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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A patient with diabetic ketoacidosis is receiving 0.9% NaCl, with potassium chloride 20 mEq/L, at 200 mL/h, and regular insulin 8 units/h, intravenously. After 8 hours, the blood glucose is
250 mg/dL and the anion gap is elevated. At this point, which of the following is the most appropriate therapy?

A) Continue the current insulin and fluid therapy.
B) Discontinue the insulin and maintain current fluids.
C) Continue the insulin infusion rate and change to dextrose-containing fluids.
D) Convert to subcutaneous regular insulin and reduce fluids to a keep-vein-open rate.

2. A 47-year-old patient with type 2 diabetes mellitus and no known coronary heart disease has the following fasting lipid profile. HDL cholesterol = 40 mg/dL, LDL cholesterol = 164 mg/dL, and triglycerides = 150 mg/dL. The patient has an ASCVD 10-year risk score of 6%. According to the ACC/AHA, which of the following is the most appropriate intervention for this patient's LDL?

A) Reduce LDL by 30-50% (moderate intensity statin)
B) LDL lowering only warranted if the LDL was > 190 mg/dL
C) No indication to lower LDL
D) Reduce LDL by >50% (high intensity statin)

3. A 50-year-old woman experienced acute renal failure after receiving contrast dye for an imaging study. Her estimated creatinine clearance is now 20 mL/min. Her medications include:
* Piperacillin/tazobactam 4.5g intravenously every 8 hours
* Azithromycin 500 mg intravenously daily
* Famotidine 40 mg orally twice daily
* Enoxaparin 40 mg subcutaneously daily
* Metoprolol succinate 100 mg orally daily
Which drugs require dose reduction due to acute renal failure?

A) Piperacillin/tazobactam, famotidine, and enoxaparin
B) All of her current medications
C) Piperacillin/tazobactam, famotidine, and metoprolol succinate
D) Piperacillin/tazobactam, azithromycin, and enoxaparin

4. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?

A) A pre-distribution digoxin concentration, which may be misinterpreted
B) A post-distribution digoxin concentration, which indicates significant toxicity
C) Reflects the effect of furosemide on the renal excretion of digoxin
D) A concentration within the desirable range

5. Initial efficacy data on an experimental drug in the United States are usually collected in:

A) Phase trials.
B) Phase III trials.
C) Phase IV trials.
D) Phase trials.

Solutions: