Question 1

As you are reading a technical paper, you notice that the writers have included the statement that within a specific data set, p<0.001. How would you interpret the p value?

Accepted Answer

A smaller p value indicates there is a greater probability that the differences measured between the control and the test group are statistically significant and not based on a random process. A p-value > 0.05 is not considered significant.

Question 2

Which of the following statements accurately reflects the difference between accuracy and precision in measurements?
I. Accuracy is a measure of how close an experimental value is to the expected value.
II. Precision is a measure of how close a series of experimental values are to each other.
III. Accuracy is a measure of how close an experimental value is to the dependent variable.
IV. Precision is a measure of how close an experimental value is to the dependent variable.

Accepted Answer

Statements I and II are the definitions of accuracy and precision. Neither accuracy nor precision relies on the dependent variable.

Question 3

A pharmacist is asked about the mechanism of action of a particular drug. Of the following resources, which is the most appropriate source of valid information?

Accepted Answer

The AHFS (American Hospital Formulary Service) Drug Information is the only resource for drug information that is listed. The DSM-IV is the Diagnostic and Statistical Manual of Mental Disorders. ICD-9 is the International Statistical Classification of Diseases manual used for diagnostic coding. The Handbook on Injectable Drugs is a useful resource, but only for injectable drugs.

Question 4

Which of the following statements is true concerning Phase I, II, or III clinical trials?

Accepted Answer

Each statement is an accurate description of clinical trials.

Question 5

A woman comes into the pharmacy and tells you she has an at-home glucometer and regularly tests her blood sugar. It is sometimes a fasting blood sugar and sometimes not, but she remembers at least twice when she was fasting, her numbers were 128 and 134 mg/dL. What should you talk to her about?

Accepted Answer

Diabetes is defined as 2 or more fasting glucose levels greater than or equal to 126mg/dL. Therefore, she should be directed to get a formal diagnosis and begin formal educational classes.

Question 6

A patient is diagnosed with an H. pylori associated ulcer. Which is generally the first-line treatment with such an ulcer?

Accepted Answer

An H. pylori associated ulcer is treated with a PPI and antibiotics to decrease the acidity and eradicate the bacteria, respectively. The etiology of these ulcers indicates that a PPI alone is not an effective treatment. OTC NSAIDs are often the cause of ulcers and should be avoided. Infliximab is a TNF (Tumor Necrosis Factor) inhibitor and is used to treat GI inflammations (IBD) such as Crohn's disease and ulcerative colitis (UC).

Question 7

Azathioprine is used as an immunosuppressant in GI disorders. Which of the following should be monitored in a patient on azathioprine?
I. Amylase and lipase levels
II. Liver Function Tests (LFTs)
III. CBC with differential
IV. Creatine phosphokinase levels

Accepted Answer

Azathioprine patients should be monitored consistently for pancreatic enzyme levels (amylase and lipase), LFTs, and CBCs. Creatine phosphokinase levels are more important in musculoskeletal disorders and do not need to be monitored in immunosuppressed patients.

Question 8

Which of the following is not a characteristic drug and delivery system used in the treatment of iron deficiency anemia?

Accepted Answer

Iron sucrose is used in the treatment of iron deficiency anemia, but it is used intravenously (IV). The other drug/delivery systems are correct-ferrous sulfate is the only oral preparation listed for the treatment of iron deficiency anemia.

Question 9

Cytarabine is a nucleoside analog used as a chemotherapeutic agent. Which of the following should be co-administered to limit chemically induced arachnoiditis on intrathecal injection?

Accepted Answer

Chemical arachnoiditis (nausea, vomiting, headache, fever) is a primary side effect of intrathecal injection of cytarabine. Dexamethasone, co-administered, limits the effects of the arachnoiditis. There is no clear correlation between the rate of infusion and the appearance of the arachnoiditis.

Question 10

Which of the following statements is true concerning Tamoxifen?

Accepted Answer

Tamoxifen (Nolvadex) is a SERM (Selective Estrogen Receptor Modulator). Bone pain is considered indicative of a positive response and should be managed with analgesics. Thromboembolic events occur more frequently in patients on tamoxifen therapy and must be monitored.

Question 11

Which of the following would be an effective anti-androgen therapy in a 58 year old patient with prostate cancer?
I. Bilateral orchiectomy.
II. A testosterone antagonist such as bicalutamide only.
III. An LHRH antagonist such as cetrorelix.

Accepted Answer

A bilateral orchiectomy and/or the use of an LHRH antagonist are considered to be effective therapy for prostate cancer. Testosterone antagonists alone are not considered an effective therapy.

Question 12

A woman comes into the pharmacy and tells you she has been diagnosed with bipolar disorder. Which of the following would be the best approach therapeutically?

Accepted Answer

Bipolar disorder is often treated with mood stabilizers such as lithium or lamotrigine. Buspirone is an anxiolytic (not an antipsychotic) with an affinity for serotonin and dopamine receptors. Oxcarbazepine is a mood stabilizer and not an anxiolytic. Oxcarbazepine may, however, be used in bipolar disorder.

Question 13

Which of the following drugs is used to treat osteoarthritis?

Accepted Answer

All the drugs listed may be used in the treatment of osteoarthritis. Diclofenac is marketed as Voltaren. Celecoxib is marketed as Celebrex. Acetaminophen is marketed as Tylenol.

Question 14

What information do the Commission E monographs provide?

Accepted Answer

Commission E monographs are statements from a German commission on botanical medicines and do not include information on vitamins, supplements, or OTC medications.

Question 15

Which of the following is an appropriate agent and dosing schedule for a newly-diagnosed patient with depression?

Accepted Answer

Venlafaxine is the only antidepressant listed and dosage listed is possible. Carbamazepine is an anticonvulsant. Ezetimibe is a cholesterol absorption inhibitor and hydroxocobalamin is Vit. B₁₂. All dosages and routes for all the agents listed are possible.

Question 16

Of the following lab value and medication, which are incorrectly matched?

Accepted Answer

Statement C is incorrectly matched - Filgrastim is a granulocyte colony-stimulating factor and EEG is unwarranted. Moricizine is a Na channel blocker used in ventricular arrhythmias. ECGs should be monitored. Erlotinib is an epidermal growth factor receptor (EGF-r) inhibitor and can affect liver enzymes. Lovastatin is an HMG-CoA reductase inhibitor and can also affect liver function.

Question 17

Which of the following requires monitoring of serum concentrations of the drug?
I. Risperidone
II. Valproic acid
III. Lamotrigine

Accepted Answer

Valproic acid (Depakene) should be monitored closely to achieve a therapeutic range of 50-100 mcg/mL. Neither risperidone (Risperdal) nor lamotrigine (Lamictal) need to be monitored by serum concentrations.

Question 18

Migraine prophylaxis is most likely to be obtained with which class of medication?

Accepted Answer

Antidepressants may be used for migraine prophylaxis. ACE inhibitors, and Angiotensin II receptor blockers have no proven preventive benefit for migraines.

Question 19

What is liothyronine used to treat?

Accepted Answer

Liothyronine (Cytomel) is T3 and is used to treat hypothyroidism. Grave's disease is the most common form of hyperthyroidism. Adrenal fatigue, while related to hypothyroidism, would not be treated with T3.

Question 20

Which of the following is an appropriate agent and dosing schedule for managing obesity?

Accepted Answer

Orlistat is a GI lipase inhibitor used to treat obesity along with a calorie-restricted diet. Omeprazole is a proton-pump inhibitor used to treat GERD, duodenal ulcers, gastric ulcers, and hypersecretory conditions. The dosing schedule given is appropriate. Piroxicam is an NSAID used to treat inflammatory disorders such as arthritis. The dosing schedule given is appropriate. Ranitidine is a histamine-2 receptor antagonist-the dosing schedule listed would be appropriate for acute duodenal ulcer.

Quiz 2: Clinical