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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A patient with rheumatoid arthritis has been experiencing increased pain over the last 2-3 weeks. The patient's rheumatoid arthritis has previously been controlled with methotrexate and periodic NSAID and steroid use for acute flares. However, currently this regimen is inadequate.
The physician wants to initiate therapy with etanercept.
Which of the following infections should be screened for prior to initiating therapy?

A) Candida
B) Legionella
C) Hepatitis A
D) Tuberculosis

2. A 22-year-old woman presents to a clinic for her annual pap smear. At this time, she explains that she has engaged in increased unprotected sexual activity over the last few years and is concerned about sexually transmitted diseases, especially human papillomavirus (HPV). She completed the bivalent HPV vaccine series at age 15 and is questioning its duration of effect.
Which option is the most appropriate regarding continued efficacy of the vaccine?

A) Boost with the quadrivalent HPV vaccine because the bivalent HPV vaccine does not protect against genital warts.
B) Obtain a geometric titer; if low, boost with either the bivalent or quadrivalent HPV vaccine to treat any genital warts present.
C) Since the patient had only the bivalent HPV vaccine and more than 5 years passed with increased sexual activity, a repeat series should be given.
D) A lack of evidence exists regarding the geometric titer efficacy; therefore, FDA does not recommend a repeat series.

3. A MEDLINE search fails to retrieve a clinical trial known by the searcher to have been published in a recently established open-access medical journal. This failure has most likely occurred because of which of the following?

A) The searcher limited the search to "humans" and "English language."
B) MEDLINE does not index open-access journals.
C) MEDLINE selectively indexes articles of the highest scientific merit.
D) The time that the journal has been available does not meet criteria for indexing.

4. A pharmacotherapy specialist is contemplating Writing a case report on a suspected penicillin induced neutropenia in a patient who received intravenous penicillin G for treatment of infective endocarditis. The specialist has established a temporal relationship between the period of medication administration and the onset of neutropenia, and has excluded other potential causes of the adverse effect.
Which of the following is the most appropriate next step in composing the case report?

A) Describe the incidence, severity, and outcome of penicillin-induced neutropenia for the introduction section of the report.
B) Generate ideas and wording for the patient case summary portion of the report.
C) Collect all pertinent patient information, including past medical history, laboratory data, medication history, and consent.
D) Perform a comprehensive literature search to identify existing literature describing neutropenia in penicillin-treated patients.

5. A 53-year-old patient is admitted to the hospital with diarrhea. He has been experiencing five unformed stools daily for 2 days. The patient had a previous admission 6 weeks ago for C.
difficile diarrhea, which was treated successfully with oral metronidazole. Stool tests are again positive for C. difficile toxin A.
On presentation, his vital signs are: BP 128/86 mm Hg, HR 75 bpm, RR 14 bpm, and T37.8°C.
WBC count shows 12,300 cells/ul (80% neutrophils-segs, 10% neutrophils-bands), serum creatinine 1.2 mg/dL, and albumin 3.4 g/dL. The patient has no evidence of colitis, toxic megacolon, or perforation on imaging studies of the abdomen.
What is the most appropriate treatment recommendation for this patient?

A) Metronidazole 500mg orally three times daily
B) Vancomycin 125 mg orally four times daily plus metronidazole 500 mg three times daily intravenously
C) Vancomycin 125mg orally four times daily
D) Rifaximin 550mg orally three times daily

Solutions: