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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. Which of the following quality performance measures would be most appropriate to evaluate in relation to anticoagulation management in the outpatient setting?

A) Bleeding and thromboembolic complication rates
B) Percentage of extremely high INRS
C) Percentage of time in therapeutic range
D) Medication adherence rates

2. A patient presents at a physician's office with gait unsteadiness and clumsiness. The patient has a history of type 2 diabetes mellitus, hypertension, and chronic numbness and tingling of the feet and fingertips.
Examination reveals mild distal wasting, glove-and-stocking sensory impairment, absent ankle jerks, brisk knee jerks, and bilateral Babinski reflexes. Gait is slightly ataxic.
CBC reveals a hemoglobin of 10.1 g/dL, WBC of 4,500 cells/mL, MCV 120 fL, and platelets
163,000 cells/ul.
Which of the following is the most important laboratory test for assisting in diagnosis?

A) Ferritin
B) Serum vitamin B12
C) Erythrocyte sedimentation rate
D) Folic acid

3. Many clinically important adverse drug reactions (ADRs) are detected after the marketing of a drug, rather than during premarketing clinical trials. Of the following, which is the primary reason for this phenomenon?

A) Adverse reactions that are due to drug interactions or drug accumulation in renal insufficiency cannot be studied prospectively during the premarketing phase of clinical evaluation.
B) Premarketing studies focus on efficacy rather than on safety; therefore, the study design accounts for the failure to detect ADRs.
C) Too few patients are studied for too short a period of time during premarketing clinical trials.
D) Pharmaceutical companies prefer to market agents with favorable side-effect profiles, so they focus premarketing studies on efficacy rather than on ADRs.

4. A study compared treatment with cinacalcet versus treatment with placebo in subjects with known hyperparathyroidism. The primary outcome of the study was the proportion of study subjects with a mean intact parathyroid hormone level < 250 pg/mL. Among the cinacalcet group (n = 371), 43% of subjects achieved the primary outcome; among the placebo group (n =
370), 5% achieved the primary outcome (p<0.05).
Which of the following is the number needed to treat (NNT)?

A) 8
B) 3
C) 1
D) 14

5. A 65-year-old woman on chronic hemodialysis presents with difficulty breathing and inability to sleep. The patient has had shortness of breath, diaphoresis, and nausea, but has not vomited.
She denies having abdominal pain, diarrhea, or chest pain. She has tachycardia and tachypnea, and exhibits peaked T waves with occasional PVCs on the ECG. Serum chemistry values are:
* Sodium: 137 mEq/L
* BUN: 125 mg/dL
* Potassium: 7.2 mEq/L
* Creatinine: 12.8 mg/dL
* Chloride: 97 mEq/L
* Glucose: 95 mg/dL
* HCO3- : 11 mEq/L
* Calcium: 8.5 mg/dL
* Albumin: 3.1 g/dL
* Phosphorus: 1.7 mg/dL
Which of the following should the pharmacotherapy specialist recommend for immediate therapy?

A) Sodium polystyrene sulfonate with sorbitol orally
B) Hemodialysis
C) Calcium gluconate intravenously
D) Sodium bicarbonate intravenously

Solutions: