY COMMUNICATION SKILLS
1) Which of the following is the most effective communication skill?
I-Verbal skills
II-Nonverbal listening skills
III-Verbal skills only
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
2-A pharmacist is required to give knowledge of drugs and supply the patient with
enough pieces of information to overcome the patient ignorance. This is done by:
a) Written information only
b) Verbal information only
c) Verbal and written information
d) Magazines and folders information
e) Video information
5) A patient who does not speak English and you don't understand his language. How do
you resolve this problem?
A-Find a interpreter or translator
B-Patient problem do not worry
C-Pharmacist problem learn his language
D-Both pharmacist and technician problem
E) Use non verbal techniques
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7) As a pharmacist you should have speaking skills. All the following are true except:
A) Speak in a monotonous voice pitch.
B) Speak with precise language.
C) Write when verbal is not sufficient.
D) Greet the patient.
8) All the non verbal skills to use during telephone conversations except:
A) Give your full attention to phone call.
B) Put the patient on hold if you are busy.
C) Be prepared.
D) Smile
10) A patient coming to take OTC cough syrup and pharmacist noticed that patient took
same medication yesterday, what you should do?
a. Tell her no more medication available
b. Ask her what medical conditions she needs the medication
c. Give her the name of the addiction group
d. Call the police
11) If you open a pharmacy in multicultural area, what will you do increase sales?
A) Display signs of different culture
B) Hire staff of different cultures
C) Offer only one culture service
D) Refuse all the customer who disagree with opinion
E) Offer services in different languages
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D) Advertise in mall
14) Customer of your pharmacy with kids. Parents discipline their kids but they are
beating and spanking? What to do?
A) Talk to parents and kids
B) Call police and inform about it
C) Call children society to protect kids
D) Ignore and let them go
15) Adult women come to your pharmacy to buy analgesics for her wounds. She seems
to physically and sexually abused what to do?
A) Call police
B) Ask her to go emergence
C) Refer to doctor
D) Give her police phone number to contact
E) Ask her to contact sexually abused support groups
ANSWERS:
1) C
2- C
3- B
4- B
Tips:The language can be barrier. However it is not distraction.
5. A
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6- D
7. A
Tips: It is boring to speak in a monotonous language
8. B
9. A
10) B
11) E
12) C
13) D
14) A
15) E
16) D
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Pharmacy PREP
ETHICAL STANDARDS
5. Patient cannot afford to buy new medication that is not covered by his insurance
plan. Pharmacist called his doctor and asked him to change the medication into another
medication covered by the patient’s insurance plan. Which ethical principle did the
pharmacist follow?
A. Beneficence
B. Veracity
C. Justice
D. Nonmaleficence
E. Fidelity
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8. A physician phones a pharmacist asking him not to tell the patient about the side
effects of a drug because if he does, the patient will not take it. The pharmacist
complies. Both the physician and pharmacist are seeking which ethic for the patient?
A. Nonmaleficence
B. Beneficence
C. Autonomy
D. Veracity
E. Justice
9. A physician phones a pharmacist asking him not to tell the patient about the side
effects of a drug because if he does, the patient will not take it. The pharmacist
complies. Both the physician and pharmacist have violated which ethic principle?
A. Nonmaleficence
B. Beneficence
C. Autonomy
D. Veracity
E. Justice
10. A pharmacist who refuses to counsel and AIDS patient violates which ethic?
A. Nonmaleficence
B. Beneficence
C. Autonomy
D. Veracity
E. Justice
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11. A father of teenage girl approach to your pharmacy. Asks if her teenage 16 yo
daughter using oral contraceptives? What ethical dilemma of pharmacist?
A. confidentiality and veracity
B. confidentiality and autonomy
C. confidentiality and beneficence
D. confidentiality and fidelity
E. confidentiality and justice
12. A father of teenage girl approach to your pharmacy. Asks if her teenage 16 yo
daughter using oral contraceptives? What ethical dilemma of pharmacist?
A. Veracity and confidentiality
B. Beneficence and confidentiality
C. Justice and confidentiality
D. Nonmaleficence and confidentiality
E. Autonomy and confidentiality
14. What is the principle of confidentiality does not break if a pharmacist disclose the
following medical conditions to the society?
A. diabetes B. Harm full C. HIV D. high BP E. cancer
Ans. B
15. In which of the following situation you can break confidentiality of patient?
A. patient is suffering from HIV
B. patient is on parole
C. suspect patient can harm himself
D. patient is in jail
Ans. C
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17. Can you release information to a prescriber if you have firsthand knowledge from
the third party or DUR about double doctoring?
A. Patient information is confidential
B. Let third part inform to prescriber
C. Yes, you can inform to prescriber because it is in circle of care
D. Ask patient first, before informing doctor
18. Pam is working in rural pharmacy. She is friend with all colleagues, including Chris.
Chris had vision problems in the past, but underwent laser surgery and now is ok. He
does not work pharmacy anymore, but Pam is still has his profile in her computer.
Should she date him?
19. Patient is using Terbutaline inhaler a lot. The pharmacist failed to advise patient to
see his doctor to add corticosteroids therapy to manage his condition. What is violated?
A. Beneficence B. Nonmaleficence C. veracity D. autonomy E. Paternalism
20) A patient has diagnosed with terminal ill cancer. His doctor advised him about his
serious illness. What ethical principle is followed?
A. Beneficence
B. Nonmaleficence
C. veracity
D. autonomy
E. Paternalism
22. A pharmacist Joe is being restricted from practice because of history of substance
abuse. Based on what the college makes this decision?
A. Incompetent B. Incapacity C. Negligence D. Mis-conduct E. accountability
23) A returned medication is placed on shelf by the technician? what you have to as
staff pharmacist?
A) talk to technician
B) inform to manager
C) complain to college of pharmacist
D) Discuss in meeting
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26. While preparing prefilled syringes, in laminar airflow hood. After packaging you find
some syringes leaking. What you have to do?
A. Call the company complain
B. Discard all the batch leaking syringes and document
C. Select the good ones and through the damage
D. Just discard one leaking syringe from the batch and rest can be used
E. Continue processing of this batch of syringe but investigate to prevent leakage again
27. A doctor is asking a patient to sign a consent form for a particular treatment. Which
of the following applies?
A. Inform consent
B. Implied consent
C. Express consent
D. All of the above
Ans. C
28) A patient comes to your pharmacy with a prescription of his wife who is not covered
under his prescription drug plan. He requests you to process her prescription under his
name. He will pay cash for the cost and later send the receipt to his insurance company
to process the claim?
A) it is unethical
B. It is illegal
C. It is ok
D. He can claim from insurance
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30. This principle expresses the concept that pharmacist have a duty to be honest and
trustworthy in their dealings with people.
A. Principles of Ethics
B. Code of Professional Conduct
C. Principle of veracity ("truthfulness")
D. Principle of honesty
31. A physician write prescribed for own use or family member for emergency?
A. Unethical
B. Illegal
C. physician can prescribe can prescribe in emergency
D. physician to refer to emergency
32. A very frequent customer at your pharmacy, request for 15 days supply of Lipitor 10
mg tablets. Next few hours he has to take a flight for vacation. Currently all walk-in-
clinics are closed and his physician is not available for prescription. Customer has no
prescription and no refills of Lipitor? pharmacist dispensed meds. what ethical principles
were followed (uphold)?
A. Beneficence
B. Nonmaleficence
C. veracity
D. Justice
E. Autonomy
33) A terminally ill cancer patient. Doctor did NOT informs patient that patient is
seriously ill and may die in few weeks? What ethics violated?
A) Beneficence B) Veracity C) Justice D) Nonmaleficence E) Fidelity
34) A police officer comes to your pharmacy, wants a patient profile of medication, who
has been caught on street drugs and in traffic rules violation? What is appropriate
action?
A) Ask police ID and patient ID and give patient profile
B) Ask police ID and if he is real police officer give patient profile
C) Refuse to give any patient information to police
D) Ask police officer if he has any court letter (search warrant) or letter of authorization
from patient to release patient information.
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35) A lawyer calls to your pharmacy wants to get medication information of a divorced
spouse. Children? What to do?
A. Talk to lawyers, client and provide information
B. Refuse to provide information
C. Children information only can be shared by parents
D. Lawyer should provide official letter of patient authorization from adults
Ans. d
36) A phone call from emergency medical services, wants to a patient profile of patient
who is found unconscious in his apartment? What is appropriate action?
A) Ask ID of EMS and refuse to give patient information
B) Never trust any phone calls ask EMS to come personally to pharmacy.
C) Verify and give patient profile to EMS, it is in best interest of patient.
D) Ask EMS to contact to doctor of a patient to get information
E) Ask EMS to contact family member of patient.
37. A frequent customer, on benzodiazepine for long time, his doctor away and there
are no walk in clinics open. He wants to get some pills advance? What you do?
A. talk to that person
B. ask patient to see other doctor to get prescription
C. advance benzodiazepine
D. Refer to pharmacist
39) A father of two adults children and wife customer of your pharmacy, wants you to
print receipts of their medications for filing tax returns.
A) Get the authorization from wife and adult children
B) Receipts only without specifying medication just total amount can be printed to
father
C) Refuse to provide receipts
D) Ask to contact revenue Canada
Ans. A
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43. A 16 yr old girl brings a prescription of oral contraceptive pills. However, her parents
calls to your pharmacy and warns you to not dispense OCP to their daughter because
using contraception is against of their belief system. What parents actions are:
A. Justice B. Paternalism C. Fidelity D. Beneficence E. Veracity
44) A woman comes to your pharmacy, ask if her husband has HIV? As your pharmacy
has her husband profile. He is HIV positive? What to do?
A) Do check for yourself and speak to your husband
B)Tell her yes! he has HIV
C) Don't tell her the truth
D) Tell her not to worry, HIV is treatable
Ans. a
45) The pharmacist preserves the confidentiality of information about individual patient
acquired in the course of his or her professional practice, and does not divulge this
information except where authorized by the patient or required by law. Which of the
following federal regulation protects personal health information of patient?
A)Canadian health act
B)Therapeutic directorate, health Canada
C)Institute of safe medication practices
D) Personal Health Information Protection Act
E) All of the above
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Ans: D
ANSWERS:
1. D
2. E
3. C
4. B
5. A
6. C
7. C
8. B
9. D
10. E
11. A
12. A
13 A
14. C
15. A
16. C
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17. C
Tips. Information can be shared in circle of care (if patient is under the care of a doctor,
pharmacist, nurse or caregivers).
18.
19. B
Tips. By not preventing harm. The nonmaleficence is violated
20. C
21. E
Tips. The consent can be obtained by three types express, implied, and informed.
22. B
Incompetent: lack of knowledge, skills, judgment
Incapacity: substance abuse or accidents
Negligence: working lower than standard
Misconduct: unethical
Accountability: legally and morally liable when carrying out duty
Advance directives = legal will
23. A
24. D
Tips. According to pharmacy technician standards of practice. A regulated technician or
pharmacy assistant cannot recommend prescription or non prescription therapies to
patient. Any clinical recommendations or counseling is CANNOT be performed by
pharmacy technicians.
25. A
26. B
27. C
28. B
29. D
30. C
31. C
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32. A
33. B
34. D
35. C
36. C
Tips: It is circle of care, you can share information after confirmation.
37. B
38) E
39) B
40) C
41. A
42. D
43. B
44. A pharmacist believes, using Plan B is against his faith. If a customer wants to use
plan B. would you dispense?
45. A physician write prescription for own use or family member for emergency?
46. A very frequent customer of your pharmacy, requests for 15 days supply of Lipitor
10 mg tablets. Next few hours he has to take a flight for vacation. Currently all walk in
clinics are closed and his physician is not available for prescription. Customer has no
prescription and no refills of Lipitor? If you dispensed what ethics are followed?
47. A patient of your pharmacy approaches to refill salbutamol inhaler. Patient asthma
is getting worse and using more frequent salbutamol. However pharmacist did not
suggest patient to see the doctor to get steroid inhaler prescription. What ethical
principles have been violated?
48. There are two customers of pharmacy, one customer all family members come to
your pharmacy. Other customer family members go to other pharmacy. A pharmacist
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takes NO copayment from a customer who comes with all family members, where as
customer comes as single persons pays co-payment, What ethical principle is violated?
49. A pharmacist refuses to dispense plan B, because of pharmacist beliefs are against of
using contraception?
50. A family two adults and one 16 yo daughter are customer of your pharmacy. one of
the family member comes to your pharmacy, ask for list medications their family
members using for the past 6 months. What to do?
A cancer patient has one month to live. Doctor did not inform the patient about cancer.
What ethical principles is broken?
A) Beneficence
B) Veracity
C) autonomy
D) Confidentiality
E) Paternalism
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Covenant relationship?
A patient approach at your pharmacy for OTC drugs. Patient expressed that
he did not like this medication. Pharmacy tech got upset and verbally abused
patient?
a. illegal
B. unethical
C. professional misconduct
D. Pharmacy act
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PHARMACY PREP
PHARMACY PRACTICE INFORMATION RESOURCES
3. One of your regular patients comes to the pharmacy in search of Dogmatil® for her
brother. He has just arrived from Singapore for a visit, but his medication was lost with
his luggage. She says her brother needs the medication for a CNS condition and
shouldn’t go without it. She wants to know if he can get Dogmatil® here. Which of the
following appropriate reference:
A. Canadian hospital journal
B. American hospital journal
C. Compendium of pharmaceutical specialties
D. Martindale, The complete drug reference
E. National formulary
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10. If a patient comes and asking for drug information, you would do?
A. search for compendium of pharmaceutical specialties
B. Ask doctor
C. search on Internet
D. Call information center
E. Search Medline
11. Which of the following are the most credible information resources?
A. scientific journals containing clinical studies
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B. indexes
C. abstracts
D. text books
E. TV and radio, internet
15. Which of the following resources would provide the most up-to-date answer when
checking if a drug is marketed in Canada?
A. e-CPS
B. CPS
C. PubMed
D. Martindale’s
E. USP-DI vol.1
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ANSWERS:
1. D
2. D
3. D
4. A
5. B
6. D
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7. E
Tips: brands of over the counter products can be found in compendium of self care
products (CPSP)
8. D
9. D
10. D
11. A
12. D
13. A
14. C
15. A
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PharmacyPrep.Com Medication Errors
PHARMACY PREP
MEDICATION ERRORS
1. Verbal prescriptions of drug "names sound like" drugs, can cause medication errors. What
should manager do to decrease the error EXCEPT:
A. Put them away from each other
B. Put label on vial (call for error)
C. Put in computer system alarm to work on dispensing
D. Technician ask patient for what disease being treated for
E. Make two persons double check before dispensing
2-Busy pharmacies a long line up in 15 customers, a person came he is insisting and fighting
with pharmacist, do dispense him first?
A-ignore that customer
B-dispense him first
C-don’t dispense
D-just talk to him and explain there are other before you.
E-Call police
3) A very angry customer comes to your pharmacy and complains that you have dispensed
wrong medication. What is initial appropriate action?
I-offer private counselling area
II-check or verify medication
III-if there is dispensing error, apologize and correct it
A) I only B) III only C) I and II D) II and III E) I, II, III
5) Angry person walks in your pharmacy and complains that you have dispensed wrong
medications? What is appropriate first step in resolving this problem?
A-Apologise patient for dispensing error
B-Calm down patient
C-Acknowledge his anger, ask and verify what is error
D-Ignore and let him vent his anger
E-Acknowledge his anger and refer to doctor
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8) Angry customer comes to your pharmacy. Says dispensing error occurred, which of the
following first step should be done?
A) Apologize customer
B) Calm down and verify prescription error
C) Calm down angry customer
D) Apologize and return new drug
E) Refuse to accept any error
9) Which of the following should first checked by the pharmacist to minimize the dispensing
error?
A) Patient name B) Dr name C) DIN D) Date of birth E) Drug name
10) A patient comes to your pharmacy and complains that he got 10 less tablets of oxycontin
for his prescription. What is the better strategy to minimize these errors.
A) always count tablets in front of patient
B) double or triple count in pharmacy before dispense
C) if some patient complains just give extra tablets
D) narcotics cannot be dispensed extra tablets
E) Check inventory and reassure patient we double check
11) Which of the following is the best method of minimizing calculations errors in
preparations?
A) Choose a person has multiple years of experience
B) Choose a inexperience a new pharmacy graduate
C) Ask a pharmacist or technician to double check the calculation before preparation
D)The calculations should be performed by calculators
E) None of the above
12) Which of the following medication error would not risk harm?
A)Wrong drug B) Wrong instruction C)minor spelling mistakes D)inappropriate auxiliary
labels E) expired medications
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13) A pharmacy dispensing error dispensed Pradox (dabigatran) instead of Plavix (clopidogrel).
If patient used. Which of the following problem expected?
A) Increase risk myocardial infarction
B) Increase risk of platelet aggregation
C) Increase risk of bleeding
D) Increase risk of blood clot formation
14) If patient used Lasix (furosemide) instead of Losec (omeprazole). What problem is
expected?
A) hyperglycemia B) hyperthyroidism C)hypotension D)Hypercalcemia E)None
15) A pharmacy technician prepared a prescription of Pradox instead of Plavix. What is the
appropriate strategies to prevent this error.
I) Advise technician to change to Plavix (clopidogrel)
II) Educate technician on drug name sound similar
III) Read label to patient while dispensing
A) I only B) III only C) I and II D) II and III E) I, II, III
16) A pharmacy intern receive a phone call from doctor for a new prescription. Dr want to
prescribe Losec. However pharmacy intern documented as Lasix. What is appropriate to
minimize this error?
A) Only pharmacist should take phone call for a new prescription
B) Pharmacy intern should require more training on sound like name drugs
C) Ask doctor to give generic name for the sound like name drugs
D) Ask doctor to fax prescription for sound like name drugs
E) Ask doctor to written prescription for all new prescriptions
19) What is the best recommendation to write prednisone and prednisolone to avoid errors.
A) prednisone and prednisolone
B) predniSONE and predniSOLONE
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23. The practice of writing part of a drugs name in upper letter to help distinguish?
A. Dispensing error of generic and brand name drugs
B. Packaging error of medication
C. Dose errors of drugs
D. To prevent incidents of Sound alike and look alike drugs
E. drugs name with same first and last letter
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Medication Errors
ANSWERS:
1. Ans: D
2- Ans: D
3) Ans: E
4) Ans: B
5) Ans: C
6) Ans: D
Tips: Vicarious liability of pharmacist of dispensing
7) Ans: C
Tips: pharmacist should contact doctor to correct prescription.
8) Ans: B
9) Ans: A
10) Ans: B
11) Ans: C
12) Ans: C
13) Ans: C
Tips: Pradox is a new anticoagulant dabigatran act as factor Xa inhibitor. However Plavix is
clopidogrel an antiplatelets drugs. So increase risk of bleeding
14) Ans: C
Tips: Lasix is furosemide can cause hypotension. Losec is omeprazole.
Immodium (Loperamide) and Motilium (domperidone)
Dimenhydrinate and diphenhydramine
Cyclosporine and Cyclophosphomide
Proscar and Prozac
Lamisil (terbinafine) and Lamictal (lamotrigine)
15) Ans: E
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16) Ans: C
17) Ans: C
18) Ans: B
19) Ans: C
Tips: Tallman letter can be used to avoid error
20) Ans: B
21) Ans: D
22 Ans:) D
23. Ans: D
24. Ans: B
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PHARMACY PREP
Secondary care: This is specialized service from a specialist. This requires referral from
primary health care levels.
Tertiary care. This is specialized in diagnosing and highly technical care and treating
complicated or unusual health problems. This generally takes place in hospital setting
where generally diagnostic and complicated therapies can take place.
3. Sunscreen protect?
A. UVA
B. UVB
C. UVC
D. All of the above
Ans. B
Tips. UVA aging, UVB burns, UVC is safe
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1. Ans. A
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PHARMACY PREP
Collaboration and Teamwork
1. Pharmacist identify a potential drug related problem for patient and then provide the
prescriber with a clinical recommendation to resolve the problem, is described as?
A. Advancing
B. Adaptation
C. Pharmaceutical opinion
D. Beneficence
E. Regulations
Ans.c
4.A doctor switched patient to a new opioid therapy and started low dose. It is due to?
A. Tolerance
B. Resistance
C. Dependency
D. Addiction
E. Ineffective therapy
Ans. a
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PHARMACY PREP
STERILE PREPARATIONS
9) What sizes of HEPA filters are used in laminar airflow hood that is used for parenteral
preparations?
A) 0.22 mm B-0.33 mm C-0.11 mm D) 0.44 mm E) 0.55 mm
Ans-B
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PHARMACY PREP
PHARMACEUTICAL STORAGE CONDITIONS
1- You received a new drug in your pharmacy and the manufacture instructions tell you to
keep this drug in a cool place. Which temperature should you keep this drug?
a) <0 C b) 2 to 8 C c) 8 to 15 C d) 15 to 30 C e) >30 C
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D. In a safe cabinet
Ans (B)
Tips: It is a vaccine.
8. All the drugs and supplies use in the sterile room should be unpack ?
A. After bringing into the sterile room
B. Before brining into the sterile room.
C. Anytime and anywhere can be unpacked
D. Manufacturer should not pack supplies that are used in sterile preps
Ans. B
1- Ans: C
2- Ans: A
3- Ans: B
4- Ans: B
5. Ans: A
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PHARMACY PREP
2. A 60-year-old patient with congestive heart failure who has been stabilized for 3
months on digoxin, furosemide, and potassium chloride is gradually placed on the
following additional medicines. Which of these drugs is most likely to cause a problem if
added to patient treatment?
A. Quinidine
B. Temazepam (restoril)
C. Meperidine hci (demerol)
D. Aspirin
E. Nitroglycerin
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6. A doctor has prescribed salbutamol inhaler prn for stuffy nose 3 months ago.
However, patient experiencing tremor and shaky for past 6 days. What to do?
A. Increase dose of salbutamol
B. Decrease dose of salbutamol
C. Ask patient how often use salbutamol puffs
D. Refer to doctor
E. Refer to emergency
7. A 65 yo COPD patient using ipratropium PRN inhalers and tiotropium once daily.
Complains dry mouth and dry eye. What to do?
A. refer to doctor
B. recommend use frequent sip of water or ice chips C)recommend to use artificial eye
drops
D. refer to emergency
E. B and C
8. A hypertensive patient who has COPD and who is non compliant would be best
treated with which of following beta blockers?
A. Propranolol B. Atenolol C. Esmolol D. Timolol
10. A doctor has prescribed oxycontin for prn 7days after appendectomy surgery. Which
of the following appropriate products to recommend?
A. mineral oil B. psyllium C. sennakot/stool softener D. stool softener only
E. Magnesium antacids
11. A pregnant women diagnosed UTI, and she allergic to penicillin, what is the drug of
choice?
A. Nitrofurontoin B. Fosphomycin C.Cephalosporin's D.Tetracycline E. Ciprofloxacin
12. A patient is using tetracycline for the treatment of acne. What is the best
counseling?
A. take with glass of water B. take with glass of milk C. must take empty stomach D.
take with glass orange juice E. avoid taking with antacids
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13. A patient is medication shows ramipril, nadolol, ASA and rosuvastatin. What are the
adverse effect may be related to ramipril?
A. bradycardia, bronchospasm, cardiac decompensation
B. skin rash, and proteinuria
C. postural hypotension, fever, positive Coombs' test
D. First dose syncope, postural hypotension, and palpitation
15. A patient had ileostomy surgery, which of the following dosage form is not used?
A. immediate release
B. sustain release
C. oral dosage form
D. intra venous
E. sublingual
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PHARMACEUTICAL CARE AND DRUG RELATED PROBLEMS
ANSWERS
1. Ans: B
2. Ans: A
Tips: Although digoxin and quinidine may be used together, it is well documented that
administering quinidine to a patient previously stabilized on digoxin will cause serum
digoxin levels to rise an average 2 to 2.5 fold. The mechanism of this interaction may
involve both a displacement of digoxin from tissue-binding sites and a reduction in renal
clearance of digoxin. Even though the significance of this interaction remains
controversial, many clinicians suggest reducing the dose of digoxin by 50% when adding
quinidine. In any case, the patient should be monitored carefully for signs of digoxin
toxicity.
3. Ans: B
4. Ans: E
5. Ans: D
6. Ans: C
7. Ans: E
8. Ans: B
Tips: Cardio selective BBs "EMAA". Esmolol is iv infusion. Acebutolol and Atenolol are
long acting once daily. Timolol is long acting but not cardio selective
9. Ans: C
10. Ans: C
Tips: stimulants laxative like senna, bisacodyl are effective to treat constipation caused
by opioids.
11. Ans: A
12. Ans: C
13. Ans: B
14. Ans: E
Tips: Thiazide cause "hyperGLUC"
15. Ans: C
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PHARMACY PREP
5. Which of the following drug should not be taken if it is not effective with first dose?
A. Nitro glycerine spray
B. Nitro-glycerine SL
C. Beta blockers
D. Nifedipine
E. Sumatriptan
D. Quetiapine
E. topiramate
9. Which of the following drugs priapism side effects, patient should report to doctor?
A. Trazodone
B. Sildenafil
C. fluoxetine
D. Alprostadil
E. All of the above
10. All of the following drugs can give pulmonary fibrosis, except?
A. Bromocriptine
B. Cisapride
C. Amiodarone
D. Ropinirole
E. Methotrexate
E. Bloating
A. bulimia nervosa
B. anorexia nervosa
C. sexual dysfunction
D. weight gain
E. A and B
23. A 50 year old female currently she is on atorvastatin, and atenolol and Tylenol # 1 for
arthritic pains. She visit pharmacy complaining of diarrhea, which of the following medication
may associated to her problem:
A. Atenolol
B. Codeine in Tylenol
C. Tylenol
D. Atorvastatin
E. All of the above
24. All of the following drugs may require WBC or CBC monitoring, except?
A. clozapine B. ticlopidine C. levothyroxine D. propylthiouracil E. methimazole
25. All of the following drugs give constipation side effect, except?
A. Atropine B. Ipratropium C. Tiotropium D. Scopolamine E. Donepezil
26. A 45 yo person using ramipril 10 mg daily for the treatment of hypertension. However,
hypertension was not controlled, and now doctor have added prazosin 10 mg daily. What is
the pharmacist concern?
A. potassium levels
B. low blood pressure
C. side effects of prazosin
D. drug interactions
E. patient age
27. A 72 yo person on atenolol and ASA 325mg, clopidogrel 75 mg, therapy. Recently
diagnosed with hypothyroidism. Doctor has recommend low dose, levothyroxine 12.5 mcg
daily dose. Why is the low dose given?
I)cardiovascular disease II)age III)drug interactions with atenolol, ASA and clopidogrel
A. I only B. III only C. I and II D. II and III E.I,II, III
28. A customer of your pharmacy using sumatriptan for migraine headache. However, this
person headache is not relieved after using sumatriptan. What is appropriate to do?
A. double the dose of sumatriptan
B. wait for 2 hour and try again sumatriptan
C. add other triptan with sumatriptan
D. Decrease dose and gradually increase the dose
E. Do not use sumatriptan
65-4
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30. A 72 year old regular customer of your pharmacy brings a new prescription of
levothyroxine 12.5 mcg daily. Recently patient is discharged from hospital after MI. Dr
prescribed low dose of levothyroxine because?
I) Myocardial infarction
II) Age 72 yr
III) Regular customer of your pharmacy
A. I only B. III only C. I and II D. II and III E.I,II, III
31. A 55 yo man using warfarin 5 mg daily to treat deep vein thrombosis. Recently doctor
prescribed metoprolol 50 mg bid to treat hypertension. What is the pharmacist concern?
A. high dose of warfarin
B. deep vein thrombosis at age of 55 y
C. Metoporolol is a beta blocker
D. Not a concern
E. INR monitoring is required
33. Which of the following drug pharmacist should counsel to stop taking and contact doctor
immediately if you feel suicidal ideas?
A. Haloperidol
B. Mefloquine
C. Lisinopril
D.Hydrochlorothiazide
E. Isoniazid
Ans. B
34. What agency in Canada issue warning related adverse reactions for drugs in post
marketing surveillance?
A. Health Canada's, Med Effect
B. Institute of Safe Medication Practices Canada
65-5
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35. Health professionals, Adverse reactions detected through cases should report to?
A. Canada vigilance program
B.ISMP
C. CIHI
D. C.PhA
1. Ans: C
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2. Ans: A
3. Ans: B
4. Ans: C
5. Ans: E
6. Ans: B
7. Ans: E
8. Ans: E
9. Ans: B
10. Ans: D
11. Ans: A
12. Ans: C
13. Ans: B
14. Ans: B
15. Ans: C
16. Ans: A
17. Ans: C
18. Ans: D
19. Ans: A
20. Ans: D
21. Ans: A
22 Ans:. E
23. Ans: D
65-7
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24. Ans: C
25. Ans: E
Tips: all anticholinergic drug gives constipation side effect. However donepezil is
anticholinesterase (agonist) drug.
26. Ans: B
27. Ans: C
Tips: low dose levothyroxine is used in seniors and cardiovascular disease patient. However
no interactions with atenolol, ASA and clopidogrel
28. Ans: E
Tips: do not use triptans if no relief with first dose.
29. Ans: B
30. Ans: C
31. Ans: C
65-8
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65-9
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PharmacyPrep.Com Drug Interactions
PHARMACY PREP
1. A 55 year old male patient receiving warfarin for deep vein thrombosis, he get the
prescription of carbamazepine; which of the following drug interaction possible:
I-Carbamazepine decrease metabolism of warfarin
II-Carbamazepine is has not interaction with warfarin
III-Carbamazepine increase metabolism of warfarin
A. I only B. III only C. I and II only D. II and III only E. All of the above
2. A 20 year old female patient currently on fluoxetine for depressive disorder, she get
the prescription of Tylenol # 3 for sever headache. Which of the following drug
interaction are possible:
A. Fluoxetine metabolism increases
B. Codeine metabolism increases
C. Fluoxetine metabolism decrease
D. Codeine metabolism decrease
E. No change and there is no drug interactions
3. A 40-year old female is regular customer of your pharmacy, her current medical
history include lovastatin. She brings prescription for her recent condition, Which of the
following medication is safe for her medical profile:
A. Erythromycin
B. Ketoconazole
C. Grapefruit juice
D. Niacin
E. Hydrochlorothiazide
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8) A patient using calcium supplements 500 mg tid. Now gets the prescription of
ciprofloxacin 500 mg bid for 3 days. What is appropriate method of administration?
A) Take Ca supplements and ciprofloxacin together morning and evening.
B) Take Ca supplements before 2 hour and after 4 hours of ciprofloxacin.
C) Stop taking Ca supplements for 3 days and continues ciprofloxacin
D) Stop taking ciprofloxacin and continue Ca supplement daily.
E) Call the doctor, change to levofloxacin.
9. Which of the following statement is incorrect about alcohol and drug interactions?
A. Alcohol and Metronidazole can give disulfiram reactions
B. Alcohol and metformin can give lactic acidosis
C. alcohol and chlorpropamide an antidiabetic drug can give lactic acidosis
D. alcohol and benzodiazepine can give sedation
10. A patient using Sildenafil 50mg should not take nitrates, because?
A. It can cause hypotension
B. It can cause hypertension
C. It can cause angina
D. It can cause congestive heart failure
E. None of the above
11. All of the following agent can cause urine discoloration, EXCEPT;
A. Metronidazole
B. Rifampin
C. Sulfasalazine
D. pyrivinium pamoate
E. tetracycline
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A. Altering GI flora
B. altering prothrombin time
C. increasing bleeding time
D. Increasing warfarin metabolism
14. A patient has migraine 3 to 4 times a months. Currently also diagnosed with benign
prostatic hyperplasia. Doctor has prescribed prazosin. Medical profile also includes
constipation. What drug is recommendation are suitable for migraine prophylaxis?
A. Amitriptyline
B.Verapamil
C. Propranolol
D. Sumatriptan
E. Nortriptyline
15. What over the counter drugs should be avoided with MAOIs?
A. Pseudoephedrine
B. Xylometazoline
C. Dextromethorphan
D. Food containing Tyramine
E. All of the above
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I-antacids
II-bi valent ions
III-tri valent ions
A. I only B. III only C. I and II only D. II and III only E. All of the above
20. A patient using atorvastatin 80 mg daily, also wants to use daily 1 glass of grapefruit
juice, what is pharmacist concern?
A. grapefruit juice induce CYP3A4
B. grapefruit juice inhibit CYP3A4
C. grapefruit juice is substrate for CYP3A4
D. grapefruit juice is essential for statin metabolism
E. grapefruit juice may decrease cholesterol
21. A patient using sildenafil 50 mg, should be cautious taking high dose of take the
following antihypertensive drugs
A. Amlodipine B. Propranolol C. Hydrochlorothiazide D. Prazosin
E. Ramipril
23. A 60 year old women taking calcium supplement bid. Recently doctor prescribed
alendronate 70 mg/wk. What is appropriate recommendation?
A. Take together calcium supplements and alendronate 70 mg once weekly
B. Do not take calcium supplements during the therapy of alendronate
C. Separate calcium supplements 2 to 4 hours from the dose of alendronate
D. Do not use alendronate while taking calcium supplement therapy
24. A 56 yo female using levothyroxine 25 mcg daily and metformin 500 bid. She comes
to buy Calcium supplements to prevent osteoporosis. What is true statement?
A. levothyroxine, calcium supplement should be separated for 4 hours so take
levothyroxine empty stomach first thing in the morning.
B. avoid taking calcium supplements because she is using levothyroxine
C. Separate Ca supplement 4 hour from levothyroxine
D. take Ca supplement in morning and take levothyroxine in evening
E. Never take levothyroxine, metformin and calcium supplement together
25. A 56 yo female using metformin 500 bid, and ciprofloxacin 500 mg tid for 3days. She
comes to buy calcium supplements 1500 mg tid to prevent osteoporosis. What is true
statement?
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26. A customer of your pharmacy enquiring that can she use herbal therapy like
grapefruit juice to treat her borderline high cholesterol, She using atorvastatin for
cholesterol therapy. what is appropriate to do?
A. talk to your doctor
B. definitely she can use grapefruit juice
C. She should start taking statins and avoid grapefruit juice
D. She should never take grapefruit juice for high cholesterol
E. Give her some information to read about high cholesterol therapy
27. A customer of your pharmacy using allopurinol for the past 10 yrs for hyperurecimia
and currently diagnosed for cancer. A doctor want to initiate azathioprine
chemotherapy. What is appropriate to do?
A. decrease dose of azathioprine
B. decrease dose of allopurinol
C. avoid allopurinol during chemotherapy
D. avoid azathioprine chemotherapy
E. do not change, any medications
28. A customer of your pharmacy profile shows nitroglycerin SL spray prn. He brings
prescription of sildenafil 50 mg prn. What to do?
A. Do not dispense sildenafil 50 mg because it can cause severe hypotension with
nitroglycerin SL
B. Dispense low dose sildenafil 25 mg
C. Dispense sildenafil 50 mg and counsel customer not to combine with nitroglycerin
D. dispense sildenafil 50 mg and counsel not to use nitroglycerin SL in case of chest pain
E. Talk to doctor and inform doctor about patient profile nitroglycerin SL
29. A customer of your pharmacy wants to use St. Johns wart to improve mood.
Currently he is on paroxetine for major depression. What is your opinion?
A. ok to use B. do not use St. Johns wart during paroxetine therapy C. refer to doctor D.
give him some literature of general health E. none of the above
30. Which of the following is the least drug interaction with levothyroxine?
A. Iron supplements
B. Calcium supplements
C. Magnesium supplements
D. Aluminum supplements
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E. Vitamin D supplements
31. A regular customer, takes a glass of grapefruit juice daily. If medication profile have
amiodarone, atorvastatin, hydrochlorothiazide, amlodipine and ASA 81 mg daily. Which
of the following drug is the least concern?
A. atorvastatin
B. amlodipine
C. hydrochlorothiazide
D. amiodarone
33. A regular customer of your pharmacy. Brings a new prescription of sildenafil 50 mg.
Which of the following drugs in patient profile is the least concern?
A. Nitroglycerin SL spray
B. Nitroglycerin SL tablets
C. Nitroglycerin transdermal patch
D. Sodium nitroprusside
E. Warfarin 5 mg tablets
34. If the above patient profile have nitrates, what is the pharmacist concern?
A. priapism
B. double vision
C. headache
D. hypotension
E. mood changes
35. A patient medical profile include, metformin, gliclazide, rosuvastatin, and ASA 81
mg. Occasionally patient uses omega 3, 6,9 and multivitamin supplements. Patient is
chronic alcoholic, renal disease, and liver diseases. Recently patient discharged from
hospital after congestive heart failure. What is the least concern of pharmacist with
respect to metformin?
A. chronic alcoholism
B. renal disease
C. disulfuram like reactions
D. congestive heart failure
E. lactic acidosis
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36. A patient lifestyle include high proteins diet. Which of the following is the most
concern for the pharmacist?
A. theophylline
B. levodopa
C. renal disease
D. orlistat
E. liver diseases
37. All of the following drugs decrease efficacy of oral contraceptives, except?
A. Rifampin
B. Amoxicillin
C. Phenytoin
D. Gabapentin
E. Carbamazepine
Ans. d
Tips: antibiotics and antiepileptic drugs likely decrease efficacy of oral contraceptive
pills.
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1.Ans: B
Tips: Carbamazepine is an inducer of CYP2C9, and the same enzyme is substrate of
warfarin. Therefore Carbamazepine increase metabolism of warfarin
2. Ans: D
Tips: Fluoxetine inhibits CYP 2D6 and this same enzyme is a substrate for codeine and
therefore decrease codeine metabolism
3. Ans: E
4. Ans: C
5. Ans: C
6. Ans: D
Tips: Tetracycline's bind with bi and tri valent ions such as calcium and aluminum ions.
7. Ans: E
8. Ans: C
9. Ans: C
10. Ans: A
11. Ans: E
12. Ans: D
13. Ans: A
14. Ans: C
15. Ans: E
16. Ans: E
17. Ans: A
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18. Ans: B
19. Ans: E
20. Ans: B
Tips: Grape fruit juice is potent inhibitor of the most common drug metabolizing enzyme
CYP3A4
21. Ans: D
22. Ans: D
23. Ans: C
24. Ans: A
25. Ans: C
26. Ans: C
27. Ans: A
Tips: azathioprine is metabolized by xanthine oxidase, thus reduce the dose of
azathioprine to 2/3 or 3/4
28. Ans: E
29. Ans: B
30. Ans: E
31. Ans: C
32. Ans: C
Tips: carbamazepine induce CYP 2C9 and 1A2, these enzymes are substrate of warfarin
33. Ans: E
34. Ans: D
35. Ans: C
36. Ans: C
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PHARMACY PREP
CLINICAL BIOCHEMISTRY
3. Which of the following plasma proteins has the GREATEST ability to bind acidic drugs
A. Albumin
B. Fibrinogen
C. Hemoglobin
D. Alpha glycoproteins
E. Beta lipoprotein
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E. Adipose tissue
11. What are the following lab test increase indicate myocardial infarction?
A. Creatinine kinase B. Troponin T C. Troponin I D. Troponin C E. ALP
12. A Patient with DVT was prescribed dalteparin. Which of the following lab test need
to monitor?
A. INR B. aPTT C. PT D. Vitamin K levels E. None of the above
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15. What is the best urine sample for the urine analysis?
A. end of the sample
B. sample from midstream
C. sample from end of stream
D. Sample form beginning of stream
E. any one of them is ok
16) A patient creatinine clearance 300 ml/hour. This patient is categorized as?
A) normal CrCl
B) Chronic renal disease
C) Severe renal disease
D) hepatic disease
E. None of the above
17. Anticancer drugs in chemotherapy often cause the following side effects?
A. Neutropenia
B. Thrombocytopenia
C. Leukopenia
D. decrease in basophils
E. Increased monocyte
18. Which of the following test is the most sensitive to liver cirrhosis?
A. bilirubin B. AST C. ALT D. ALP E. CK
19. Which of the following is the most sensitive test to detect cholestasis jaundice?
A. bilirubin B. AST C. ALT D. ALP E. CK
21. An osteoarthritis patient using NSAIDS to treat joint pain. Approaches to your
pharmacy ask if any pain reliever change dark brown stool color or "coffee ground".
What is appropriate?
A) some NSAIDS can change stool color to dark brown
B) No, NSAIDS change stool color however if you notice dark brown of coffee ground
stool color you should contact doctor immediately
C) all NSAIDS give dark stool color
D) color change is quite normal and not a concern.
E) Tell patient to avoid taking coffee
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22) Which of the following is the major ketone increase in blood diabetic ketoacidosis?
A) Acetone
B) Beta hydroxy butyric acid
C) Ethyl and methyl ketone
D) Long change ketones
E) Acetyl acetic acid
24. A laboratory test indicated increased number of neutrophil. This may be due to?
A. Viral infections B. Inflammation C. Bacterial infection in sinusitis
D) Seasonal flu E. Parasites infections
25. A patient on vancomycin IV to treat MRSA. Which of the following lab test should be
monitored?
A. Liver function test
B. Complete blood count
C. Renal function test
D. Creatinine kinase
E. Chest X-ray
26) A patient is diagnosed with chronic bronchitis and pneumonia in COPD. Which of the
following is increased?
A. Basophills B. Neutrophil C. Lymphocytes D. WBCs E.RBCs
27. A patient laboratory shows increase in Eosinophills. This can be indicator of?
A. COPD B. Infection C. Asthma D. pneumonia E. ulcer
28. A 55 yo patient using warfarin to treat deep vein thrombosis. Which of the following
factors increase risk of bleeding?
A. Using vitamin K supplements
B. Using ASA 650 mg for pain
C. Using dark green vegetables such as broccoli, avacado
D. Using supplements containing vitamin K
E. Using iron supplements
29. A patient serum thyroid function test (Serum TSH) shows, 10 mU/L. Doctor should
initiate therapy of?
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A. methimazole
B. Propylthiouracil
C. Levothyroxine
D. Radioactive iodide
E. Lugol's solution
31. What is lab test are related to diagnosis of lupus like syndrome?
A. Increase ESR
B. Increase C-reactive proteins
C. Antinuclear antibody test
D. Associated with myalgia, arthralgia and fever
E. All of the above
32. Which of the following is NOT a lab investigation for rheumatoid arthritis?
A. Erythrocyte sedimentation rate (ESR)
B. C-reactive protein (cRP)
C. Rheumatic factor
D. Arthralgia
E. Bone Mineral Density
33. KP is a 50 year old man using atorvastatin 40 mg daily. Get muscle pain. Which of the
following lab test increase?
A) ALT B) AST C) CK-MB D) CK-MM E) Troponin I
35. MP is 49 year old male a type 2 diabetic patient. Currently patient has uncontrolled
blood glucose. Which of the following are NOT related to diabetes or and glucometry
tests?
A. Glucose tolerance test
B. Fasting blood glucose test
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C. HbA1c test
D. Urine ketone test
E. Serum Ferritin
36. A 70 year old patient is using heparin to prevent stroke. Doctor suspect patient has
hemorrhage. Doctor should consider monitoring?
A) INR B) PT C) aPTT D) heparin assay E) no lab test
37. Acetaminophen overdose associated with hepatotoxicity. This can increase the liver
transaminases. Which of the following are liver transaminases?
A. ALP, AST and ALT
B. ALP and AST
C. AST and ALT
D. ALT and ALP
E. Bilirubin
38. Which of the following liver enzyme are indicator or liver cirrhosis?
A. AST/ALT B. Serum albumin C. Prothrombin time D. Bilirubin
E. Alkaline. Phosphate
39. A patient presents with dark urine and muscle pain. Which of the following drugs
may be patient is on?
A) metronidazole B) Rifampicin C) bismuth D) lithium E) Atorvastatin
42. ESR is nonspecific test that is often used as screening tests for patients
with unexplained fever, arthritis and muscle symptoms. The ESR elevation
indicates, all of the following, except?
A. RA
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43. A Patient with DVT was prescribed dalteparin. Which of the following
lab test need to monitor?
A. INR
B. aPTT
C. PT
D. Vitamin K levels
E. None of the above
ans.e
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CLINICAL BIOCHEMISTRY
ANSWERS:
1. Ans: E
2. Ans: B
3.Ans: A
4. Ans: E
5. Ans: A
Tips: Cockgraft-gault equation is used to estimate creatinine clearance.
6. Ans: E
7. Ans: A
8. Ans: A
Tips: CK-MM indicator of skeletal muscle, CK-BB is for brain and CK-MB for cardio.
9.Ans: B
10) Ans. D
11. Ans: C
12. Ans: E
13. Ans: A
14. Ans: D
15.Ans: B
16) Ans. C
Tips: CrCl <50 ml/min is chronic renal disease
17.Ans: C
18. Ans: B
19. Ans: D
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20. Ans: B
21. Ans: B
22) Ans: B
23. Ans:E
24. Ans: C
25. Ans: C
Tips: vancomycin renal toxicity thus patient monitored for renal function tests.
25. Ans: D
26) Ans: B
Tips: chronic bronchitis is bacterial infection in COPD, so increase neutrophils.
WBCs Normal Indicator
Neutrophils 55% to 75% Bacterial infection
Lymphocytes 20% to 40% Viral infection
Monocytes 0% to 7% Tuberculosis
Eosinophils 0% to 5% Parasites infection
Basophils 0% to 1% Inflammation, Allergies, Asthma,
27. Ans: C
Tips: Asthma and allergies increase esinophils and basophils.
28. Ans: B
29. Ans: C
30) Ans: C
31. Ans: E
32. Ans:E
33.Ans. D
34. Ans. C
35. Ans. E
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36. Ans. C
37. Ans. C
Tips: AST and ALT are liver transaminase. Whereas ALP is alkaline phosphotase enzyme.
38. Ans. D
Tips. direct bilirubin, and urine bilirubin and alkaline phosphate significant increased and
AST/ALT minimally increased in hepatocelluar jaundice, obstructive jaundice and liver
cirrhosis.
39. Ans. E
Tips. this is symptoms of myopathies associated with statins.
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PHARMACY PREP
THERAPEUTIC DRUG MONITORING
4) CK-MM indicates?
A-Creatinin kinase in skeletal muscles
B-Creatinin kinase in brain
C-Creatinin kinase in Heart
D-Creatinin kinase in liver
E-Creatinin kinase in renal elimination
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C-aPTT
D-A and B
E-All of the above
26) Which drugs patient may complain sandy and gritty feeling in eye? The pharmacist
recommends patent to consult doctor get eye exam
I) amiodarone
II) hydroxychloroquine
III) Quinidine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
11) A 52 yo women using Synthroid 75 mcg daily dose. Recently her blood test done it
showed her serum TSH are less than 0.4 mU/L. What is the appropriate action to do?
A) Increase dose of Synthroid to 100 mcg
B) Double the dose Synthroid
C) Do not change the dose of Synthroid
D) Decrease dose of Synthroid
E)Recommend to take empty stomach
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12) A 68 yo male using warfarin 4 mg daily and currently his INR is 2 to 3. Recently he
cut his finger slightly with nail clipper. and had slightly bruise on his face. What is
appropriate action do?
A) Refer him to emergency
B) Ask him to discontinue warfarin and contact doctor immediately
C)give him first aid like band aid his finger nail.
D)Recommend vitamin K supplements
E)Recommend to increase dose of warfarin
13) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, gliclazide SL
30 mg daily. A doctor recommends monitoring of lab test for metformin?
I)Renal Function Test
II) Creatinine clearance
III) Liver Function Test
A) I only B) III only C)I and II D)II and III E)I, II, III
14) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, gliclazide SL
30 mg daily. A doctor recommends regular monitoring of lab test for rosuvastatin?
A)CK-mm B)LFT C)Renal function test D) B.P E)ECG
19) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, glicalizide SL
30 mg daily. A doctor recommends regular monitoring of lab test for rosuvastatin?
A) LFT B) CK-mm C) CrCl D)glucose E)Renal function test
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20) Which of the following lithium serum levels gives lithium toxic symptoms?
A) > 1.5 mEq/L
B) < 1.5 mEq/L
C) > 2.0 mEq/L
D) > 3.0 mEq/L
E) > 4.0 mEq/L
21) A 45 yo man recently diagnosed with serum TSH 10 mU/L. However normal range of
serum TSH is 0.5 to 5 mU/L. This patient should be initiated?
A) hyperthyroidism therapy
B) hypothyroidisms therapy
C) Methimazole
D) Propylthiouracil
E) Radioactive therapy
22) A patient is using furosemide to treat congestive heart failure. Which of the
following electrolytes loss is NOT monitored?
A) Potassium
B) Calcium
C) Magnesium
D) Sodium
E) Aluminum
23) Which of the following does NOT required monitoring, serum TSH?
A) amiodarone
B) Prednisone
C) Levothyroxine
D) methyl prednisone
E) infliximab
25)A 29 yo patient using lithium carbonate to treat manic depression. What is NOT monitored?
A) serum TSH
B) CBC
C) blood glucose levels
D) serum level of lithium
E) eye exam
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1) Ans: B
Tips: Clozapine associated with side effect of agranulocytosis, thus it should be
monitored for WBC or CBC.
2) Ans: A
3) Ans: A
4) Ans: A
5) Ans: A
6) Ans: A
7) Ans: D
8 Ans:) B
9) Ans: C
10) Ans: E
Tips: Amiodarone, hydroxychloroquine and quinidien may conreal deposits.
11) Ans: D
Tips: TSH are less than 0.4 mU/L is indicator of overdose of Synthroid, thus decrease
dose.
12) Ans: C
13) Ans: E
14) Ans: B
15) Ans: B
16) Ans: C
Tips: hydrochlorothiazide and furosemide can cause hypokalemia, this can lead to
digitalis toxicity.
17) Ans: D
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18) Ans: C
Tips: furosemide can cause hypocalcemia (loop loose calcium)
19) Ans: A
20) Ans: C
21) Ans: B
22) Ans: E
23) Ans: E
24) Ans: D
Tips: thiazides cause hypercalcemia or hyperGLUC. Whereas loop diuretics cause
hypocalcemia
25) Ans: E
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www.pharmacyprep.com OTC medications dermatological conditions
PHARMACY PREP
OTC DRUGS FOR DERMATOLOGICAL CONDITIONS
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9) What is the drug of choice to treat complicated diaper rash (diaper rash more than 3 days):
A. barrier bases (zinc oxide, petrolatum)
B. antifungal agents clotrimazole 1% cream, miconazole and Nystatin
C. Anti-inflammatory agents (0.5% hydrocortisone)
D. Alcohol wipes
E. Changing diaper
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C-Zinc pyrethione
D-Hydrocortisone
E-Selenium sulfide
15) A 20 year old women treated with topical treatment for acne, however, it not treated,
which of the following is recommended?
A-Benzoyl peroxide
B-Tretinoin
C-Isotretinoin
D-Salicylic acid
E-None
16) Which of the following skin condition have symptoms of red scaly patches?
A) Psoriasis B) Dermatitis C) Acne D) Rosacea E) Urticaria
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20. What is appropriate socks for athletes foot and diabetic foot problems?
A. 100% cotton socks
B. Nylon socks
C. Synthetic fiber
D. Synthetic socks
E. Cotton (60% less) blend with synthetic fiber, nylon, acrylic or rayon
21. What is the drug of choice for head lice in child with seizures?
A. permethrin 1%
B. Lindane 1%
C. Sulfur 5%
D. Isopropyl mersteate
E. permethrin 5%
Ans. a
22. What is the drug of choice to treat mild acne with inflammation?
A. benzoyl peroxide
B. topical retinoids
C. Tetracycline
D. Clindamycin topical
E. Erythromycin topical
Ans. b
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25. What is appropriate socks for athletes foot and diabetic foot are recommended?
A. 100% cotton socks
B. Nylon socks
C. Synthetic fiber
D. Synthetic socks
E. Cotton (60% less) blend with synthetic fiber, nylon, acrylic or rayon
Ans. e
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1- Ans: D
2- Ans: D
3) Ans: E
BURNS CLASSIFICATION
st nd
1 degree 2 degree 3rd degree
superficial burns, that may superficial and partial severe burns that can give
cause by sunburn thickness burns that may lathery skin.
cause by hot water, oil spills
and splashes
4- Ans: B
5- Ans: E
Head lice
6- Ans: E
7) Ans: B
8- Ans: C
Tips: Astringents such as calamine lotion, aluminum acetate, zinc oxide
9. Ans: C
Tips: The drug of choice to treat complicated diaper rash is clotrimazole 1% cream.
Uncomplicated diaper rash Complicated diaper rash
Limited rash Confluent tomato red plaques, white scaly border.
ZnO, petrolatum, hydrocortisone Clotrimazole, miconazole, nystatin and ZnO,
hydrocortisone
10- Ans: B
11- Ans: A
Tips: snow, high altitude, and beach, mountains can give more sun burn.
12) Ans: D
13) Ans: B
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14- Ans: B
15) Ans: C
16) Ans: A
17) Ans: D
18) Ans: C
20. Ans. E
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PHARMACY PREP
OTC AND PRESCRIPTION DRUGS FOR OPHTHALMIC, EAR AND MOUTH
DISORDERS
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9. Which of the following ophthalmic conditions required referral to doctor?
A. Red eye B. Pain in eye C. Blurred vision D. Dry eye E. B and C
10) Which of the following ophthalmic conditions require referral to doctor? except
A) Red eye or pink eye
B) Pain in eyes
C) Blurred vision
D) Dry eye in diabetic patient
E) Blepharitis
Ans. A
11) A customer of your pharmacy using metformin 500 mg bid and glyburide qd.
Complains to have gritty and sandy feeling in eye. What is appropriate to do?
A) Refer to doctor because of diabetic condition
B) Refer to doctor because sandy and gritty feeling in eye is conjunctivitis
C) Refer to doctor because glyburide side effect is dry eye
D) Refer to doctor because metformin side effect is dry eye
E) Refer to doctor because these are side effects of anticholinergic drugs
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15. Which of the following eye condition can be treated by non prescription therapy?
A. Eye pain
B. Vision changes
C. Blepharitis
D. Red eye
E. Foreign object in eye
Ans. D
1.Ans: D
2. Ans: B
3. Ans: B
4. Ans: B
5. Ans: A
6. Ans: D
7. Ans: C
Tips: Calamine lotion (ZnO+FeO) and oatmeal bath and oral antihistamine can be helpful
in treatment of cold sores.
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8. Ans: D
Tips: Sympathetic agonist (sympathomimetics) increases IOP. Open angle glaucoma
(OAG) is due to increase in IOP and increase in H 2 O humor of eye or could be due
decrease in drainage of H 2 O humor in the eye. For the treatment of OAG sympathetic
blockers such as Timolol are effectively used to decrease IOP and H 2 O humor.
9. Ans: E
10. Ans: D
11. Ans: A
Tips: Diabetic retinopathy symptoms require referral to doctor
12. Ans: C
13. Ans: C
14. Ans: D
Tips: amiodarone gives ocular deposits SEs.
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PHARMACY PREP
OTC ANTIHISTAMINE, DECONGESTANTS AND ANTITUSSIVES
6-Alpha 1 agonist, phenylephrine has all of the following side effect EXCEPT:
A-vasoconstriction B-Headache C) orthostatic hypotension D-Arrhythmias
E-Mydriasis
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8-A mother comes to your pharmacy with concern of her child 2 yr old having fever and
pharyngitis, currently using amoxicillin. What is appropriate recommendation?
A-recommend ASA
B-recommend oral ibuprofen
C-Recommend acetaminophen suppositories
D-Recommend cold sponges
E-do not recommend any medications
10) A customer of your pharmacy using MAO Inhibitors for major depression. Now looking for
nasal congestion medication. What is recommended?
A) pseudoephedrine B) ephedrine C) codeine D)d extromethorphan E) saline nasal drops
11. A regular customer, purchased dextromethorphan 2 times in last 20 days. Pharmacist talk
to patient and checked patient profile and referred to doctor. Which of the following
medication in patient profile prompted pharmacist?
A) Glyburide B) Metformin C) Rosuvastatin D) Ramipril E) All of the above
12. A 50 year old school bus driver brings prescription of alprazolam and clonazepam to treat
anxiety. He is frequent customer of pharmacy to purchase diphenhydramine and
dimenhydrinate. Pharmacist informed to doctor patient use of benzodiazepines and
antihistamine. Dr reported to employer of patient. What ethical principle were applied?
A) Nonmaleficence
B) Beneficence
C) Autonomy
D) Veracity
E) Justice
13. Which of the following is the most commonly abused over the counter medication?
A. Dextromethorphan
B. Pseudoephedrine
C. Tylenol #1
D. Diphenhydramine
E. Marijuana
Ans. a
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1) Ans: E
2- Ans: A
3- Ans: E
4) Ans: C
5- Ans: D
6- Ans: C
Tips: Hypertension is common side effect phenylephrine.
7- Ans: B
8- Ans: B
9) Ans: A
10) Ans: E
Tips: with MAO I for nasal congestion avoid using pseudoephedrine, ephedrine can cause
hypertension crisis For cough avoid dextromethorphan cause serotonin syndrome
11. Ans: D
Tips: ACE Inhibitors may induce cough. This can be managed by changing therapy to ARBs.
12. Ans: A
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PHARMACY PREP
OTC DRUGS FOR NAUSEA, VOMITING, CONSTIPATION, DIARRHEA,
HEMORRHOIDS AND HELMENTHS
1) A 60 yo customer of your pharmacy using oxycontin daily for severe pain after fracture.
What is the treatment best option for constipation?
I) Sennakot II) Docusate sodium III) high fiber diet
a) I only b) III only c) I and II only d) II and III only e) I, II, III
2- Psyllium (Metamucil) is a bulk-forming laxative agent. Patients using should get the
following instructions:
I- Avoid psyllium (Metamucil) in pregnancy
III- It should mix the dose with a glass of cool water or other fluid and drink it down quickly.
II-This should be followed with more fluids.
a) I only b) III only c) I and II only d) II and III only e) I, II, III
3)Antacids are normally used to equilibrate the stomach pH and protect the stomach from the
effect of acids. Which of the following antacids has a cathartic side effect?
a) Calcium carbonate
b) Dihydroxyaluminum sodium carbonate
c) Magnesium hydroxide
d) Calcium sulfate
e) Aluminum silicate
6) A mother of 6 month old child approaches to your pharmacy. Her child has diarrhea. She is
also breast feeding her child, what is appropriate recommendation?
A) recommend ORS and ask to continue breast feeding
B) Recommend ORS and ask to stop breast feeding
C) Recommend ORS and refer to doctor
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D) Refer to emergency
E) Do nothing, it will be alright
8) All of the following are self care measure should be recommended in hemorrhoids, except?
A. Increase high fibre diet B) Increase fluid intake C) Avoid food on the run
D) Regularize toilet habits e)Prolong stay on toilet seat
11)A mother comes to pharmacy and has concern about a 6 months baby have diarrhea. She
is also breast-feeding child, what is appropriate recommendation?
A-recommend ORS and ask to continue breast feeding
B-Recommend ORS and ask to stop breast feeding
C-Recommend ORS and refer to doctor
D-Refer to emergency
E-Do nothing, it will be alright
12) A cancer patient experiencing severe nausea and vomiting, should be recommended, all
except?
A-Avoid large meals B-Avoid fat-oily meals C-Avoid taking small and frequent meals
D-Take divided meals E-Avoid heavy meals
14) All of the following are self care measure should be recommended in hemorrhoids,
except?
a)Increase high fiber diet b)Increase fluid intake C)Avoid food on the run
D)Regularize toilet habits e) Prolong stay on toilet seat
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17) Which of the following is the correct statement about nausea and vomiting in pregnancy
A-initial therapy is Diclectin B-initial therapy is dimenhydrinate and self care for nausea and
vomiting recommended C)Refer to emergency D)None of the above
18) A customer of your pharmacy, want to buy something for hard stool. What is good
recommendation
A) Senna B) Bran C) Psyllium D) Docusate E) Enema
19) A pregnant women comes to your pharmacy, and have nausea and vomiting. What is
appropriate to do initial therapeutic approach in first 3 days of nausea and vomiting?
A-Recommend dimenhydrinate to treat mild N&V and self care
B-Refer to doctor for Diclectin
C-Recommend self care measure to minimize nausea vomiting
D-Refer to emergency
E-Recommend ginger root tablets
22) Which of the following microorganism have can cause traveler diarrhea in customer
travelling to south east Asia?
I) E. coli II) Shigella sp III) Compylobacter jejuni
a) I only b) III only c) I and II only d) II and III only e) I, II, III
23) A patient is buying Tylenol # 1, 200 tablets. Which of the following is pharmacist concern?
I) Constipation II) Liver toxicity III) Addiction
a) I only b) III only c) I and II only d) II and III only e) I, II, III
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24) A patient with terminal metastatic breast cancer gets the prescription of oxycontin and
Psyllium. Later after few days her daughter comes to pick a prescription of hydromorphone
and lactulose. What is pharmacist concern?
A) addiction potential B) False prescription C) Contraindication D) constipation E) Overdose
25) 1. What suggestions and advice should be given to the patient with pinworm infection?
I. Treatment of pin worms should be taken for all members of the family
II. Must not share under garments
III. Must not share dishes
a) I only b) III only c) I and II only d) II and III only e) All of the above
26. What is the drug of choice to treat chemotherapy induced nausea and vomiting?
A. Ondansetron B. Dexamethasone C. Lorazepam D. Metoclopramide E.
Dimenhydrinate
Ans. b
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3- Ans: C
4- Ans: D
5- Ans: C
Tips: Portal – systemic encephalopathy. Osmotic laxative like lactulose, decrease blood
ammonia levels and as result this effect on mental status in encephalopathy patients.
7) Ans: D
8) Ans: E
9) Ans: A
10) Ans: B
11) Ans: A
12) Ans: C
13) Ans: D
14) Ans: E
15) Ans: A
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16) Ans: B
17) Ans: B
18) Ans: D
19) Ans: A
20) Ans: D
21. Ans: A
22) Ans: E
23) Ans: C
24) Ans: B
25) Ans: E
Tips: spreads by oral-fecal infestation.
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PHARMACY PREP
OTC DRUGS FOR HEADACHE, SPORTS INJURIES, PRESSURE ULCERS, AND LOW
BACK PAIN
4. Dyspnea means
a) Painful muscle spasms b) Pain in the heart c)Pain in extremities d)Painful breathing
e) Painful menstruation
6-Which of the following is not a side effect of an opioids analgesic for example morphine:
a) C.V depression
b) Constipation
c) Sedation
d) CNS depression
e) Dilatation of eye pupil
7-A sports person has ankle sprain while playing ice hockey, what is inappropriate
recommendation?
A-Rest to injured part
B-Apply ice
C-Warm compress
D-Elevate injured area
E-Recommend OTC NSAIDs
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11) A 45 yo man diagnosed with benign prostatic hyperplasia, and migraine prophylaxis.
Which of the following is the appropriate therapy for migraine prophylaxis?
A) Propranolol
B) Nortriptyline
C) Amitriptyline
D) Sumatriptan
E) Zolmitriptan
12) A customer of your pharmacy using sumatriptan for migraine attacks. What is correct
statement?
A)after taking sumatriptan migraine headache does not relieve than double the dose of
sumatriptan
B)after taking sumatriptan migraine headache does not relieve than decrease the dose of
sumatriptan
C)after taking sumatriptan migraine headache does not relieve than do not use sumatriptan
D. If sumatriptan is not effective in relieving headache then try other triptan
E. None of the above
13) A 12 month old child swallowed acetaminophen 10 ml syrup. A panic mother contact
pharmacy. What is the initial symptoms of acetaminophen overdose?
A) Nausea B) Vomiting C) Stomach upset D) Diarrhea E) Hepatotoxicity
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C. Damage to nerve
D. Diabetes
E. Post herpes infection
Ans. B
15. A patient with renal disease and has low back pain. What is the treatment option?
A. Diclofenac topical
B. Capsaicin
C. Oral NSAIDs
D. Methadone
E. Codeine
Ans. A
16. All of the following can be used to manage low back pain, except?
A. Tramadol
B. Acetaminophen
C. Diclofenac
D. Colchicine
E. Tramacet
Ans. D
17. A 12 yo boy got severe injury in his ankle during a soccer game. All of the following are
appropriate, except?
A. use acetaminophen for pain
B. use ibuprofen pain
C. Apply cold compress
D. Apply warm compress
E. Rest injured area
Ans. D
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OTC DRUGS FOR HEADACHE, SPORTS INJURIES, PRESSURE ULCERS, AND LOW
BACK PAIN
ANSWERS:
1. Ans: C
2- Ans: E
3- Ans: B
4. Ans: D
5. Ans: C
6- Ans: E
7- Ans: C
Tips: R-I-C-E is recommended approach for sports injuries.
R= rest to injured part, I = apply ice, C = cold compress, E = elevated injured part.
8) Ans: A
9) Ans: E
10) Ans: D
11) Ans: A
12) Ans: C
13) Ans: B
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PHARMACY PREP
ASTHMA AND COPD
4) A 3 yr child was newly diagnosed with asthma. All of the following questions are
important to ask his mother EXCEPT:
A) Any cardiovascular problems?
B) Does other family member have asthma?
C) How often symptoms come?
D) Old asthma medication he used before?
E) How many times wake up in night due to symptoms
5) A 45 yo patient with emphysema and pain, and is not controlled, the doctor switched
him to morphine and his daughter came to pharmacy, you will call the doctor because:
a) You will ask to change the medication
b) To tell the dose of medication because its too much
c) To ask for written prescription of morphine
d) Her concern about constipation
12. Which of the following asthma device at home helps patient to determine when to
go emergence?
A) Peak expiratory flow rate (PEFR)
B) Forced expiratory volume in one second (FEV1)
C) Forced vital capacity (FVC)
D) Total lung capacity
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15) Asthma acute exacerbation can be triggered by all of the following EXCEPT:
A. warm and dry weather
B. stressful emotional time
C. bacterial and viral pneumonia
D. withdrawal of asthma medications
17) Which of the following inhaler require rinsing mouth after use.
A. Servent (salmetrol)
B. Ventolin (albuterol)
C. Atrovent (ipratropium)
D. Pulmicort (budesonide)
18) In emergency treatment of asthma, the preferred first line treatment is:
A. theophylline
B. salbutamol
C. cromolyn sodium
D. Zafirlukast
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34) Drugs are not affected by catecholamine O-methyl transferase (COMT) enzymes
except:
A. Salmeterol
B. Salbutamol
C. Metoproterenol
D. Terbutaline
37) All of the following drugs can be indicated for the treatment of asthma EXCEPT:
A. Ipratropium
B. Metoprolol
C. Albuterol
D. Zafirlukast
38) A 45 yo patient with emphysema and pain, and is not controlled, the doctor switched
him to morphine and his daughter came to pharmacy, you will call the doctor because:
a) You will ask to change the medication
b) To tell the dose of medication because its too much
c) To ask for written prescription of morphine
d) Her concern about constipation
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41) A 40 yr old asthma patient brings a new prescription of montelukast bid. Currently
medication profile include salbutamol prn, Symbicort (budesonide and formoterol) 1
puff bid. What is the action to do?
A) ask patient to stop using Symbicort
B) ask patient to stop using salbutamol prn
C) dispense montelukast and counsel how to use it
D) Contact doctor to change Symbicort to Advair
E) Contact doctor to change to Zafirlukast
45) Which of the following asthma device at home helps patient to determine when to go
emergence?
A) Peak expiratory flow rate (PEFR)
B) Forced expiratory volume in one second (FEV1)
C) Forced vital capacity (FVC)
D) Total lung capacity
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48) The volume of air that passes in and holds and out of the lungs in normal breathing
is called?
A. Total lung capacity
B. Tidal volume
C. Breathing capacity
D. Peak flow
E. Vital capacity
B. Fluticasone inhaler
C. hydrocortisone injection
D. Long acting beta agonist
E. Tiotropium
Ans. b
Ans. d
59. A copd patient prescribed theopylline. Which of the following least likely toxic
symptoms if theophylline serum levels are over 10-20 mcg/ml?
A.vomiting B. tachycardia C. sweating D. anxiety & restlness E.sedation
Ans. E
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1)Ans: C
Tips: neonates and infants have slowest rate of clearance
2) Ans: C
Tips: Theophylline is substrate of CYP1A2, and ciprofloxacin is the inhibitor of CYP1A2
3) Ans: B
4) Ans: A
5) Ans: D
6. Ans: E
Tips: Theophylline is added id doses not response to anticholinergic)
7) Ans: D
8) Ans: C
9) Ans: D
10. Ans: C
11. Ans: B
Tips: In an emergence situation, the most rapidly acting agent is used first. The choice of
route of administration depends on severity of attack.
12. Ans: A
13. Ans: E
14) Ans-A
15) Ans-A
16) Ans: D
17) Ans-D
18) Ans-B
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19. Ans: D
20. Ans: D
21) Ans: A
22)Ans: D
23)Ans: D
24) Ans: D
26) Ans: A
27) Ans: A
28. Ans: C
29. Ans: D
30. Ans: B
31. Ans: A
32) Ans: D
33) Ans: B
34) Ans: A
Tips: Short acting is not affected by COMT enzyme because this is activated by non
COMT enzyme.
35) Ans: D
36) Ans: C
37) Ans: B
Tips: Asthma is characterized by increased responsiveness of trachea and bronchi to
various stimuli and narrowing of airways. It is associated with shortness of breath, chest
tightness, wheezing and coughing. The Beta-2 receptors stimulation generally dilates the
bronchial smooth muscles and helps in controlling asthma.
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38) Ans: D
39) Ans: E
Tips: Theophylline is added id doses not response to anticholinergic)
40) Ans: D
41) Ans: C
42) Ans: D
43) Ans: C
44) Ans: B
Tips: In an emergence situation, the most rapidly acting agent is used first. The choice of
route of administration depends on severity of attack.
45) Ans: A
46) Ans: E
47) Ans: E
48)Ans. B
49) Ans. A
50) Ans. A
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PHARMACY PREP
SMOKING CESSATION
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SMOKING CESSATION
ANSWERS:
1) Ans: C
2) Ans: B
3) Ans: D
4) Ans: D
Tips: bupropion has least sexual dysfunction among antidepressants.
5) Ans: B
6) Ans: A
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PHARMACY PREP
SLEEPING DISORDERS
4) Zopiclone is?
A-Non-benzodiazepine act on BZ 1 receptors
B-Benzodiazepine act on BZ 1 receptors
C-Non-benzodiazepine act on BZ 2 receptors
D-Non-benzodiazepine act on BZ 1 and BZ 2 receptors
E-Benzodiazepine act on BZ 2 receptors
6) Which of the following drug has NOT taste change side effects?
A) zopiclone B) captopril C) metformin D) tetracycline E)metronidazole
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7) Which of the following drug has faster rebound insomnia side effects?
A) Triazolam B) Diazepam C) Oxazepam D) lorazepam E) Alprazolam
8) What benzodiazepines are preferable to treat the type of insomnia that is associated with
difficulty in falling in sleep?
A) Short acting B) Intermediate acting C) Long acting D) intermediate and long acting E)
short and long acting
9) MK is 50 year patient comes to pick up prescription of lorazepam 0.5 mg tab. Which of the
following statement is relevant?
A. Taking alcohol concomitant with lorazepam can cause severe sedation thereby avoid.
B) Take benzodiazepine with food
C) avoid taking with grapefruit juice
D) All of the above
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SLEEPING DISORDERS
ANSWERS
1) Ans: C
Tips: avoid exercise at least 2 to 3 hours before bedtime
2) Ans: B
3) Ans: D
4) Ans: A
5) Ans: C
Tips: Lethargy = fatigue; Hangover = disorientation; Sedation = sleepy; Somnolence = sleepy
6) Ans: D
7) Ans: A
8) Ans: A
9) Ans: A
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PHARMACY PREP
EATING DISORDER AND WEIGHT LOSS TREATMENTS
2-You notice Ms A’s, a young girl of normal weight, in the pharmacy purchasing laxatives. You
take the time to talk to her about her laxative use, and find that she has been binge eating
and using laxatives about three times per week for the last six months.
Based on this information, which of the following statements is most likely to be correct?
A. She may have bulimia nervosa of the non-purging type since she is not self-inducing
vomiting
B. She may have bulimia nervosa of purging type since she uses laxatives
C. She does not have bulimia nervosa, since she is of normal weight
D. She does not have bulimia nervosa, since her bingeing episodes are not frequent enough
5-All of the following drugs are used to treat weight loss except?
A-Meridia B) Orlistat C-Bupropion D-Topiramate E-Mirtazapine
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EATING DISORDERS
ANSWERS
1.Ans: B
2- Ans: B
3- Ans: B
Tips: BMI = weight/height2 = kg/m2
4- Ans: C
Tips: = kg/m2
5- Ans: E
6- Ans: C
7) Ans: A
Tips: BMI = weight/height2 = kg/m2
8- Ans: A
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PHARMACY PREP
GASTROINTESTINAL DISORDERS
3- Drugs are mainly metabolized in the GIT by many different reactions. The most
common drug reaction in the GIT may include:
a) Oxidation
b) Reduction
c) Hydrolysis
d) Dealkylation
e) Ionization
4. Acetyl salicylic acid (ASA) is one of the most used worldwide analgesics. Which of the
following reactions metabolizes it in the gastrointestinal tract and liver?
a) Oxidation
b) Hydrolysis
c) Reduction
d) Dealkylation
e) Deamination
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9) One of the most common conditions associated with acute hemorrhagic gastritis may
include:
a) Chronic alcoholism
b) H. pyloric bacterial infection
c) Carcinoma of stomach
d) Carcinoma of colon
e) Traveler’s diarrhea
10) Antacids are normally used to equilibrate the stomach pH and protect the stomach
from the effect of acids. Which of the following antacids has a cathartic side effect?
a) Calcium carbonate
b) Dihydroxyaluminum sodium carbonate
c) Magnesium hydroxide
d) Calcium sulfate
e) Aluminum silicate
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c) I and II only
d) II and III only
e) All are correct
12- Metoclopramide is a parasympathetic agent that may have which of the following
characteristics?
I- Cholinomimetic agent that stimulates motility of the stomach
II- Used in treatment of diabetes gastro paralysis and GERD
III- Used centrally as antiemetic during cancer chemotherapy
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- All of the following are correct statements regarding bile, EXCEPT:
a) It is secreted by the liver
b) It is poured into the small intestine via the bile ducts
c) It is constituted of bile acids, cholesterol, phospholipid, bilirrubin and electrolytes
d) Bile is acid due to its bicarbonate content
e) It is also responsible for the alkalinization of intestinal content
14) Proton Pump Inhibitors are irreversible direct inhibitors of K pump. Correct
statements regarding these drugs may include:
I- Used in gastric and duodenal ulcers
II- Omeprazole and lansoprazole are examples of proton pump inhibitors
III- They decrease stomach acid secretion
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
15- Zollinger-Ellison disease is a grave stomach disease. Drug of choice in the treatment
of Zollinger-Ellison diseases may include:
a) Ranitidine
b) Famotidine
c) Loratidine
d) Omeprazol
e) Antacids
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19- The digestive process is done in many different steps. The first step of digestion may
be taken in:
a) Mouth
b) Esophagus
c) Stomach
d) Small intestine
e) Large intestine
21- The small intestine is classified in three parts, the anatomical order division of small
intestine is known as:
a) Jejunum, duodenum and ileum
b) Ileum, jejunum and duodenum
c) Duodenun, jejunun and ileum
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22- Conditions that may be the main cause of duodenal ulcers include:
a) High motility of stomach
b) Bacterial migration
c) Squirting of acid stomach content into the duodenal wall
d) Reflux of stomach content into the esophagus
e) Hyperacidity of stomach
23- The pancreas is constituted of endocrine and exocrine glands. What is the function
of endocrine gland of pancreas?
a) Production of enzymes
b) Production of insulin
c) Production of proteins
d) Production of glycogen
e) Production of bile
24- Colon is the last part of the digestive system and may be anatomical divided in:
a) Ascending colon
b) Transverse colon
c) Descending colon
d) Sigmoid colon and rectum
e) All are correct
25- H 2 is involved in gastric acid and pepsin secretion. All of the following are examples
of H 2 inhibitors, EXCEPT:
a) Ranitidine
b) Nizatidine
c) Cimetidine
d) Omeprazole
e) Famotidine
26- H 2 inhibitors are used in the treatment of gastric hyper secretion and GI ulcers. One
of the most potent H 2 inhibitors may include:
a) Famotidine
b) Cimetidine
c) Ranitidine
d) Nizatidine
e) Promethazine
27- Example(s) of conditions that may be treated with H 2 inhibitors may include:
a) Gastric hyper secretion
b) Duodenal ulcers
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c) Zollinger-Ellison syndrome
d) Pain associated with GERD
e) All are correct
29- The most common side effect during treatment with proton pump inhibitors may
include:
I- Headache
II- Diarrhea
III- GIT pain
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
30- Ulcers are complications of gastrointestinal tract. The risk of having ulcers is bigger
in people having which of the following conditions:
a) Smokers
b) Alcoholics
c) NSAID long-term treatment
d) Corticosteroids long-term treatment
e) All are correct
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c) Mucosal protectant
d) Antisecretory prostaglandin analog
e) Proton pump inhibitor
33- Antacids are commonly used to neutralize gastric acid pH. Example of best antacids
constitution may include which of the following combinations?
a) Magnesium hydroxide only
b) Aluminum hydroxide only
c) Calcium carbonate only
d) Magnesium and aluminum hydroxide
e) Calcium and aluminum hydroxide
35- Diarrhea is a common side affect seen with which of the following antacids?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
36- Constipation and/or diarrhea may be side effects of antacids therapy. Which of the
following antacids may have constipation as side effect?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium and magnesium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
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c) I and II only
d) II and III only
e) All are correct
38- Laxative is normally contra-indicated during pregnancy. The only agent with laxative
effects that may be used during pregnancy include:
a) Senna
b) Magnesium hydroxide
c) Psyllium
d) Docusate sodium
e) Bisacodyl
39- Examples of stimulant laxative may include all of the following, EXCEPT:
a) Senna
b) Cascara
c) Bisacodyl
d) Lactulose
e) Castor oil
40- Common or regular diarrhea may best be treated by the administration of:
I- Loperamide
II- Aluminum hydroxide
III- Bismuth subsalicylate
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Antidiarrheal agent that appears to be bactericidal to H. pylori being useful in the
treatment of duodenal ulcers and gastric ulcers associated with H. pylori:
a) Bismuth subsalicylate
b) Loperamide
c) Docusate sodium
d) Psyllium
e) Milk of magnesium
42- Drug(s) used for the short-term treatment of gastro esophageal reflux and peptic
ulcer diseases may include which of the following?
I- H 2 receptors antagonists
II- Proton pump inhibitors
III- Corticosteroids
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
43- One of the most frequent side effect seen with SULCRAFATE therapy may include:
a) Diarrhea
b) Constipation
c) Edema
d) Cramps
e) Vomiting
44- Metoclopramide can act as effective agent in the management of many different
conditions. Some characteristics of metoclopramide include:
I- It increases the rate of gastric emptying
II- It has both peripheral and central effect
III- It can induce Parkinson’s disease
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
46- A 5-Aminosalicylate active metabolite drug used in the treatment of Crohn’s disease:
a) Lansoprazole
b) Famotidine
c) Misoprostol
d) Sulfasalazine
e) Omeprazole
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50- Which of the following drugs are available in a transdermal form for the prevention
of motion sickness?
a) Metoclopramide
b) Granisetron
c) Ondasetron
d) Scopolamine
e) Diphenhydramine
53- The primary function of simethicone used in antacid products is to act as:
a) Suspending agent
b) Adsorbent
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c) Buffer
d) Anti-flatulent
e) Flavoring agent
57) Which of the following is the drug of choice to treat Crohn's disease
A) Methotrexate B) azathioprine C) NSAIDS D. Infliximab E. 5ASA
58) A 34 yo male diagnosed with chronic gastritis and peptic ulcer disease. What
organism are possible cause?
A) E. coli
B) Helicobacter pilori
C) Giardia lamblia
D) Compylobacter jejuni
59) What drugs when administered with antacids, decrease the therapeutic efficacy?
I) Proton pump inhibitors (PPIs)
II) H 2 RA
III) Sucralfate
A) I only B) III only C) I and II D) II and III E) I, II, III
60) A customer walks into your pharmacy and wants something for fast relief of heart
burn symptoms?
A) ranitidine 150 mg
B) cimetidine
C) Mg antacids
D) Omeprazole
E) sucralfate
61.Ulcer is the ulceration of mucosa and underlying structuresof the Upper GI caused
by?
a. increased acidic gastric secretion
b. decrease mucus production
c. H.pylori infection
D. all of the above
ans. d
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GASTROINTESTINAL DISORDERS
ANSWERS
1- Ans: E
Comments: Hernias is a protrusion of a loop of an organ or tissue normally through the
GI area. Hernia hiatus is a herniation of stomach through the esophageal hiatus of
diaphragm. Strangulated hernia is an incarcerated hernia that is so tightly constricted as
to compromise the blood supply of the contents of the hernia sac.
2- Ans: A
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion.
3- Ans: C
Comments: The most common drug reaction in the GIT is hydrolysis because most of
the drugs have an ester and/or amide group attached to their molecular formula and/or
react with water contests in GIT.
4- Ans: B
Comments: Salicylate compounds are largely hydrolyzed in the GIT, liver and blood to
salicylate, which is further metabolized primarily in the liver.
5- Ans: D
Comments: Ascitis is an effusion and accumulation of serous fluid in the abdominal
cavity; called also abdominal or peritoneal dropsy.
6- Ans: D
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Comments: Karaya gum is used as skin adhesives and protective skin barriers in the
fitting and care of ostomy, colostomy appliances and in other conditions involving an
artificial stoma
7- Ans: C
Comments: Somatotropin is a hormone growth with no effect on gastric acid secretion.
8- Ans: C
Comments: Gastro-esophageal Reflux disease is a chronic, pathologic, potentially life-
threatening disease manifested by reflux of the stomach and duodenal contents into the
esophagus, which is principally characterized by heartburn and regurgitation
9- Ans: A
Comments: Acute hemorrhagic gastritis is an erosive inflammation of the stomach with
bleeding normally seen with chronic alcoholism.
10- Ans: C
Comments: Magnesium salts used in antacids cause diarrhea. It also may cause systemic
effect as hypermagnesemia.
11- Ans: A
Comments: Villi and microvilli are found in the small intestine and are formed of
capillaries that works in the absorption of digestive food to rich the venous and
capillaries drainage of the gut.
12- Ans: E
Comments: Metoclopramide can be classified as dopaminergic blocking agent,
gastrointestinal emptying adjunct, peristaltic stimulant and antiemetic agent. It can be
used in cancer chemotherapy avoiding nausea and vomiting as well in diabetes
gastroparesis.
13- Ans: D
Comments: Bile is a fluid secreted from the liver and poured into the small intestine via
the bile ducts. It constituted of conjugated bile acids, cholesterol, phospholipid, bilirubin
diglucuronide and electrolytes. Bile is also responsible for the alkalinization in the
intestinal content due to its bicarbonate content.
14- Ans: E
Comments: Proton-pump inhibitors are the ultimate mediator of gastric acid secretion
inhibition; they are specific inhibitors of H+, K+ ATPase enzyme system at the secretory
surface of the gastric parietal cells. The most widely used proton-pump inhibitors are
omeprazole and lansoprazole.
15- Ans: D
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16- Ans: E
Comments: Antacids should be taken 1 hour before meals, 3 hours after meals and at
bedtime
17- Ans: C
Comments: Gastrin, also known as G-cell is present in the stomach and stimulates acid
secretion.
18- Ans: E
Comments: Salivary glands are composed of 3 pairs of glands: Parotid, submandibular
and sublingual gland.
19- Ans: A
Comments: The first step of digestion is done in the mouth by the salivary enzymes,
amylase, ptyalin and lysozyme.
20- Ans: D
Comments: Gastrin is responsible for the stimulation of gastric acid secretion
21- Ans: C
Comments: The small intestine is anatomically divided in Duodenum, Jejunum and
ileum.
22- Ans: C
Comments: Duodenal ulcers also known as peptic ulcers are mainly characterized by
squirting of acid stomach into the duodenal wall.
23- Ans: B
Comments: The pancreas has two different glands. 1-Exocrine, responsible for the
production of enzymes which go to the duodenum via the pancreatic duct and 2-
Endocrine gland, responsible for the production of insulin, the blood sugar regulator.
24- Ans: E
Comments: The colon is anatomically divided into: Ascending colon, transverse colon,
descending colon, sigmoid colon and rectum.
25- Ans: D
Comments: Omeprazole is a proton-pump inhibitor.
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26- Ans: A
Comments: Famotidine is the most potent H 2 blocker. It reduces the gastric acid in 94%
up to 10 hours.
27- Ans: E
Comments: H2 blockers can be used to treat gastric hyper secretion, duodenal ulcers,
Zollinger-Ellison disease and reduce pain associated with gastroesophageal reflux
disease.
28- Ans: C
Comments: Proton-pump inhibitors are irreversible direct inhibitor of potassium pump.
29- Ans: E
Comments: The most frequent side effect seen in the treatment with proton-pump
inhibitors are: Abdominal pain or colic, diarrhea or constipation, unusual tiredness,
muscle pain, headaches, dizziness and skin rashes
30- Ans: E
Comments: Long-term treatment with NSAIDs and corticosteroids definitely increase the
risk of ulcers disease because these drugs cause many different GI side effects as pain,
cramps, acidity of stomach and other GI motility effects. Ulcers are also increased in
alcoholism and in smokers due to irritation and destruction of gastric mucosa. Other
agents that may increase the incidence of ulcers are coffee, orange juice, fatty and spice
food and emotional stress.
31- Ans: E
Comments: The basic pharmacological choices in the treatment of ulcers include H2-
antagonists, proton-pump inhibitors, misoprostol and sucralfate. Ulcers associated with
H. pylori can be treated by triple therapy with omeprazole, clarithromycin and
amoxicillin.
32- Ans: C
Comments: Sucralfate acts as protective coating of the gastric mucosa, it is particularly
used in ulcerated areas.
33- Ans: D
Comments: The mixtures of aluminum and magnesium are the most widely used
combination of antacids, because they compensate the side effects of each other.
34- Ans: A
Comments: Antacids act neutralizing gastric acid, which increases the pH of refluxed
gastric contents and lower esophageal sphincter pressure.
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35- Ans: B
Comments: Diarrhea is the most common side effect seen with the administration of
magnesium hydroxide antacid. Aluminum and calcium carbonate cause constipation.
37- Ans: E
Comments: Magnesium and aluminum mixtures are commonly used together because
they provide more even sustained action than used as single agent and permit lower
dose of each compound. The constipation effect of aluminum may counter the diarrhea
caused by magnesium.
38- Ans: C
Comments: Therapeutically safe in pregnancy, psyllium is a bulk-forming agent used as
laxative, it contains plant matter that absorbs water and softens the stool.
39- Ans: D
Comments: Lactulose is an osmotic laxative.
40- Ans: E
Comments: Diarrhea caused by infections, toxins and drugs are mostly treated with
specific agents, however the regular diarrhea normally caused for stress or stomach
indisposition is best treated with loperamide, bismuth subsalicylate or aluminum
hydroxide.
41- Ans: A
Comments: Duodenal and gastric ulcers are often caused by H. pylori. The treatment
objective is eradication of the bacterium with combination of antibiotics and h2-
antagonists, however bismuth subsalicylate is also used because it appears to be
bactericidal to H. pylori in high doses concentration.
42- Ans: C
Comments: Corticosteroids are neither used in the treatment of GERD nor in the
treatment of peptic ulcers. They normally induce or make worsen the ulcer condition.
43- Ans: B
Comments: Sucralfate is used as protective coating of the gastro intestinal mucosa and
have constipation as its main side effect.
44- Ans: E
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45- Ans: C
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion. It is used to treat NSAID-induced ulceration.
46- Ans: D
Comments: Sulfasalazine is an 5-Aminosalicylate (5-ASA) active metabolite agent used as
the drug of choice in the treatment of crohn’s disease.
47- Ans: E
Comments: The pharmacologic action of sulfasalazine is seen through its active
metabolite 5-Aminosalicylate (5-ASA).
48- Ans: A
Comments: Sulfasalazine is metabolized in the colon by resident bacteria into 5-ASA and
sulfa pyridine. Sulfapyridine is absorbed while the 5-ASA remains in the colon.
49- Ans: B
Comments: Orlistat is a lipase inhibitor being used to treat obesity, it binds to
pancreatic and gastric lipase and inactivate the enzyme reducing the dietary absorption
of fat by about 30%.
50- Ans: D
Comments: Scopolamine is the only available transdermal drug used to treat motion
sickness.
51- Ans: B
Comments: Simvastatin is a statin (HMG-CoA reductase inhibitor) used as
antihyperlipidemic agent.
52- Ans: C
Comments: Lactulose is an osmotic laxative that can be used to treat constipation and
portal systemic encephalopathy as well.
53- Ans: D
Tips: Simethicone is mainly used in antacids preparations as antiflatulant agent (anti-
gas).
54) Ans: E
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56) Ans: B
Tips: Sucralfate is taken empty stomach to have better action. Because it make barrier
on to ulcer and prevent acid contact. Avoid taking with food, antacids, H 2 RA, and PPIs.
57) Ans: E
58) Ans: B
59) Ans: E
60) Ans: E
BIBLIOGRAPHIC REFERENCE
4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS -
2003/2004
6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I.
A patient brings prescription for ciprofloxacin 500 mg bid for 3 days. Currently patient
calcium carbonate 500 mg tid. What is appropriate recommendation.
a) Separate 2 hr before and 4 hr after calcium supplement from ciprofloxacin dose
b) Skip using calcium supplements for 3 days till finish of ciprofloxacin
C) For 3 days combination of ciprofloxacin and calcium supplements does not affect
therapy
D) None of the above
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PHARMACY PREP
DIABETES
1)What is incorrect about insulin's?
A-insulin Lispro is rapid acting
B-regular insulin's is available as iv and sc
C-NPH is intermediate acting insulin is available as iv and sc
D-Glargine is long acting insulin should not physically mix with other insulin
E-All insulin preps should be stored in refrigerator
4-Which of the following drug associated hypoglycemia treated with glucose rather than
sucrose:
I-Metformin
II-Insulin
III-Acarbose
A-I only
B-III only
C-I and II only
D-II and III only
E.I,II,III
5-A 17-year-old type 1 diabetic patient is currently on diabetic medications. All of the
following antidiabetic drugs are not used in type I diabetes EXCEPT:
A-Chlorpropamide
B-Glyburide
C-Repaglinide
D-Nateglinide
E-Pioglitazone
6-Which of the following antidiabetic drug is increased risk of edema and congestive
heart failure
A-Metformin
B-Chlorpropamide
C-Glyburide
D-Rosiglitazone
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8)Which of the following antidiabetic drug effect on lipid levels (increase HDL, LDL and
decrease TG).
A-Metformin B-chlorpropamide C-Pioglitazone D-Repaglinide
E-Insulin
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B-Chlorpropamide
C-Glyburide
D-Rosiglitazone
E-Acarbose
16) A doctor prescribed metformin 1000 mg tid as initial treatment, what is anticipated
most common side effect?
A-Diarrhea B-lactic acidosis C-liver failure D-Congestive heart
failure E-Renal failure
17) The risk of lactic acidosis, associated with metformin, is enhanced by?
I-Congestive heart failure II-Renal disease
III-Alcohol intake
A-I only
B-III only
C-I and II only
D-II and III only
E-I, II, III
18) A obese patient has CHF, renal disease and drinks alcohol. Recently diagnosed with
type II DM, what is drug of choice?
A-Metformin
B-Chlorpropamide
C-Rosiglitazone
D-Acarbose
E-Glyburide
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25) A patient with hyperglycemic in the evening and hypoglycemic in the morning and
currently on regular insulin and NPH insulin, he should receive:
I) Increase NPH insulin in the morning
II) Decrease NPH insulin in the evening
III) Increase regular insulin levels in the morning
A. I only
B. III only
C. I and II only
D. II and III only
E) I, II, III
26) A patient is in emergence with diabetic ketoacidosis. Which of the following insulin
is used to treat diabetic ketoacidosis (DKA) ?
A) Rapid lispro
B) Regular
C) NPH
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D) Glargine
E) Detemir
28. A type I DM patient on insulin regimen. Mistakenly take double the dose of insulin
at bed time. What symptoms are/is NOT expected?
A) confusion B) sweating C) heart burn D) palpitation
E) Tremors
29. What ketones are formed in blood sample of diabetic ketoacidosis patient?
I) beta hydroxy butyric acid
II) acetone
III) glucose
A) I only B) III only C) I and II D) II and III E) I, II, III
30. A T2DM patient currently using low dose of glyburide, metformin and insulin. What
is the pharmacist concern?
A. Weight gain
B. Hypoglycemia events
C. sulfa allergy
D. alcohol intake
ans. b
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DIABETES
ANSWERS:
1) Ans: C
2. Ans: C
Tips; sweating, hunger, dizziness, fainting, fatigue are symptoms of hypoglycemia.
Polyurea, polydipsea, polyphagea, neuropathic pains, and blurred vision are symptoms
hyperglycemia.
3- Ans: E
4- Ans: B
Tips: Acarbose impair the digestion of sucrose. Hypoglycemia in-patient taking acarbose
should be treated with glucose rather than sucrose.
5- Ans: E
6- Ans: D
Tips. Health Canada warning on rosiglitazone regarding increased risk of edema and
congestive heart failure.
7) Ans: A
8) Ans: C
9) Ans: D
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Tips: Orlistat (Xenical) act as intestinal lipase inhibitor and prevents absorption of fat
soluble vitamins ADEK.
10- Ans: D
11- Ans: A
12- Ans: D
Tips: Metformin is a biguanide chemical class of medication , it does not have sulfa
group, and thus it can be used in sulfa allergy patients.
13- Ans: E
14- Ans: D
Tips: Rosiglitazone can be taken with or without meals, where as metformin.
Chlorpropamide, glyburide taken with food, and acarbose is taken with first bite of
meals.
15) Ans: A
16) Ans: A
17) Ans: E
18) Ans: D
Tips Metformin is contraindicated in renal, hepatic, diseases. Chlorpropamide dose
adjustment required in renal impairment and rosiglitazone is contraindicated in
congestive heart failure.
19) Ans: A
20) Ans: A
21) Ans: D
22) Ans: B
23) Ans: D
24) Ans: B
25) Ans: C
26) Ans: B
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27. Ans: E
28. Ans: C
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PHARMACY PREP
THYROID DISORDERS
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11- A woman with Grave’s disease. Doctor prescribed methimazole. All of the following
statements are true, EXCEPT:
a) This drug inhibits thyroid hormone
b) Onset of action is after 2 weeks synthesis
c) Do not stop the drug if there is a rash
d) Call the doctor if there are symptoms of infection
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a) Cold tolerance
b) Tachycardia
c) Diarrhea
d) Weight loss
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23) All of the following drugs are used to treat thyrotoxicosis, (Graves disease) except?
A) propylthiouracil
B) methimazole
C) Lugol's solution
D) Propranolol
E) Levothyroxine
26) Which of the following stimulate calcitonin production from thyroid gland?
A) Hypocalcemia
B) Hypercalcemia
C) Hypokalemia
D) Hyperkalemia
E) Hypothyroidism
27) A customer of your pharmacy uses insulin to treat diabetes. she is active and
decided to jogging 5 km daily. What is correct suggestion?
A) Take insulin injection before exercise
B) Take insulin injection after exercise
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30) A patient is on insulin therapy. Which of the following is NOT correct about
hypoglycemia?
A) Patient may be sweating
B) Patient blood glucose in lower than 4 mmol/L (fasting)
C) Patient have palpitation
D) Patient have confusion
E) Patient should increase insulin dose
31) An asthma patient excessive dose of prednisone. Which of the following can cause?
A) Graves disease
B) Hoshimoto disease
C) Addison disease
D) Cushing syndrome
E) Weight loss
32) A 49 yo women is using treatment of Synthroid 75 mcg daily for hypothyroidism. She
complains palpitation, weight loss and sensitivity to heat. What is appropriate?
A) refer doctor to increase dose of Synthroid 100 mcg
B) refer to doctor to decrease dose of Synthroid
C) hypothyroid symptoms so should refer to doctor
D) She may have some new problem so refer to doctor
E) None
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35. Which of the following is the least likely decrease absorption of levothyroxine
A) Al antacids
B) Mg antacids
C) Diary products
D) Iron supplements
E) Low fiber diet
36. If you get prescription of thyroxin120 mcg daily as initial dose for senior patient.
What symptoms may expected?
A) hyperthyroidism
B) hypothyroidism
C) Parkinson's disease
D) Schizophrenic symptoms
E) Serotonin syndrome
THYROID DISORDERS
ANSWERS
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1- Ans: E
Tips: Graves disease is hyperthyroidism
2- Ans: E
3- Ans: B
4- Ans: A
5- Ans: A
Tips: in hyperthyroidism, there is weight loss
6- Ans: B
7- Ans: B
8- Ans: A
Tips: Lugol's solution is used as oral drops, Lugol's solution is indicated in
hyperthyroidism patients.
9- Ans: B
10- Ans: C
11- Ans: C
12- Ans: A
Synthroid should not be taken with aluminum hydroxide, cholestyramine resins,
colestipol, ferrous sulfate, sod. Polystyrene sulfonate, soybean flour (infant formula)
due to decreased absorption of levothyroxine from GI tract. May be given to children by
crushing the tab. and suspending them in a small amount of water, breast milk or non-
soybean based formula. Do not store the suspension for any period of time.
13- Ans: A
14- Ans: C
15- Ans: A
16- Ans: B
Tips: elevated serum TSH > 5 mU/L indicate hypothyroidism.
17- Ans: B
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18- Ans: E
19- Ans: B
20) Ans: E
Tips: increase serum TSH and decrease Free T4 and TT3
21) Ans: B
22) Ans: D
23) Ans: E
24) Ans: D
Tips: FT4, TT4, TT3 and FTI decrease in hypothyroidism, only serum TSH increase. For
hyperthyroidism, exactly opposite changes.
25) Ans: E
26) Ans: B
27) Ans: C
28) Ans: D
29) Ans: C
30) Ans: E
31) Ans: D
32. Ans: B
Tips: patient experiencing overdose or hyperthyroidism symptoms, may be due
overdose of levothyroxine. So refer to doctor to decrease dose of levothyroxine
33. Ans: D
Tips: In hyperthyroidism increase T4 and T3.
34. Ans: A
35. Ans: E
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Tips: Food and formula containing large amount of soybean, fiber, or iron should not be
used for administration of levothyroxine. However low fiber food does not interact with
thyroxin.
36. Ans: A
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PHARMACY PEP
CONTRACEPTION
1-Contraceptive methods that protect STDs such as, gonorrhea, syphilis, chlamydia, and AIDS?
A-Oral contraceptive B-Condoms C-Contraceptive sponges D-Vaginal cream
E-Plan B
2-A 18 year old women walks into pharmacy, wants to buy emergency contraception Plan-B.
Pharmacist on duty believes do not allow dispensing contraceptive, and refuse to give oral
contraceptives. What ethical principle is violated?
A-beneficence
B-Non maleficence
C-Autonomy
D-veracity
E-Justice
5) A customer of your pharmacy she asking for your opinion to choose a contraceptive
method, that she does not want to use daily and convenience and also near future she has
plan to start family. What is the good contraceptive you recommend?
A)OCP B) Condoms C)Evra path D)Nuvaring E) contraceptive injections
6) Which of the following questions is appropriate to ask a customer who wants to buy plan
B?
I)when was the last period II) are you pregnant? III)how long ago the unprotected intercourse
A) I only B) III only C) I and II only D) II and III only E)I, II, III
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7) Which of the following contraceptive methods prevents gonorrhea and chlamydea
infections?
A) Transdermal contraceptives B) Intrauterine device C) Vaginal cream D) Subdermal
progesterone implants E) None of the above
8) Many women who take OCs are poorly informed about the proper use of these
medications. Which of the following is the first effective methods of providing information?
A) The patient first should be given package insert of OCs
B) Auxiliary labels on OCs
C) Verbal information describing the way medication works
D) Patient should be told that this do not protect STIs
E) Patient using these products should have knowledge of this product from internet
11.A female client is using combined oral contraceptive pills. She forgot to take one pill on her
second week of 21 contraceptive pills. She had Sunday start. What is appropriate
recommendation?
a. Take two pills next day
b. Stop taking COC till Sunday and start a new pack from Sunday
c. Take two pills on Sunday
D. Stop taking COC till Sunday and take two pills on Sunday
E. Stop using contraceptives and see doctor
ans. a
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12.Which of the following the side effect of emergency contraception?
a. breast tenderness
B. stomach upset
C. Deep vein thrombosis
D. menstrual bleeding
E. none of the above
Ans. b
CONTRACEPTION
ANSWERS:
1- Ans: B
2- Ans: C
3) Ans: C
4) Ans: A
5) Ans: D
6) Ans: E
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7) Ans: E
Tips: STI are only prevented by condoms contraceptive methods
8) Ans: A
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PHARMACY PREP
GENITOURINARY CONDITIONS
2-Toxic shock syndrome may have risk with the use of:
I-Tampons use
II-Diaphragm contraceptive
III-Condoms as contraceptive
A-I only
B-III only
C-I and II only
D-II and III only
E.I, II, III
4-All of the following are the benign prostate hyperplasia, (BPH) symptoms, EXCEPT:
A-Nocturia
B-Frequent urination
C-Jet urination
D-Urinary retention
E-Post void dripping
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c) I and II only
d) II and III only
e) I, II, III
11) A 50 year old lady will begin to take Hormone Replacement Therapy. All of the
following questions will help achieved appropriateness of her medication EXCEPT:
A) Did she have any children?
B) When did you last monitor your lipids?
C) Hysterectomy
D) When is the last menstruation period?
13) If a patient is not treated for asymptomatic sexually transmitted infections. What is
correct?
A) symptoms are obvious after few days
B) can cause pelvic pain and dysmenorrhea
C) can cause pelvic inflammatory disease and infertility
D) can cause endometrial cancer
E) can results in cervical cancer
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17) A customer of your pharmacy presents with symptoms of vaginal discharge, yellow
and fishy odor.
A) Recommend over the counter antifungal drugs
B) Refer to doctor is appropriate because this bacterial infection
C) Recommend self care
D) None of the above
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20) Which of the following methods of contraception can prevent sexually transmitted
diseases
A-oral contraceptives
B-reservoir type contraceptive
C-Intrauterine devices
D-condoms
E-contraceptive sponges
24. Which of the following is NOT associated with toxic shock syndrome?
A. Tampon B. Cervical cap C. contraceptive sponges D. condoms E. IUDs
Ans. D
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26. What is the drug of choice to treat patient with vaginal pruritus, curdy vaginal
discharge, no odor and no color discharge?
A. Metronidazole vaginal cream
B. Metronidazole oral
C. Clotrimazole
D. Amoxicillin
E. Cotrimoxazole
Ans. C
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CORRECT ANSWERS
Genitourinary Conditions
1- Ans: B
2- Ans: C
3- Ans: C
4- Ans: C
5- Ans: D
9. Ans: C
Tips: diphenhydramine belongs to the ethanolamine class of antihistamines gives
anticholinergic side effects such as urinary retention, and induce sedation.
Hydrochlorothiazide, furosemide and acetazolamide are diuretics increase urinary
frequency.
10- Ans: A
11) Ans: A
12. Ans: E
13) Ans: C
14) Ans: D
15) Ans: C
16) Ans: C
17) Ans: B
Tips: Color discharge and fishy odor is indicator of bacterial infection, thus refer to
doctor.
19) Ans: D
20) Ans: D
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PHARMACY PREP.
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PHARMACY PREP
OSTEOPOROSIS
1) These two components in bone are responsible for the hardness and pliability of bone:
a) osteoclasts & collagen
b) mineralized salts & osteocytes
c) mineralized salts & collagen
d) collagen & elastic fibres
e) collagen & mesenchyme
4) Chondroblasts produce:
a) basement membranes
b) bone matrix
c) cartilage matrix
d) mesothelium
e) endothelium
5) These structures are at the center of compact bone lamellae and carry blood vessels along
the bone length:
a) Haversian canals
b) canaliculi
c) perforating canals
d) osteocytes
e) lacunae
6) The cell type that is responsible for maintaining bone matrix once it has formed is:
a) osteoclasts
b) chondrocytes
c) osteocytes
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d) fibroblasts
e) osteoblasts
7) Soft connective tissue membranes between the cranial bones at birth are:
a) an indication of microcephaly
b) frontal sinuses
c) epiphyseal plates
d) cribriform plates
e) fontanelles
9) The two pairs of bones that make up the hard palate are the right and left:
a) zygomatic and temporal
b) palatine and maxillae
c) maxillae and zygomatic
d) maxillae and mandible
10) The two bones that make up the posterior nasal septum are the:
a) nasal and lachrymal
b) inferior nasal choncae and vomer
c) vomer and ethmoid
d) ethmoid and sphenoid
12)All of the following are the risk factors for osteoporosis, except?
A-Race
B-Family history
C-Obesity
D-Smoking
E-Excessive coffee intake
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14. All of the following are side effect of a systemic corticosteroids prednisone: EXCEPT:
A-Weight gain
B-Glucose intolerance
C-Osteoporosis
D-Cataract
E-reduce infection
17) The type of calcium supplement produced from oyster’s shells is?
A-Calcium citrate
B-natural calcium
C-Calcium carbonate
D-dairy calcium
E-Calcium gluconate
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20-A patient using alendronate 70 mg/wk and calcium supplement, what is incorrect?
A-Avoid calcium supplement while using alendronate therapy
B-It is important to take calcium supplement while using bisphosphonates therapy
C-separate alendronate and calcium supplement at least 2 hour before and 4 after.
D-It is also essential to take vitamin D supplements
E-It is recommended to take daily 800 mg IU vitamin D
21- To monitor alendronate safety and efficacy all are needed EXCEPT:
a) Hypercalcemia
b) Bone pain and swelling
c) Ca and Vitamin D intake
d) Bone mineral density
e) Esophagitis
24- A 35 yo women get the prescription of 50,000/wk unit of vitamin D. What to do?
A) talk to doctor and dispense
B) this could extremely high dose and may cause toxicity
C) reduce dose to 500 units and dispense
D) May be prescription error just dispense 500 units
E) It is outrageous to get prescription of 50, 000 units
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PharmacyPrep.Com Osteoporosis
28. Which of the following is least likely risk factor for osteoporosis?
A) Inadequate vitamin D and Ca supplement intake
B) Age
C) family history of osteoporosis
D) Prednisone therapy for over 3 months
E) alcohol intake
31. What is drug is used to treat vertebral and non vertebral fracture?
A. bisphosphonates
B. Raloxafine
C. Calcium supplement
D. Teriperatide
E. Calcitonin
Ans. A
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OSTEOPOROSIS
ANSWERS:
1) Ans: C
2) Ans: C
3) Ans: D
4) Ans: C
5) Ans: A
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6) Ans: C
7) Ans: E
8) Ans: B
9) Ans: B
10) Ans: C
11) Ans: C
12) Ans: C
Tips: obesity or overweight is not a risk factor of osteoporosis. Race, family history, smoking,
excessive coffee intake, deficiency of estrogen, and sedentary lifestyle are some of the risk
factors.
13- Ans: E
Tips: Osteoporosis is characterized by the loss of bone mass. Vitamin D supplements have
been used in the treatment of osteoporosis because vitamin D increases the absorption of
calcium that is essential to reduce bone loss. Antacids interact with vitamin D in many ways,
magnesium containing antacids may lead to hypermagnesemia and aluminum containing
antacids have its levels increased leading to aluminum bone toxicity when currently used with
vitamin D.
14. Ans: E
Tips: Corticosteroids increase the risk of infections.
15- Ans: E
16- Ans: C
17- Ans: C
18- Ans: A
19- Ans: D
20- Ans: A
21- Ans: A
22- Ans: A
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23- Ans: B
24- A
25- Ans: E
Tips: protein diet like dietary are plant derived phytoestrogen present in soy proteins
26- Ans: C
27- Ans: A
28. Ans: E
29. Ans: C
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PharmacyPrep.Com Osteoporosis
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PharmacyPrep.com Hypertension
PHARMACY PREP
HYPERTENSION
3.. Which of the following main complication is NOT associated with persistent hypertension?
A. Kidney B. Brain C. Retina of eye D. Liver E. diabetes
Ans. d
4. Which of the following is the blood pressure goal for clients that 60 yo and above without
diabetes or renal diseases?
a. less than 120/80
b. less than 130/80
c. less than 140/80
d. less than 140/90
e. less than 150/90
ans. D
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PharmacyPrep.com Hypertension
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PharmacyPrep.Com Coronary Artery Diseases
PHARMACY PREP
CORONARY ARTERY DISEASES
1) Which one of the following factors is most directly attributed to angina attacks?
A. Emotional Stress
B. Heavy smoking
C. Myocardial ischemia
D. Obesity
E. None of the above
3. Which medication CAN NOT BE used for prinzmetal angina (vasospastic angina)?
A. Amlodipine
B. Metoprolol
C. Acetyl salicylic acid
D. Verapamil
E. Diltiazem
4. Which effect of nitroglycerin is most likely responsible for its therapeutic action in angina
pectoris?
a. Dilation of coronary artery
b. Relaxation of peripheral vascular smooth muscle
c. Decrease myocardial after load
d. A and B
e. A and C
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7-Which of the following anticholesterol medication may increase his blood sugar levels:
A-Atorvastatin
B-Niacin
C-Simvastatin
D-Fluvastatin
E-All of the above
8-Administration of which of the following drugs is most likely to PROLONG clotting time?
A. Morphine
B. Vitamin K
C. A barbiturate
D. Acetaminophen
E. Acetyl salicylic acid
10) All of the following are low molecular weight heparins (LMWH), except?
A-Enoxaparin
B-Dalteparin
C-Tinzaparin
D- Nadroparin
E-Heparin
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PharmacyPrep.Com Coronary Artery Diseases
13) What is the drug of choice for ST segment elevated myocardial infarction (STEMI)?
A-Anticoagulants B-LMWH C-Heparin D-Alteplase E-Propranolol
18) What statin do not require dosage adjustment in renal disease patient?
A-Fluvastatin B-Lovastatin C-Simvastatin D-Atorvastatin
E-Rosuvastatin
20) What antiplatelets drugs is used for prophylactic for angina pectoris?
A-dipyridamol b-metoprolol c-nifedipine D-all of the above
22. Which of the following is recommended to minimize the warfarin dispensing error?
I) dose of warfarin should be indicated in milligrams
II) check the color of tablets
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23. Exercise induced angina, which is relieved by rest nitroglycerine or both referred as?
A) Prinzmetal angina B) stable angina C) unstable angina
D) Myocardial infarction
25. A patient with angina receiving metoprolol and diltiazem should be monitored for?
I) increased heart rate
II) decreased cardiac output
III) decreased heart rate
A-I only B-III only C-I and II only D-II and III only E) I, II, III
26) A 35 year old craftsman is on nitroglycerin pills, which of the following statements should
discuss with him:
A) It causes an elevation of intracellular cGMP
B) It can cause postural hypotension, take medication while sitting.
C) Store medication away from light, and keep in tightly metal capped bottle.
D. B&C
Ans-D
Tips: Nitroglycerin increases synthesis of intracellular cGMP. However, mechanism of action
may not be discussed in counselling.
28) Aspirin should be used cautiously in patient receiving heparin because aspirin:
A. inhibit vitamin k absorption
B. has antithrombin activity
C. inhibit metabolism of heparin
D. inhibit platelet aggregation
Ans-D
Tips: a drug that increases metabolism of the anticoagulant will lower the steady state plasma
concentration both free and bound form, where as one that displaces anticoagulant will
increase plasma level of free form only, until elimination of drug as again lower it to steady
state levels.
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PharmacyPrep.Com Coronary Artery Diseases
30) In angina pectoris, the MOST rapid and dependable relief will be provided by
A. oral glyceryl trinitrate
B. oral isosorbide dinitrate
C. oral erythrityl tetranitrate
D. sublingual glyceryl trinitrate
Ans: D
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B. Nifedipine
C. Nicardipine
D. Felodipine
E. Amlodipine
Ans: A
Tips: Diltiazem and Verapamil side effect is bradycardia
38) An imbalance between oxygen supply and oxygen demand in cardiac muscle may produce
a condition known as:
A. CHF
B. Heartburn
C. MI
D. Angina pectoris
Ans: D
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43. An ambulatory patient, the most fastest acting nitroglycerine dosage form?
A. SL spray B. SL tab C. wafers D. liquid E. suspension
ans. a
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ANSWERS
Coronary artery diseases
1. C
2- C
3. B
Tips: TC page 275, avoid beta blockers in prinzmetal angina, beta blockers cause
vasoconstriction (vasospasm)
4. D
5. C
6. E
Tips: Verapamil act as coronary vasodilator by inhibiting calcium ion influx in coronary smooth
muscles, and it does negative inotropic effects.
7- B
8- E
9. B
11) D
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12. A
13) D
14) E
15) D
16) B
Tips: Lovastatin should be always administered with food to increase Bioavailability, otherwise
it can decrease 30% Bioavailability.
17) D
Tips: Atorvastatin can be taken anytime of the day, because has long half life.
18) D
Tips: The best agent for renal disease patient is atorvastatin, because it has minimal renal
elimination, thus do not require dose adjustments. Simvastatin and lovastatin require dose
adjustment in severe renal diseases however it can be used in minor and moderate renal
diseases
19) E
20) A
21. D
22. C
23. B
24. B
25. B
26) Ans-D
Tips: Nitroglycerin increases synthesis of intracellular cGMP. However, mechanism of action
may not be discussed in counselling.
27) Ans-E
28) Ans-D
Tips: a drug that increases metabolism of the anticoagulant will lower the steady state plasma
concentration both free and bound form, where as one that displaces anticoagulant will
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increase plasma level of free form only, until elimination of drug as again lower it to steady
state levels.
29)Ans: C
30) Ans: D
31) Ans: B
32) Ans: A
33) Ans: A
34) Ans: D
35) Ans: A
Tips: Diltiazem and Verapamil side effect is bradycardia
36)Ans: A
Tips: All dihydropyridine calcium channel blockers cause reflex tachycardia except amlodipine
37) Ans: A
38) Ans: D
39) Ans: E
40) Ans: A
41) Ans: C
42) Ans: C
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www.pharmacyprep.com
PHARMACY PREP
STROKE
1.A client presents with following symptoms, Which of the following symptoms is the most
pharmacist concern, which require referral to emergency?
A. patient face changes to uneven
B. patient arm drifting down
C. patient speech changes to strange
D. severe unprovoked headache
E. All of the above
Ans. E
87-1
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PharmacyPrep.com Congestive Heart Failure (CHF)
PHARMACY PREP
CONGESTIVE HEART FAILURE
4. What is the drug of choice for mild hypertension in patient with congestive heart failure?
A. Ramipril B. Hydralazine C. Losartan D. Hydrochlorothiazide E. Furosemide
ans. A
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PharmacyPrep.Com Arrhythmias
PHARMACY PREP
DYSARRHYTHMIAS
1. Embolus (clot) enters into common carotid artery and travels toward the brain due to atrial
fibrillation can increase risk?.
A. angina
B. Cardiogenic stroke
C. myocardial infarction
D. DVT
E. CHF
Ans.b
3. Patient with atrial fibrillation. Which of the following is used to prevent risk of cardiogenic
stroke.
A. ASA B. Warfarin C. ACEi D. Beta blockers E. Calcium channel blockers
Ans. B
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B.Atril flutter
C. Ventricular tachycardia
D. Sinus tachycardia
E. all of the above
Ans. C
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PharmacyPrep.Com Peripheral Vascular Diseases
PHARMACY PREP
1) Aneurysm is ?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
2) Thrombus is?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
3) Embolus is ?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
6) Symptoms of Stroke?
A)headache B)confusion C)dizziness D)blurred vision E)all of the above
10. Which of the following monitoring parameter is essential for patient who currently taking
Low molecular weight heparin:
A-International normalized ratio (INR)
B-Prothrombin time
C-Heparin assay
D-Sensitive TSH
E-provide predictable response, thus no monitoring required
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11. Which of the following are the monitoring parameters of warfarin therapy?
I Complete blood count (CBC)
II PT (prothrombin time)
III INR (international normalization ratio)
a. I only
b. III only
c. I and II
d. II and III
e. I, II, III
13) Which of the of the following can be used in a pregnant women with deep vein
thrombosis ?
A-Captopril B-Warfarin C-Atorvastatin D-Heparin E-Rosuvastatin
14) Which of the following is NOT a low molecular weight heparins (LMWH)?
A-Dalteparin B-Heparin C-Nadoparin D-Enoxaparin E-Tinazeparin
16)Which of the following the most important drug is used to prevent peripheral vascular
diseases?
A)Beta blocker B)ACEI C) warfarin D)digoxin E)ASA
17) Which of the following the most important drug is used to treat peripheral vascular
diseases?
A)Beta blocker B)ACEI C) warfarin D)digoxin E)ASA
18) Which of the following drug is least likely used to treat peripheral vascular diseases?
A)Beta blocker B)ACEi C) warfarin D)digoxin E) ASA
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20) Which of the following drugs increase risk of blood clots in peripheral vascular system?
A) Enoxaparin B) Alteplase C) combined oral contraceptive pills D. Warfarin E. NSAIDs
21) Which of the following drugs least likely used in DVT patients?
A) warfarin B) Dabigatran C) LMWH D) heparin E) cardio selective beta blockers
22) All are risk factors of deep vein thrombosis (DVT), except?
A) pregnancy
B) cancer and chemotherapy
C) Progestin only oral contraceptive pills
D) diabetes
E) mobility
23) A 64 yo man weighing 115 kg, and tall 60 inches, presents to his physician after long
international flight complaining of pain, swelling of his right lower leg. The patient had knee
surgery a month before he travelled. His medication profile include, CHF (ejection fraction <
15%), remission from lymphoma, MI. His father, mother, and sister are all diseased from
stroke, pulmonary embolism. Given his profile. Patient most likely suffering from?
A) deep vein thrombosis
B) coronary artery disease
C) congestive heart failure
D) diabetes
24) Which of the following is NOT risk factors of deep vein thrombosis (DVT)?
A) Knee surgery B) over weight C) long flight D) family history E) gender
26. All of the following conditions are associated with atherosclerosis plaque, except?
A. DVT
B. Stable angina
C. MI
D. Stroke
E. Raynaud's phenomenon
Ans. E
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CORRECT ANSWERS
Peripheral Vascular Diseases
1)Ans: A
2) Ans: B
3) Ans: C
4) Ans: D
5) Ans: D
6) Ans: E
7) Ans: D
8) Ans: E
9) Ans: A
10. Ans: E
Tips: INR and PT is monitored for warfarin, aPTT for heparin, where as for LMWH these tests
are not effective
11. Ans: D
12- Ans: A
13) Ans: D
14) Ans: B
15) Ans: C
16) Ans: C
Tips: Anticoagulants like warfarin is commonly used to treat peripheral embolic disorders.
17) Ans: C
18) Ans: A
Tips: beta blocker cause vascular constriction thus it is contraindicated in peripheral vascular
diseases
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19) C Ans:
20) Ans: C
Tips. Combined oral contraceptive pills are combination of estrogen and progestin increase
platelet aggregation and thus increase risk of blood clot formation.
21) Ans: E
22) Ans: E
Tips: mobility or physical activity lower the risk of deep vein thrombosis
23) Ans: A
24) Ans: E
Tips: RF for above patient, except gender. other RFs include age > 40 yr, cancer, CHF, MI, and
obesity.
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Pharmacy Prep
ANTICOAGULANTS
2. A drug is said to reach "steady state" when 5 half-lives have elapsed. In the case of warfarin
(a blood thinner), however, the steady state is dependent not upon the drug's half-life, but
upon the half-life of the clotting factors it inhibits. The clotting factors inhibited by warfarin
have the following half-lives:
Factor II - 50 hours
Factor VII - 6 hours
Factor IX - 24 hours
Factor X - 36 hours
Based on this information, how long will it take a patient to reach maximal anticoagulation?
A- 5 days B-10 days C- 15 days D- 20 days E-48 hours
4) A patient is using injections of Dalteparin to treat deep vein thrombosis what is monitored?
A) aPTT B) antifactor Xa C) Prothrombin time D) international normalized ratio E) Heparin
assay
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8) Patient is hospitalized. Doctors initiated heparin iv infusion. What is incorrect about heparin
A) heparin dose is based on body weight
B) loading dose is 80 units/kg, and maintenance dose is 15 to 25 units/kg/hr.
C) Heparin is slower onset than LMWH
D) LMWH have longer half life
E) LMWH have predictable response thus not monitored
10) Patient is receiving warfarin after discharged from hospital. He is receiving cotrimoxazole to
treat UTI. One may expect to see the INR (2 - 3)?
I) Increase II) No change III) Decrease
A. I only
B. III only
C. I and II
D. II and III
E. I, II, III
12. The mechanism of action of Acetylsalicylic acid that results in greater effect as an
antiplatelet drug is because of:
A. Selective COX I inhibitor
B. Selective COX II inhibitor
C. COX I and COX II inhibitor
D. Acetylate cyclooxygenase
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D. Apixaban
E. Dabigatran
15) Which of the following tests are used for antithrombotic therapy:
A. INR, Prothrombin time and aPTT
B. aPTT and Prothrombin Time
C. Heparin assay and a PTT
D.INR only
E. a PTT only
16) Which of the following is the drug of choice to treat deep vein thrombosis (DVT):
A) Warfarin
B. streptokinase
C. Heparin
D. LMWH
E. Rivaroxaban
18) In order to measure effectiveness of warfarin therapy, the following monitoring tests are
used:
A. INR, must be 2-3
B. Prothrombin test (PT)
C. aPTT
D. A&B
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20) Effects of warfarin include all except:
A. Decreasing the formation of blood clot
B. Nose bleeds
C. Red-orange urine
D. Ringing in the ears
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27) Which of the following vitamins is needed for proper blood clotting?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
28) Which of the following OTC drugs is contraindicated for a patient taking warfarin?
A. Diphenhydramine
B. Loratadine
C. Psyllium
D. ASA
29) All of the following drugs should be carefully prescribed with aspirin EXCEPT:
A. Enoxaparin
B. Coumadin
C. Heparin
D. Metoclopramide
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D. warfarin is not available in liquid or injections
E. warfarin require dose adjustment in renal disease patients.
Ans. e
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ANTICOAGULANTS
ANSWERS:
1- Ans: E
2. Ans: B
Tips: “maximal” anticoagulation will be reached when all clotting factors are inhibited. This will
take approximately 10 days, since 50hrs (the half-life of the clotting factor taking the longest
time to reach steady) x 5 = 250 hours, which is 10.4 days.
3- Ans: E
Tips: Whole blood treated with anticoagulant is centrifuged in a calibrated hematocrit tube. The
volume ratio of the packed red blood cells to total blood volume is determined. The hematocrit
is normally 39 to 49 for men and 33 to 43 for women. The hematocrit value provides some
indication of both the number and size of the red blood cells present in an individual
4) Ans: B
5) Ans: D
Tips: Dabigatran an oral anticoagulants recently approved to treat atrial fibrillations. It is factor
Xa inhibitor. (competitive direct thrombin inhibitor).
6) Ans: D
7) Ans: E
8) Ans: C
Tips: Heparin iv infusion is faster onset than LMWH.
9) Ans: E
10) Ans: A
Tips: antibiotics potentiate anticoagulant effect : cotrimoxazole, erythromycin, metronidazole,
(other drugs: omeprazole, fluconazole, ketoconazole, cimetidine, amiodarone, quinidine,
vitamin E (large doses), acute phenytoin, thyroxin, acute alcohol also potentiate.
Reduce the clearance of warfarin, displacement from warfarin protein binding, decrease
intestinal flora
Drugs that inhibit anticoagulant effect: carbamazepine, penicillin, rifampin, cholestyramine,
barbiturates, high vitamin K, chronic alcohol use
11. Ans-A
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12. Ans: D
Tips: Aspirin is the only drug that irreversibly inhibits the enzyme. This action permits a longer
duration of action causing platelet aggregation and acetylation of cyclooxygenase.
13) Ans: A
14) Ans-C
15) Ans-A
16) Ans-D
Tips: LMWH is the drug of choice to treat DVT. Alternatively heparin is in emergency. The oral
anticoagulants are used for maintenance.
17) Ans. A
18) Ans-D
19) Ans-A
20) Ans: D
Tips: Ringing in the ear is associated with ASA, salicylates, quinine, and quinidine, but not
warfarin.
21) Ans: D
Tips: Metronidazole increases INR
22) Ans: A
Tips: Warfarin site of action is in vivo and heparin is either in vivo or in vitro
23) Ans: C
24) Ans: D
25) Ans: B
26) Ans: B
Tips: Chronic alcohol decreases INR while acute alcohol increases INR.
27) Ans: D
28) Ans: D
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29) Ans: D
Tips: Aspirin is a blood thinning agent indicated for prevention of heart stroke. It should be
carefully prescribed with other blood thinning agents
because of risks of bleeding. Lovenox (Enoxaparin), Coumadin (Warfarin), Heparin, Plavix
(Clopidrogel), Ticlid (Ticlopidine), Depakene (Valproic acid), Persantine (Dipyridamole), Mandol
(Cefamandole), Cefotan (Cefotetan), Cefobid (Cefoperazone) and Moxam (Moxalactam) are
agents that increase bleeding tendency in patients and should be carefully prescribed with
other blood thinning agents.
30) Ans: A
Tips: The overdose of Coumadin can be treated by administration of Vitamin K1 (Mephyton).
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PharmacyPrep.Com Anxiety Disorders
PHARMACY PREP
ANXIETY DISORDERS
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PharmacyPrep.com Depression
PHARMACY PREP
DEPRESSION
4 A patient with major depression, doctor initiated fluoxetine. However patient did not
tolerated and there was no improvement. Doctor initiated phenelzine, a week later. After
patient started therapy for phenelzine, 4 days later the patient presented with fever, high
blood pressure, diarrhea, and confusion. What is the most likely cause?
A) Neuroleptic malignant syndrome
B) Hypertension crisis
C) Serotonin syndrome
D) Serotonin withdrawal syndrome
Ans: C
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PharmacyPrep.com Depression
Tips:
Serotonin symptoms Withdrawal symptoms
Autonomic Diarrhea, Fever, Shivering, Flu like fever, chills, dizziness, light
change in BP, and & N, V headed, N &V, sleep disturbances
Neuromuscular Tremors, seizure, myoclonus, Myalgia, lethargy, sensory
Dysfunction hyper reflexes disturbances
Cognitive Agitation, Confusion, Not present
hypomania
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PharmacyPrep.Com Antipsychotics
PHARMACY PREP
ANTIPSYCHOTICS
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PharmacyPrep,Com Dementia
PHARMACY PREP
DEMENTIA
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PharmacyPrep,Com Dementia
9) What is/are the common side effects of Donepezil, Rivastigmine, and Galantamine?
A. Confusion
B. Sweating
C. Diarrhea
D. Cholinergic agonist effects
E. All of the above
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PharmacyPrep,Com Dementia
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PharmacyPrep,Com Dementia
CORRECT ANSWERS
DEMENTIA
1) Ans: C
Tips: deficiency of acetylcholine and damage of brain cells in older age causes dementia.
2) C
3) E
4) E
Tips: Lifestyle factors like alcohol intake have no evidence worsening Alzheimer's.
5) C
6) E
Tips: old age is a risk factor for Alzheimer's dementia
7) Ans: B
8) Ans: A
9) Ans: E
Tips.Dementia is treated by acetylcholinesterase inhibitors i.e. cholinergic agonist, thus
produce cholinergic agonist side effects " DUMBLESS"
10) Ans: A
Tips: Drugs that increases Donepezil are inhibitors of CYP 2D6 or CYP 3A4. Drugs that
decreases Donepezil are inducers of CYP 2D6 or CYP 3A4.
11) Ans: C
12) Ans: A
13) Ans: E
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PharmacyPrep.com Seizure and antiepileptic drugs
PHARMACY PREP
2) Phenytoin is indicated the treatment of all of the following types of seizure EXCEPT:
A-Grand mal
B-Complex partial
C-Simple partial
D-Tonic clonic
E) Absence seizure (petit mal)
6) Which of the following anticonvulsive drug treatment most likely cause kidney stone
formation.
A-Carbamazepine
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PharmacyPrep.com Seizure and antiepileptic drugs
B-Phenytoin
C-Tiagabine
D-Topiramate
E-Phenobarbital
8) Which of the following antiepileptic drugs has weight loss side effects:
A-Valproic acid
B-valproate
C-Phenytoin
D-Topiramate
E-Carbamazepine
9) A 25-year-old female patient taking gabapentin for neuropathic pain, which of the following
statement is/are true:
I-She should avoid taking oral contraceptive because, this drug decrease effectiveness of
gabapentin
II-Gabapentin chemical structure is not similar to GABA
III-Gabapentin chemical structure contains GABA structure.
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
10) Which of the antiseizure drug has weight loss side effects.
A-Topiramate
B-Carbamazepine
C-Phenytoin
D-Valproic acid
E-Gabapentin
11) A 25-year-old female patient taking gabapentin for neuropathic pain, which of the
following statement is not true:
A-She should avoid taking oral contraceptive because, this drug decrease effectiveness of
gabapentin
B-Gabapentin have advantage of the least drug interactions
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A-Gingival hyperplasia
B-Steven Johnson syndrome
C-Hirsutism
D-All of the above
E-A and C
21-Which one of the following CNS receptors is directly coupled to an ion channels, and this
do not involve secondary messenger system?
A-Alpha (NE)
B-dopamine D 2 (DA)
C-Acetyl choline (N)
D- serotonin (5HT)
E- None of the above
22-What are antimuscarinic drugs that are used in treatment of antipsychotic induced
Parkinson’s disease,
A-Benztropine
B-Trihexphenidyl
C-Bromocriptine
D-Diphenhydramine
E-Procyclidine
A-Anticholinergic
B-Sympathomimetics
C-Sympathetic blockers
D-Non dihydropyridine type of CCBs
E-All of the above
29. When changing from phenytoin syrup to phenytoin capsule, at same dose, change in
effect is due to
I. Change in salt form
II. Change in dose
III. Change in dose elimination
A-I only B-III only C-I and II only D-II and III only E-I, II,III
32) Epilepsy is resulted from the deficiency of?--> GABA action; Early symptoms of partial
seizures are?
I-Part of the brain
II-Sensory seizure or focal motor seizure
III-Patient is conscious
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A-I only B-III only C-I and II only D-II and III only E-I, II,III
34) A 25 yo women with one 2 yr old child. She has been using antiepileptic drugs for the past
1 year. Which drug least likely decrease efficacy of antiepileptic drugs?
a) Phenytoin B) Carbamazepine C) Valproic acid D) Lamotrigine
35) MP is a 23 year old women. In her medication profile she is valproic acid daily for seizure.
She calls to your pharmacy and ask if she should stop taking her medication because for the
past few weeks she has no seizures? What is the common reason for medication non
compliance in patient using antiepileptic medications?
A) because of drugs taste bad
B) because recently had no seizure
C) because expensive medications
D) because complicated storage conditions
39) Drugs that has least likely have drug interaction with oral contraceptives except:
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A. Gabapentin
B. Ethosuximide
C. Valproic acid
D. Lamotrigine
40) One side effect of Phenytoin is gingival hyperplasia, the best way to prevent it:
A. Use chlorhexidine wash
B. Use dental floss
C. Take Vitamin C
D. Gargle with water
44) Drug use as “add on” for patients nearly seizure free:
A. Gabapentin
B. Clobazam
C. Valproic acid
D. Phenytoin
A. Gabapentin
B. Valproic acid
C. Sodium valproate
D. A and C
47) What drug inhibits glutamate and aspartate release and blocks sodium channels and
prevents repetitive firing:
A. Topiramate
B. Lamotrigine
C. Clobazam
D. Gabapentin
ANSWERS:
1) Ans: A
2. Ans: E
Tips: Grand mal Valproic acid, Complex partial Carbamazepine, Simple partial
Carbamazepine, Tonic-clonic Valproic acid, Absence seizure Ethosuximide, and Status
epilepticus Diazepam
3) Ans: A
4) Ans: D
5) Ans: C
6) Ans: D
Tips: topiramate is a derivative of fructose. Indicated as anti seizure drug—partial seizure,
tonic clonic seizures. Has high kidney stone formation side effect. Fibrates also causes gall
bladder stone formation
7) Ans: E
Tips: valproic acid and valproate increase appetite and may results in weight gain,
carbamazepine may cause dizziness and confusion.
8) Ans: D
9) Ans: B
10) Ans: A
11) Ans: A
Tips: Gabapentin do not decrease efficacy of oral contraceptives and can be used along with
oral contraceptives.
12) Ans: B
13) Ans: E
Tips: butterfly rash symptoms occurs in lupus erythromatus
14- Ans: D
15- Ans: D
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16- Ans: A
17- Ans: B
18- Ans: D
19- Ans: B
20- Ans: D
21- Ans: C
Tips; Ach receptors, in the CNS are present on less than 5% of the neuronal population.
23- Ans: B
24- Ans: C
25) Ans: E
26) Ans: A
27) Ans: A
28) Ans: C
Tips: valproic acid is the drug of choice for generalized seizures and also can be used for petit
mal seizures.
29. Ans: A
Tips: Phenytoin syrup 100mg- more potent 8% increase in drug content; Phenytoin caps
100mg – free acid; Sodium salt of Phenytoin – Dilantin caps.
30) Ans: C
31) Ans: C
32) Ans: A
33) Ans: C
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34) Ans: C
35)Ans: B
Tips: Evidence shows there are two reasons seizure medication have compliance problems. 1)
because of side effects patient may not take regularly. 2) patient recently had no seizure.
Reference: Patient medication related non compliance. CE TT 2010 June
36) Ans:A
37)Ans: D
38) Ans: E
Tips: Phenytoin and Carbamazepine are not use in absence seizure
39)Ans: B
40)Ans: A
41)Ans: C
42)Ans: D
43)Ans: D
44) Ans: B
45) Ans: C
Tips: Carbamazepine stimulates phenytoin metabolism
46) Ans: D
47) Ans: B
48) Ans: A
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PharmacyPrep.Com Parkinson’s Disease
PHARMACY PREP
PARKINSON’S DISEASE
2-Involuntary movements typically involves mouth, face, limbs and trunk is characterized as:
A-Trigeminal neuralgia
B-Tardive dyskinesia
C-Neuroleptic malignant syndrome
D-Extrapyramidal symptoms
E-Akathisia
3-Which of the following Catecholamine Methyl Transferase (COMT) inhibitor has fatal liver
toxicity:
A-Selegiline
B-Tolcapone
C-Entacapone
D-Pergolide
E-Amantadine
4-A 60-year-old adult who has been treated with haloperidol for 3 weeks. He presents with
muscle stiffness, tremors. This is the most likely what kind of side effect:
A-Acute dystonia
B-Akathisia
C-Tardive dyskinesia
D-Parkinsonism disease
E-Pseudo parkinsonism
5-Which of the following is NOT used in treatment of Extrapyramidal side effects (EPS)?
A-Benztropine
B-Diphenhydramine
C-Trihexyphenidyl
D-Donepezil
E-All of the above
6-Selegiline is:
A-COMT inhibitor
B-MAO-B selective inhibitor
C-Non-selective MAO inhibitor
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PharmacyPrep.Com Parkinson’s Disease
D-Levodopa preparations
E-MAO-A selective inhibitor
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PharmacyPrep.Com Parkinson’s Disease
14) A patient is on levodopa/carbidopa therapy for the past 3 yrs. Recently patient is getting
periods of poor movements i.e return of tremor, rigidity or slowness. This conditions is
referred as?
A) Tardive dyskinesia B) Akathisia C) Dystonia D) on-off effect or fluctuations E) Freezing
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A. Tolcapone
B. Entacapone
C. Pergolide
D. A&B
22) Treatment of Parkinson’s disease may be treated with all of the following agents, EXCEPT:
A. Amantadine
B. Selegiline
C. Pergolide
D. Donezepil
E. Pramipexol
26) MP is a 75 year old patient diagnosed with Parkinson's disease. Doctor considering to
prescribe medication. What is the drug of choice for Parkinson disease is?
A. Levodopa
B. Carbidopa
C. A and B
D. Dopamine
E. Selegiline
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PharmacyPrep.Com Parkinson’s Disease
29) In treating parkinsonism, there is an increase of dopamine but on the other hand it will
increase also what neurotransmitter?
A. GABA
B. Acetylcholine
C. Norepinephrine
D. Epinephrine
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PharmacyPrep.Com Parkinson’s Disease
35) Nausea and vomiting are adverse effects of Levodopa, how do you manage this?
A. Take levodopa with food
B. Take levodopa without food
C. Take it on empty stomach
D. Do not crash or chew
36) Which of the following is the suitable combination of drugs are initiated after as drug of
choice for Parkinson disease is?
A. Levodopa and carbidopa
B. Carbidopa and Dopamine
C. Levodopa and Tolcapone
D. Dopamine and Entacapone
37) Which of the following antiviral drug indicated in Parkinson disease treatment:
A. Valacyclovir
B. Amantadine
C. Acyclovir
D. selegiline
E. Interferon's
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PharmacyPrep.Com Parkinson’s Disease
Parkinson's Disease
ANSWERS
1- Ans: A
Tips: That is why Dopamine agonist & anticholinergics are effective
2- Ans: B
Tips: dyskinesia = slow movement, tardive dyskinesia = involuntary movement of mouth, face,
limbs and trunk. Akinesia = difficulty in movement.
3- Ans: B
4- Ans: E
Tips: Pseudo parkinsonism (TRAP) may be side effects of antipsychotics. Pseudo parkinsonism
may disappear after discontinuation of medication.
5- Ans: D
Tips: anticholinergic agents such as benztropine, diphenhydramine, and trihexyphenidyl are
use in treatment of EPS. Donepezil is acetyl cholinesterase inhibitor is not indicated in EPS
treatment.
6- Ans: B
Tips: MAO-B selective inhibitors; treatment for Parkinson’s disease is: BALSAC =
Bromocriptine, Amantadine, Levodopa, Selegiline, Antimuscarinic (benztropine), and COMT
inhibitors
7) Ans: E
8) Ans: A
9) Ans: E
Tips: Ropinirole and pramipexole are selective D 2 agonist
10- Ans: B
11) Ans: B
12) Ans: E
13) Ans: A
14) Ans: D
Tips: End-of-dose wearing off gives on-off effect. This phenomenon is related to the increasing
loss neuronal storage capability of dopamine as well as short half life of dopa.
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15) Ans: B
16) Ans: D
17) Ans: E
18) D
19)Ans: A
20) Ans:B
21) Ans: D
Tips: COMT (Catecholamine O-Methyl transferase), the drugs names ends with “capone”.
COMT are indicated in Parkinson's disease
22) Ans: D
Tips: Donepezil is a drug for Alzheimers
23)Ans: D
24) Ans: D
25) Ans: B
26) Ans: C
27)Ans: C
28. Ans: A
29) Ans: B
30) Ans: A
31)Ans: B
32)Ans: A
33) Ans: D
34)Ans: A
Tips: To manage “wearing off”:Administer levodopa more frequently
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PharmacyPrep.Com Parkinson’s Disease
35) Ans: A
Tips: Take levodopa with food and increase dose of levodopa or dopamine agonist gradually
over several weeks
36)Ans: C
Tips: Sinemet is the combination of levodopa and carbidopa
37) Ans: B
38) Ans: A
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PharmacyPrep.Com Parkinson’s Disease
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Pharmacyprep.com Antimicrobial agents
PHARMACY PREP
ANTI-INFECTIVE AGENTS – ANTIBIOTICS
2.What is empiric treatment of urinary tract infection, patient has allergy to penicillin?
A. cotrimoxazole 3 d
B. Fluroquinolone 3d
C. Amoxicillin 3 d
D. Cephalexin 7 d
E. Aminoglycoside 14 d
Ans. A
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PharmacyPrep.Com Anticancer drugs and chemotherapy
PHARMACY PREP
1. What is the drug of choice to treat chemo induced nausea and vomiting
A. dexamethsone B. Ondansetron C. Metoclopramide D. dimenhydrinate
Ans. a
2) Which of the following chemotherapeutic agent is categorized as low emitogenic?
A) Cisplatin B) Cyclophosphamide C) Iphosphomide D) Vincristine
Ans. D
3) Hemorrhagic cystitis results from irritation of the lining of the bladder by acrolein, a
metabolite of ifosfamide and cyclophosphamide. Acrolein can be inactivated by?
A-Mesna
B-Doxarazoxane
C-Chlropropamide
D-Erythropoeitins
E-None of the above
Ans. A
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Pharmacy Prep
Natural Products and Pharmacognosy
1) A customer of your pharmacy wants to buy ginkgo biloba to enhance memory. What to do?
A) give gingko biloba
B) do not recommend gingko
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
2) A customer of your pharmacy wants to buy ginkgo biloba to enhance memory. Patient
currently on warfarin therapy . What to do?
A) give gingko biloba
B) do not recommend gingko because, has reports of drug interactions
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
3) A customer of your pharmacy wants to buy garlic pills to treat borderline high cholesterol.
What to do?
A) give garlic pills
B) do not recommend garlic pills
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
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ANSWERS
1) Ans: A
Tips: As long as patient is not medication and/or have no medical conditions that do not
interfere with natural products if this helps to alleviate their problems. I will give it to patient.
2) Ans: B
3) Ans: C
4. Ans: C
5. Ans. C
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