IPS2 -[Practice Question] -Part 1

Proverbs 16:3

B. Jonathan Roberts

The first hospital pharmacist.

A. Christopher Marshall

B. Jonathan Roberts

C. Carl Wilhelm Scheele

D. Friedrich Adam Serturner

C. Carl Wilhelm Scheele

A Swedish pharmacist who discovered oxygen, chlorine, prussic acid, tartaric acid, tungsten, molybdenum, glycerin, nitroglycerin, and countless organic compounds.

A. Christopher Marshall

B. Jonathan Roberts

C. Carl Wilhelm Scheele

D. Friedrich Adam Serturner

D. Friedrich Adam Serturner

A German pharmacist who discovered opium's chief narcotic principle: morphine.

A. Christopher Marshall

B. Jonathan Roberts

C. Carl Wilhelm Scheele

D. Friedrich Adam Serturner

C. Theophrastus

The "Father of Botany".

A. Dioscorides

B. Mithridates

C. Theophrastus

D. Gelen

B. Mithridates

The "Royal Toxicologist".

A. Dioscorides

B. Mithridates

C. Theophrastus

D. Gelen

D. Galen

He invented pharmaceuticals that are prepared and compounded by mechanical means like the cold cream.

A. Dioscorides

B. Mithridates

C. Theophrastus

D. Galen

D. Case Control

Study design wherein samples are chosen based on the presence or absence of the disease.

A. Cross sectional

B. Case series

C. Cohort

D. Case Control

B. Phase 2

Stage of clinical trials where proof of concept is indicated.

A. Phase 1

B. Phase 2

C. Phase 3

D. Phase 4

B. Category D

Using ASHP classification of medication errors, an error that reached the patient and required monitoring is classified as:

A. Category C

B. Category D

C. Category E

D. Category F

E. Category G

B. Type B ADR

Anaphylaxis

A. Type A ADR

B. Type B ADR

C. Type C ADR

D. Type D ADR

E. Type E ADR

D. Patient compliance

Type F ADR can occur as a result of the following, except:

A. Antimicrobial drug resistance

B. Counterfeit drugs

C. Drug instability

D. Patient compliance

B. Formulary drug

A therapeutic agent whose place in therapy is well established.

A. Non-formulary drug

B. Formulary drug

C. Investigational drug

D. Restricted drug

C. Respiratory rate

Which of the following is not a subjective parameter?

A. Anxiety

B. Indigestion

C. Respiratory rate

D. Pain

C. Commode

Health care supply described as portable toilet.

A. Bedpan

B. Rectal tube

C. Commode

D. Truss

B. Riboflavin

It is the most rapidly reduced vitamin.

A. Niacin

B. Riboflavin

C. Ascorbic acid

D. Thiamine

E. Cyanocobalamin

B. Reduced activity of diazepam

A smoker was prescribed with diazepam. What would happen if he continuously smokes while on drug therapy?

A. Enhanced activity of diazepam

B. Reduced activity of diazepam

C. No effect

D. Delayed elimination

D. Oxygen

The antiseptic property of hydrogen peroxide is due to:

A. Ozone

B. Peroxidase

C. Alcohol

D. Oxygen

E. Acetanilide

A. 2.5L/day

Starting dose of TPN per day is:

A. 2.5L/day

B. 3L/day

C. 3.5L/day

D. 4L/day

E. 4.5L/day

B. Osmotic diarrhea

Diarrhea caused by ingestion of magnesium hydroxide.

A. Secretory diarrhea

B. Osmotic diarrhea

C. Exudative diarrhea

D. Altered motility

C. Meperidine

DOC for pancreatitis related abdominal tenderness.

A. Hydromorphone

B. Morphine

C. Meperidine

D. Oxycodone

D. Hypokalemia

When caring for a patient taking Hydrochlorohiazide, you should monitor for:

A. Hypertension

B. Hypernatremia

C. Hypoglycemia

D. Hypokalemia

B. Prazosin - alpha blocker

can also cause orthostatic hypotension

First dose syncope normally reported with:

A. Captopril

B. Prazosin

C. Hydralazine

D. Minoxidi

E. A and B:

Sinemet

Tidomet

Levodopa + Carbidopa

A. Sinemet

B. Tidomet

C. Dilantin

D. Corta

E. A and B

F. B and C

A. Parkinson's Disease

Levodopa + Carbidopa is used for?

A. Parkinson's Disease

B. Cushing's Syndrome

C. Nephrogenic Diabetes insipidus

D. Central Diabetes Insipidus

A. Take before meal

Patient taking Levodopa + Carbidopa should be reminded to:

A. Take before meal

B. Take after meal

C. Take during mealtime

C. Avoid high protein diet

What diet modification should be implemented for patients taking Levodopa + Carbidopa?

A. Avoid high sodium diet

B. Avoid high potassium diet

C. Avoid high protein diet

D. Avoid taking high fat meals

A. Phenytoin

Most commonly used to treat digitalis-induced ventricular and supraventricular tachycardia:

A. Phenytoin

B. Quinidine

C. Flecainide

D. Propafenone

C. Hypertension

Most common cardiovascular disorder is:

A. Angina pectoris

B. Arrhythmia

C. Hypertension

D. Myocardial infarction

C. Tetracyclines

Fanconi syndrome is associated with:

A. Penicillin

B. Cephalosporins

C. Tetracyclines

D. Chloramphenicol

D. Hypokalemia

Cardiac glycosides have a low margin of safety. Toxicity is more likely in the presence of?

A. Hypernatremia

B. Hyponatremia

C. Hyperkalemia

D. Hypokalemia

C. Mannitol

Used for intracranial hypertension:

A. Spironolactone

B. Acetazolamide

C. Mannitol

D. Hydrochlorothiazide

D. All of the above

Smoking contributes to the exacerbation of:

A. Asthma

B. Chronic bronchitis

C. Emphysema

D. All of the above

A. MCHC - Mean Cell Hemoglobin Concentration

May be decreased in iron deficiency anemia.

A. MCHC

B. lymphocytes

C. HbA1c

D. INR

E. thrombocytes

B. lymphocytes

May have an increased value in viral infections.

A. MCHC

B. lymphocytes

C. HbA1c

D. INR

E. thrombocytes

E. thrombocytes

May have a decreased value in idiopathic thrombocytopenic purpura.

A. MCHC

B. lymphocytes

C. HbA1c

D. INR

E. thrombocytes

D. Myopathy

Muscle weakness and muscle wasting.

A. Tachypnea

B. Hypoxia

C. Afterload

D. Myopathy

E. Dysphasia

A. Tachypnea

Rapid rate of breathing.

A. Tachypnea

B. Hypoxia

C. Afterload

D. Myopathy

E. Dysphasia

E. Dysphasia

An impairment of the language aspect of speech.

A. Tachypnea

B. Hypoxia

C. Afterload

D. Myopathy

E. Dysphasia

A. I, II, III

(I)Peripheral route

(II) Central route

(III) PICC

Parenteral nutrition may be administered via:

I. Peripheral route

II. Central route

III. Peripherally Inserted Central Catheter (PICC)

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Line sepsis

(II) Line occlusion

The following are complications associated with parenteral nutrition:

I. Line sepsis

II. Line occlusion

III. Maillard reaction

A. I, II, III

B. I, II

C. II, III

D. I

E. III

E. III

(III) requires the patient to perform bowel cleansing

Colonoscopy:

I. is an artificial opening between the colon and skin

II. does not require sedation

III. requires the patient to perform bowel cleansing

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Potassium chloride

(II) Sodium chloride

Magnesium oxide

- oral form

Magnesium sulfate

- is the electrolyte form

Commercially available concentrated electrolytes include:

I. Potassium chloride

II. Sodium chloride

III. Magnesium oxide

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I - Precipitation

Type of incompatibility that may be classified as both physical and chemical.

I. Precipitation

II. Hydrolysis

III Polymorphism

A. I, II, III

B. I, II

C. II, III

D. I

E. III

E. III - Isotonic

D5NSS

I. Used in DM

II. Used in neuro patients

III. Isotonic

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

May be used during palpation

I. Fingers

II. Palms

III. Back of hands

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Psyllium

(II) Polycarbophil

(III) Methylcellulose

Bulk forming agents

I. Psyllium

II. Polycarbophil

III. Methylcellulose

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I - Antibiotics

Loperamide and codeine causes constipation aggravating the infection inhibiting the release of bacteria.

Drugs used for infection related diarrhea

I. Antibiotics

II. Loperamide

III. Codeine

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) End product of protein metabolism

(II) Filtered completely by glomerulus

*(III) Produced by liver

Which of the following is/are true regarding blood urea nitrogen (BUN)?

I. End product of protein metabolism

II. Filtered completely by glomerulus

III. Produced by liver and kidney

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I - Prednisolone

Drugs that may cause plasma sodium electrolyte disturbances include:

I. Prednisolone

II. Salbutamol

III. Propranolol

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Paget's disease

(II) Neuropathy

(III) Hemophilia

Conditions that may give rise to muscular or joint pain include:

I. Paget's disease

II. Neuropathy

III. Hemophilia

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Is an index used to measure glomerular filtration rate

(II) Measurement involves a 24 hour urine collection

1) Urine creatinine

2) Serum creatinine - more accurate and more commonly used

Creatinine clearance:

I. Is an index used to measure glomerular filtration rate

II. Measurement involves a 24 hour urine collection

III. Monitoring requires 24 hour monitoring of plasma creatinine

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Used in cardiac arrest

(II) Administration requires monitoring of blood pressure

*(III) Results in increased blood pressure

Epinephrine:

I. is used in cardiac arrest

II. administration requires monitoring of blood pressure

III. results in a fall in blood pressure

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. II, III

(II) Is addictive

(III) Is an opioid agonist

Methadone:

I. requires multiple dosing in a day

II. is addictive

III. is an opioid agonist

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) That hot flushes may occur

(II) That menstrual irregularities may occur

(III) To report sudden breathlessness and any pain in the calf

Tamoxifen is SERM with side effect similar to menopausal symptoms

They can also increase the risk of thromboembolism

1) Pulmonary embolism

2) Deep vain thrombosis

Patients receiving tamoxifen should be advised:

I. That hot flushes may occur

II. That menstrual irregularities may occur

III. To report sudden breathlessness and any pain in the calf

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Raises blood pressure

(II) Is indicated in metabolic acidosis

Parenteral sodium bicarbonate:

I. raises blood pH

II. is indicated in metabolic acidosis

III. may be used in hypomagnesemia

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Is a lipid soluble analogue of Vitamin K

(II) Promotes hepatic synthesis of active prothrombin

(III) Indicated in babies at birth to prevent Vitamin K deficiency bleeding

Phytomenadione

I. is a lipid soluble analogue of Vitamin K

II. promotes hepatic synthesis of active prothrombin

III. is indicated in babies at birth to prevent Vitamin K deficiency bleeding

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Cannot be used at the same dose as heparin

- Enoxaparin is LMW usually 2000 units

(II) Thrombocytopenia may occur with its use

(III) Agents that affect homeostasis should be used with care

- all heparin are high alert medications

Enoxaparin

I. Cannot be used at the same dose as heparin

II. Thrombocytopenia may occur with its use

III. Agents that affect homeostasis should be used with care

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) to avoid pregnancy

- it is teratogenic

(II) to avoid wax epilation during treatment

(III) to use lip balm regularly

- can cause dryness of the skin

Patients receiving oral isotretinoin should be advised:

I. to avoid pregnancy

II. to avoid wax epilation during treatment

III. to use lip balm regularly

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Metronidazole

(II) Clarithromycin

Triple regimens:

1) OCM: Omeprazole, Clarithromycin, Metronidazole

2) OCA: Omeprazole, Clarithromycin, Amoxicillin

Anti-infectives that are used in the triple therapy regimens to eradicate Helicobacter pylori include:

I. Metronidazole

II. Clarithromycin

III. Ciprofloxacin

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) is associated with insulin deficiency

(II) may be precipitated by a severe infection

*(III) diabetes itself causes retinopathy

Diabetic ketoacidosis:

I. is associated with insulin deficiency

II. may be precipitated by a severe infection

III. causes retinopathy

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. II, III

*(I) Can be combined with low dose aspirin to reduce risk of ischemia

(II) Is used for prophylaxis of thromboembolism

(III) May cause increased bleeding during or after surgery

GD is a 72 year old female whose current medications are:

1) Aspirin 80mg PO OD

2) Dipyridamole 100mg PO TID

3) Timolol 0.5% both eyes 2 drops BID

4) Lactulose 3.3g/5ml 20ml PO OD

Dipyridamole:

I. Cannot be used in combination with low dose aspirin

II. Is used for prophylaxis of thromboembolism

III. May cause increased bleeding during or after surgery

A. I, II, III

B. I, II

C. II, III

D. I

E. III

E. III

(III) Used to maintain bowel evacuation

*Lactulose is semisynthetic disaccharide without need for dose alteration.

GD is a 72 year old female whose current medications are:

1) Aspirin 80mg PO OD

2) Dipyridamole 100mg PO TID

3) Timolol 0.5% both eyes 2 drops BID

4) Lactulose 3.3g/5ml 20ml PO OD

Lactulose:

I. Dose needs to be reviewed as the maximum adult daily dose is 5ml

II. Should not be used for more than 5 days

III. Used to maintain bowel evacuation

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I - Glaucoma

Laxative is given such as lactulose

GD is a 72 year old female whose current medications are:

1) Aspirin 80mg PO OD

2) Dipyridamole 100mg PO TID

3) Timolol 0.5% both eyes 2 drops BID

4) Lactulose 3.3g/5ml 20ml PO OD

GD is receiving medications for:

I. Glaucoma

II. Diarrhea

III. Osteoporosis

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) to control symptoms of heart failure

(II) to control edema

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

The therapeutic aims for SP are:

I. to control symptoms of heart failure

II. to control edema

III. to control diabetes

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Reduces symptoms and mortality

(II) Dose may be increased to 25mg daily

*(III) It is aldosterone antagonist

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

Spironolactone:

I. Reduces symptoms and mortality

II. Dose may be increased to 25mg daily

III. Is an aldosterone agonist

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Serum creatinine

(II) Serum potassium

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

Spironolactone treatment requires monitoring of:

I. Serum creatinine

II. Serum potassium

III. Thyroid function

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Is an angiotensin-II receptor antagonist

(II) Exhibits a lower incidence of cough as a side effect compared to enalapril

(III) Dose may be increased to 50mg daily

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

Losartan:

I. Is an angiotensin-II receptor antagonist

II. Exhibits a lower incidence of cough as a side effect compared to enalapril

III. Dose may be increased to 50mg daily

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. II, III

(I) it INCREASES myocardial intracellular ionic calcium

(II) when there is atrial fibrillation

(III) because it exerts a positive inotropic effect

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

Digoxin is used in patients with heart failure:

I. because it decreases myocardial intracellular ionic calcium

II. when there is atrial fibrillation

III. because it exerts a positive inotropic effect

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) plasma digoxin concentration

(II) plasma potassium measurement

SP is a 64 year old patient who is admitted to hospital with tiredness, shortness of breath and ankle edema. She has a medical history of congestive heart failure. SP was intolerant to enalapril owing to the development of cough. Her medications upon admission are:

1) Spironolactone 12.5mg PO OD

2) Losartan 25mg PO OD

Parameters to be monitored when digoxin therapy is started:

I. plasma digoxin concentration

II. plasma potassium measurement

III. plasma sodium measurement

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Drowsiness

(II) Headache

(III) Blurred vision

BD is a 34 year-old patient admitted with an overdose of promethazine and alcohol withdrawal symptoms. Patient has a history of alcohol abuse.

Symptoms that could occur due to promethazine overdose include:

I. Drowsiness

II. Headache

III. Blurred vision

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. Antihistamine - sedating first generation

BD is a 34 year-old patient admitted with an overdose of promethazine and alcohol withdrawal symptoms. Patient has a history of alcohol abuse.

Promethazine is an:

A. Antidepressant

B. Antipsychotic

C. Antihistamine

D. Analgesic

E. Anxiolytic

D. Diazepam - Long acting BZD counteract withdrawal symptoms

BD is a 34 year-old patient admitted with an overdose of promethazine and alcohol withdrawal symptoms. Patient has a history of alcohol abuse.

A drug that can be used in alcohol withdrawal is:

A. Beclomethasone

B. Chlorphenamine

C. Lithium

D. Diazepam

E. Risperidone

B. I, II

(I) to report any muscle pain or weakness

(II) to take simvastatin at night

- cholesterol is produced more at night

MB is a 58 year-old woman who presents with a prescription for simvastatin 10mg daily. Her current medication is atenolol 50mg daily. MB suffered a heart attack last year.

MB is advised:

I. to report any muscle pain or weakness

II. to take simvastatin at night

III. to stop taking atenolol

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) headache

(II) Nausea

(III) Abdominal pain

MB is a 58 year-old woman who presents with a prescription for simvastatin 10mg daily. Her current medication is atenolol 50mg daily. MB suffered a heart attack last year.

Side effect to be expected with simvastatin include:

I. headache

II. Nausea

III. Abdominal pain

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) follow moderate exercise

(II) Adopt a low-fat diet

MB is a 58 year-old woman who presents with a prescription for simvastatin 10mg daily. Her current medication is atenolol 50mg daily. MB suffered a heart attack last year.

Recommendations made to MB include:

I. follow moderate exercise

II. Adopt a low-fat diet

III. Take atenolol 2 hours before simvastatin

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. Herpes zoster

LB is a 55 year-old male patient who developed vesicles unilaterally around his waist. LB complained of a stabbing irritation in the area. LB is prescribed acyclovir 800mg 5 times a day for 5 days.

The likely diagnosis for LB is:

A. Prickly heat

B. Herpes zoster

C. Herpes labialis

D. Cytomegalovirus infection

E. Hepatitis B

B. I, II

(I) to take doses at regular intervals

(II) to avoid exposure to sunlight

LB is a 55 year-old male patient who developed vesicles unilaterally around his waist. LB complained of a stabbing irritation in the area. LB is prescribed acyclovir 800mg 5 times a day for 5 days.

Patient should be advised:

I. to take doses at regular intervals

II. to avoid exposure to sunlight

III. to wash hands thoroughly after drug administration

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Headache

(II) Nausea

(III) Diarrhea

LB is a 55 year-old male patient who developed vesicles unilaterally around his waist. LB complained of a stabbing irritation in the area. LB is prescribed acyclovir 800mg 5 times a day for 5 days.

Side effects that may be expected include:

I. Headache

II. Nausea

III. Diarrhea

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) Calamine Lotion

- for itching and pain

(II) Amitryptiline

- for post herpetic neuralgia

LB is a 55 year-old male patient who developed vesicles unilaterally around his waist. LB complained of a stabbing irritation in the area. LB is prescribed acyclovir 800mg 5 times a day for 5 days.

Adjuvant therapy that may be used for LB include/s:

I. Calamine Lotion

II. Amitryptiline

III. Ergotamine

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. Benzylpenicillin

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Penicillin G is:

A. Phenoxymethylpenicillin

B. Benzylpenicillin

C. Penicillin V

D. Piperacillin

E. Pivmecilinam

D. 3

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Penicillin G is available at 600mg vials. How many vials are required for each dose?

A. 0.5

B. 1

C. 2

D. 3

E. 4

C. II, III

(II) Is bactericidal

- cell wall synthesis inhibitor

(III) Can be given IM

- also given IV

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Penicillin G:

I. is bacteriostatic

II. Is bactericidal

III. Can be given IM

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I

(I) has a broad spectrum of activity

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Gentamicin

I. has a broad spectrum of activity

II. is contraindicated in hepatic impairment

III. therapy may be changed to oral administration when patient is stabilized

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Allergy to gentamicin

(II) Allergy to penicillin

(III) Development of heat rash

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Patient developed a rash and started complaining of generalized itch after the administration of the drugs. A possible reason for these symptoms is:

I. Allergy to gentamicin

II. Allergy to penicillin

III. Development of heat rash

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) Prolonged fever

(II) Embolic phenomena

(III) Renal failure

AD is a 39 year-old female wit bacterial endocarditis. She is started on gentamicin 80mg IV q12 and penicillin G 1.8g IV q6.

Manifestation of bacterial endocarditis include:

I. Prolonged fever

II. Embolic phenomena

III. Renal failure

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. may be due to excessive production of uric acid

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD.

> He started on colchicine 500mcg PO OD for 6 days now.

Gout:

A. may be due to excessive production of uric acid

B. may be due to increased renal elimination of uric acid

C. results in the deposition of crystals of xanthine in the joints

D. is characterized by excessive calcium deposited in the joints

E. is the result of hypourecemia

A. I, II, III

(I) Heart failure

(II) Hydrochlorothiazide

(III) Excessive consumption of meat

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD.

> He started on colchicine 500mcg PO OD for 6 days now.

Gout may be precipitate in JZ by:

I. Heart failure

II. Hydrochlorothiazide

III. Excessive consumption of meat

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I

(I) Presents as a painful condition in the big toe

*(II) Onset is rapid

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Gout:

I. Presents as a painful condition in the big toe

II. Onset is insidious

III. Recurrence is rare

A. I, II, III

B. I, II

C. II, III

D. I

E. III

D. I

(I) is based on clinical signs

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Diagnosis of gout:

I. is based on clinical signs

II. requires confirmation of urate crystals in the synovial fluid of affected joint

III. requires a positive ESR level

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) resting the affected joint

(II) maintaining high fluid intake

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Non-pharmacological measures for JZ include:

I. resting the affected joint

II. maintaining high fluid intake

III. maintaining a high calcium intake

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) reduces the inflammatory reaction to urate crystals

(II) provides dramatic relief from acute attacks of gout

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Colchicine:

I. reduces the inflammatory reaction to urate crystals

II. provides dramatic relief from acute attacks of gout

III. is also used in rheumatoid arthritis

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) should be used when there is a contraindication to NSAIDs

(II) is more toxic than NSDAIDs

(III) occurrence of diarrhea and vomiting are used as an index to review therapy

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Colchicine:

I. should be used when there is a contraindication to NSAIDs

II. is more toxic than NSDAIDs

III. occurrence of diarrhea and vomiting are used as an index to review therapy

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) indomethacin

(II) Diclofenac

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Alternatives to colchicine in the management of gout include:

I. indomethacin

II. Diclofenac

III. aspirin

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) lose weight

(II) follow a diet low in purines

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

To prevent further attacks, JZ should be advised to:

I. lose weight

II. follow a diet low in purines

III. keep taking colchicine on a long-term basis

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) should be started 2-3 weeks after acute attack has subsided

(II) reduce urate production

(III) is given once daily

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Allopurinol:

I. should be started 2-3 weeks after acute attack has subsided

II. reduce urate production

III. is given once daily

A. I, II, III

B. I, II

C. II, III

D. I

E. III

A. I, II, III

(I) can be used instead of allopurinol

(II) are ineffective in patients with impaired renal function

(III) increase urate excretion

> JZ is a 78-year-old obese male who is diagnosed with an acute attack of gout.

> PMH: (1) hypertension, (2) heart failure. DH: (1) Enalapril 5mg PO OD, (2) Hydrochlorothiazide 25mh PO OD, (3) Atenolol 100mg PO OD, (4) Aspirin EC 80mg PO OD

> He started on colchicine 500mcg PO OD for 6 days now.

Uricosuric agents:

I. can be used instead of allopurinol

II. are ineffective in patients with impaired renal function

III. increase urate excretion

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. II, III

(II) is monitored in patients receiving warfarin

(III) stands for international normalized ratio

INR:

I. is monitored in patients with arthritis

II. is monitored in patients receiving warfarin

III. stands for international normalized ratio

A. I, II, III

B. I, II

C. II, III

D. I

E. III

C. II, III

(II) are used to determine severity of respiratory disease

(III) are used to monitor outcomes of therapy

Lung function tests:

I. always involve administration of bronchodilators before the procedure

II. are used to determine severity of respiratory disease

III. are used to monitor outcomes of therapy

A. I, II, III

B. I, II

C. II, III

D. I

E. III

B. I, II

(I) chest radiographs may show cardiac enlargement

(II) the pulse rate may indicate arrhythmias

*(III) body extremities are very cold

In heart failure:

I. chest radiographs may show cardiac enlargement

II. the pulse rate may indicate arrhythmias

III. body extremities are very hot

A. I, II, III

B. I, II

C. II, III

D. I

E. III

E. III

*(I) is carried out to confirm the occurrence of neurovascular disease

*(II) procedures does not require patients to be totally sedated

(III) stands for electroencephalography

EEG:

I. is carried out to confirm the occurrence of cardiovascular disease

II. procedures require patients to be totally sedated

III. stands for electroencephalography

A. I, II, III

B. I, II

C. II, III

D. I

E. III