Pharmacy CPA Free Questions Flashcards
HB, a 76-year old, 40 kg patient wishes to purchase the following herbal products. Which would you NOT sell based on the following patient medical record information?
Current medications:
Warfarin 2.5mg daily x 2 years
Donepezil 5 mg daily x 2 months
Ginkgo biloba
Evening primrose oil
Vitamin B complex
Both Ginkgo biloba and Evening primrose oil interact with warfarin.
Evening primrose + warfarin = increased anticoagulant?
A child has ingested an unknown substance and has evidence of respiratory depression. This symptom is usually found with poisoning due to:
Amphetamines Atropine Mushrooms Kerosene Opioids
opioids
Joan Linscombe approaches you confidentially stating that she has a problem, every month for the last 5 months and has tried Miconazole and Clotrimazole ovules, 3 day therapy as per her prescribers guidance. Both were effective, but the problem recurs frequently. This time her symptoms include frequent urination and thirst. She had her menstrual period ten days ago, but it is unpredictable. She has not been to her doctor for almost a year. What is your advice?
The polydipsia and polyuria are the most worrying symptoms here, diabetics are more prone to all types of infection including those of the urinary tract. She is not overusing the antifungals as she is following her prescribers guidance which seems not to be excessive. Dependent on the services available at the pharmacy a dipstick urinalysis for pathogenic or hyperglycaemic markers could be performed, which may aid in further diagnosis by a suitably qualified healthcare professional.
A patient complains of headache and his blood pressure is 120/80. His medications include hydrochlorothiazide and hydralazine. Which of the following would seem most likely?
The headaches are secondary to thiazide-induced hypokalemia
The headaches are secondary to hydralazine therapy
The headaches are probably unrelated to drug therapy
The headaches are related to hydralazine-induced agranulocytosis
The headaches are caused by an temporary increased blood pressure
One of the side effects of hydralazine therapy is headaches.
MD, a 17 year old, presents with a purpuric skin rash. She wonders if she is having another flare-up of her eczema, but this rash looks different to previous presentations. Her patient medical record reveals the following:
Allergies: penicillin
History: eczema x 2.5 years epilepsy x 1 month
Current medications:
Betamethasone Cr 0.05% bid prn x 2.5 years
Ethinyl estradiol/ levonorgestrel x 10 months
Phenytoin 200mg qhs x 1 month
What is the most probable cause of her skin rash?
Phenytoin is a highly effective and widely prescribed anticonvulsant agent. Phenytoin is however, associated with both dose related side effects and hypersensitivity reactions. 5-10% of patients using phenytoin have a skin reaction.
Which of the following is a cause of hyperkalemia?
Acidosis
Crush injury
ACEi
Hypoaldosteronism
All of them can.
Medication that interferes with urinary excretion: ACE inhibitors and angiotensin receptor blockers Potassium-sparing diuretics (e.g. amiloride and spironolactone) NSAIDs such as ibuprofen, naproxen, or celecoxib.
The calcineurin inhibitor immunosuppressants ciclosporin and tacrolimus.
The antibiotic trimethoprim.
The antiparasitic drug pentamidine.
Mineralocorticoid deficiency or resistance, such as: Addison’s disease Aldosterone deficiency.
Some forms of congenital adrenal hyperplasia Type IV renal tubular acidosis (resistance of renal tubules to aldosterone)
Which of the following would be considered the most common cause of hypocalcemia?
Rickets Osteomalacia Renal failure Massive blood transfusion Idiopathic hypoparathyroidism
Rickets - caused by low calcium etc.
Osteomalacia
Osteomalacia - softening of bones caused by impaired bone metabolism primarily due to low phosphate, calcium and vitamin D.
Renal failure - healthy kidneys turn vitamin D into an active hormone (calcitriol), which helps increase calcium absorption from the intestines into the blood.
Massive blood transfusion is a relatively rare cause of hypocalcemia.
Hypoparathyroidism leads to decreased levels of calcium and increased levels of blood phosphate.
Which of the following white blood cells is capable of phagocytosis?
Basophil Eosinophil Lymphocyte Neutrophil Platelets
Phagocytosis is the process by which a cell can ingest and digest other cells. The two WBCs that are phagocytic in nature are neutrophils and monocytes.
Which of the following will increase theophylline serum levels if combined with theophylline?
Carbamazepine
Tobacco smoking
Phenytoin
Ciprofloxacin HCl
Carbamazepine will decrease the level or effect of theophylline by altering drug metabolism.
Smoking inhibits CYP1A2, smoking thus decreases level of theophylline.
Phenytoin significantly reduces the half-life of theophylline = reduced serum levels.
Ciprofloxacin HCl may significantly increase serum levels of theophylline.
Which one of the following is least likely to cause a significantly elevated level of ALT (SGPT)?
Viral hepatitis Diabetes Congestive heart failure Liver damage Transient ischaemic event
TIA.
Significantly elevated levels of ALT (SGPT) often suggest the existence of other medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy, so ALT is commonly used as a way of screening for liver problems.
Elevated ALT may also be caused by dietary choline deficiency.
However, elevated levels of ALT do not automatically mean that medical problems exist. Fluctuation of ALT levels is normal over the course of the day, and they can also increase in response to strenuous physical exercise.
ALT is most commonly measured clinically as a part of a diagnostic evaluation of which of the following?
Hepatocellular injury Brain injury Cardiac injury Respiration injury Ocular nerve degradation
Liver
Which of the following is an example of an enzyme inhibitor?
Grisoefulvin Phenytoin Phenobarbitone Fluconazole Smoking cigarettes
Smoking
