Pcoa Exam Practice Flashcards
The overarching element of any planning process is the:
Organizations vision
Cimetidine can increase the risk of bleeding in a patient receiving Warfarin therapy by what MOA?
Inhibition of warfarin metabolism
The standard of substituted judgement as it relates to situations when a patient is unable to express treatment preferences:
A family member decides on the patients treatment based on how he believes the patient would decide
Example of a publication type that is LEAST likely to be subject to author bias:
Practice guidelines
Example's of publication type's that may be subject to author bias:
Case ReportsCase SeriesEditorials
Nitric oxide or Nitrous oxide is also known as "laughing gas" and cause:
Hypotension, sweating, dizziness
Factors that contribute to the development of ascites:
Increased aldosterone secretionIncreased portal venous pressureIncreased sodium reabsorption Decreased albumin synthesis
Ascites definition:
The accumulation of fluid in the peritoneal cavity, causing abdominal swelling
Central fill pharmacies must:
Be staffed with a licensee pharmacist
Database studies differ from randomized controlled clinical trials in that:
1. The time needed to conduct the studies is likely to be shorter2. The studies are likely to be less expensive
Asthma pathophysiology is characterized by:
Chronic inflammation
Zanamivir (Relenza) is indicated for:
Influenza A
Acyclovir is primarily used for the treatment of:
Herpes simplex virus infections, chickenpox, and shingles
Inspiratory reserve volume is:
The maximal amount of air that can be inhaled
Residual volume:
The amount of air remaining in the lung at the end of a maximal exhalation
Vital capacity:
The maximum amount of air a person can expel from the lungs after a maximum inhalation
Conditions that could cause a lower than normal initial dose of Warfarin:
Heart failure or Heart conditions Deep Vein Thrombosis Pulmonary embolism
Telling a patient "Don't worry Im sure this medication will make you feel better" is an example of?
Placating
Metabolic acidosis secondary to diabetic ketoacidosis is partially caused by the accumulation of:
Acetoacetate, b-hydroxybutrate
Ezetimibe side effects:
Allergic reaction skin rashDark yellow or brown urineYellowing of the skin and eyes
Simvastatin side effects:
Diabetes Sexual dysfunctions
Cholestyramine side effects
N/V/DBloating and gas Rash
What questionnaire would be appropriate to detect possible alcoholism when taking a patient history?
CAGE; 2 or more yes answers indicates a drinking problem
The mini-mental state examination (MMSE) is used to test for:
Cognitive impairments
A delirium monitoring instrument for ICU patients is the:
Confusion assessment method (CAM-ICU)
The CIWA-Ar is:
Clinical institute withdrawal assessment for alcohol
For a straight line plot of log k vs 1/temperature for a drug, the slope of the line is related to the drugs:
Energy of activation
Aminoglycoside doses should be adjusted for obese patients because:
There is significant difference in the total amount of water per kg in obese patients
Three drug treatments have equivalent outcomes, what is the most appropriate economic analysis to use to select the least costly alternative?
Cost-minimization analysis
Cost-Utility
A form of economic study design in which interventions which produce different consequences, in terms of both quantity and quality of life, are expressed as 'utilities'
Cost-Benefit is a
Method in which all costs and consequences of a program are expressed in the same units, usually money
Cost-effectiveness is a:
Method for assessing the gains in health relative to the costs of different health interventions
A 12 year old child who is consistently higher than 80% on her peak flow meter should:
Continue using her current dose of albuterol Continue using her spacer with her albuterol
Inflammation resulting from conversion of arachidonic acid to prostagladins is accomplished through the actions of:
Cyclooxgenase
Epimers:
2 isomers differ in configuration at only one stereogenic center
Tautomers:
Look similar, one may have a double bond and the other a single bond
Conformers:
Cis, trans
Enantiomers:
Mirror images
Examples of "high alert" medications according to the Institute for Safe Medication Practices
Insulin, EPINEPHrine, Epoprostenol, methotrexate, promethazine, vasopressin, opium, oxytocin, potassium chloride or phosphate,
Infections commonly seen in immunosuppressed patients
Thrush caused by Candida albicans
Alveolar deposition of particles from metered dose inhalers is most affected by:
The particle size of the drug molecules
Examples of Secondary literature:
New England Journal of Medicine EMBASEMedline
Third party payers utilize patient cost sharing primarily to:
Control utilization
Rational drug use is promoted when:
Drug utilization procedures have been implemented
The cerebrum controls all:
Voluntary motor activity
ST segment elevation is a major ECG abnormality associated with:
The diagnosis of myocardial infarction
A prolonged QRS complex means:
Conduction is impaired within the ventricles
A patient presents to the pharmacy complaining of constipation for several days. What recommendation will likely improve the patients symptoms?
Regular exerciseIncrease fiber intake Increase fluid intake
Hypercalcemia associated with cancer is most often the result of:
Increased bone reabsorption secondary to hyperparathyroidism
What is the therapeutic index for a drug?
The ratio of the median toxic dose (TD50) to the median effective dose (ED50)
True regarding patients in a hospital patient-focused care unit:
1. They have shorter average hospital stays2. They have fewer follow up emergency room visits3. They are readmitted to these units less often
Required by federal law in skilled nursing facilities:
1. Continuous 24 hour RN supervision2. Monthly drug regimen reviews conducted by a consult pharmacist
Plasma cells are component of:
Acquired specific immunity
What method is most appropriate when incorporating a small amount of potent substance with a large amount of excipient:
Geometric dissolution
Levigation is the process of:
Moistening a powdered chemical before mixing it into a cream or ointment to lessen the graininess of the drug
Trituration:
Reduction to powder by friction or grinding
How many moles of sodium hydroxide are required to fully hydrolyze 0.25 moles of triglyceride?
0.75 moles
Deliquescence occurs when:A. Two hygroscopic durgs mixB. a hygroscopic drug is exposed to water vaporC. a hydrophobic drug is exposed to a water vaporD. the vapors of two drugs do not follow Henry's law
B. a hygroscopic drug is exposed to water vapor
Regarding point mutations, the exchange of a purine for a pyrimidine is:A. translocationB. frameshift substitutionC. transversionD. an inversion
C. transversion
Out-of-pocket payments are an example of which type of healthcare financing mechanism?A. NeutralB. ProgressiveC. ProportionalD. Regressive
Progressive - payments are an increasing proportion of ability to pay.Regressive - payments are a decreasing proportion of ability to pay.Proportional - payments remain a constant proportion of ability to pay.D. Regressive
An accurate definition of clearance is the:A. volume of drug removed from the blood per unit timeB. volume of blood from which the drug is completely removed per unit timeC. amount of drug removed from the blood by glomerular filtration per unit timeD. amount of drug removed from the blood by metabolic processes per unit time.
C. amount of drug removed from the blood by glomerular filtration per unit time.
The most likely complication of poorly-controlled type 1 diabetes mellitus is:A. increased serum transaminasesB. impaired hearingC. impaired sensation in the lower extremitiesD. increased serum amylase
C. impaired sensation in the lower extremities
If a somatic motor neuron is stimulated, which of the following occurs?A. the sensation of painB. Skeletal muscle excitationC. Constriction of blood vesselsD. A Change in the diameter of the pupil
B. Skeletal muscle excitation
A patient with chronic obstructive pulmonary disease treated with prednisone and theophylline is started on a 14 day course of ciprofloxacin. Which of the following is the most likely to happen?
Ciprofloxacin will cause an increase in theophylline concentrations.
A healthy, 55 year old patient asks what she can do to prevent osteoporosis. The pharmacist can appropriately recommend all of the following EXCEPT:A. begin taking OsCal + D 500 mg TIDB. hydrotherapy 30 minutes a day, TIDC. begin walking 30 minutes a day, TIDD. Begin drinking an 8 ounce glass of milk TID
D. begin drinking an 8 ounce glass of milk TID (Previous research has shown that the calcium in milk can help strengthen bones and prevent osteoporosis. ... But this new study found that drinking large amounts of milk did not protect men or women from bone fractures, and was linked to an overall higher risk of death during the study period) - not effective for patients age
Which of the following statements regarding the adverse effects of antiplatelet doses of aspirin is true?A. The risk of gastric ulcer is highB. Hypersensitivity reactions are not a concernC. The most common adverse effect is intracranial hemorrhageD. The incidence and severity of reported adverse effects are low
D. the incidence and severity of reported adverse effects are low
What is the primary determinant of a journal's impact factor?A. years of publicationB. circulation of the journalC. number of articles published annuallyD. number of citations in other journal articles
D. Number of citations in other journal articles
Which of the following combinations represents a pharmacodynamic drug-drug interaction?A. rifampin/phenytoin (PK decrease phenytoin)B. amiodarone/warfarin (increase risk of bleeding)C. diazepam/oxycodone (respiratory depression)D. Ciprofloxacin/theophylline (PK increase theophylline)
C. diazepam/oxycodone (additive effect)
Which of the following questions is NOT part of the three prime questions methods of patient counseling?A. Do you know how to take this medication?B. What did your doctor tell you this medication is for?C. What did your doctor tell you to expect from this medication?D. Just to make sure I advised you correctly, please tell me how you will use this medication
A. Do you know how to take this medication? (close ended question)
Which of the following is the most appropriate for treating constipation in a patient receiving an opioid analgesic?A. SennaB. PsyllumC. PolycarbophilD. Magnesium citrate
A. Senna (mush and push)Bulk formulations - these agents may increase the risk of bowel obstruction in patients with impaired GI motility.
Which of the following liquids has the greatest surface tension?A. Water with saltB. Ethanol with saltC. Water with surfactantD. Ethanol with surfactant
C. water with surfactant(water is higher than ethanol and surfactant increases surface tension when combined with water)
Gentamicin is clinically utilized as a mixture or three compounds because:A. stereoselective synthesis and purification is unable to be accomplishedB. Chemical interconversion occurs during prolonged storage conditionsC. reconstitution of lyophilized product leads to a decomposition prior to administrationD. commercial extraction of fermentation broths provides a mixture of bioactive molecules
D. commercial extraction of fermentation broths provides a mixture of bioactive molecules
Which substituent (R) would provide for a nitrogen mustard that should only be administered intravenously?
A. (not sure)
Cyclodextrins can enhance the water solubility of drugs via the mechanism of:A. cavitationB. SublimationC. complexationD. PEGylation
C. Complexation
Which of the following statements is true regarding fixed drug eruptions?A. Lesions are frequently associated with skin necrosisB. Severity of eruptions is related to the dose of offending drugC. These are the most common type of dermatologic reaction to drugsD. Lesions recur at the same location after repeated exposure of the offending drug
D. Lesions recur at the same location after repeated exposure of the offending drugThe term fixed drug eruption describes the development of one or more annular or oval erythematous patches as a result of systemic exposure to a drug; these reactions normally resolve with hyperpigmentation and may recur at the same site with reexposure to the drug. Repeated exposure to the offending drug may cause new lesions to develop in addition to "lighting up" the older hyperpigmented lesions
Which of the following bacterial species requires combination therapy in neutropenic patients with bloodstream infection?A. Serratia marcescensB. Enterobacter cloacaeC. Staphylcoccus aureusD. Pseudomonas aeruginosa
D. Pseudomonas aeruginosa
Which of the following citations is an example of primary literature?Picture attached
A. N Engl J Med
How should a pharmacist's questions differ for patients when counseling on new prescriptions and refills?A. ask what the doctor told them to expect on new; ask what problems occurred on refillsB. Ask what the patient expects on new; ask what positive outcomes occurred on refillsC. Ask what the doctor asked them about their expectations on new; ask the patient's expectations on refillsD. Ask what the patient wants to have happen on new; ask what actually happened on refills
A. ask what the doctor told them to expect on new; ask what problems occurred on refills
metabotropic receptors use which of the following mechanisms to alter cell function?A. Binding of the receptor-ligand complex to a nuclear response elementB. Activation of G-proteins resulting in depolarizationC. Opening of ligand-gated ion channels leading to depolarizationD. Impulse transmission via gap junctions
B. Activation of G-proteins resulting in depolarizationIonotropic receptors form an ion channel pore. In contrast, metabotropic receptors are indirectly linked with ion channels on the plasma membrane of the cell through signal transduction mechanisms, often G proteins. Hence, G protein-coupled receptors are inherently metabotropic.
Which of the following activities represents an inappropriate practice for pharmacists in the prevention of medication errors?A. regularly visiting patient care areasB. Reviewing the original medication orderC. Counseling patients and caregiversD. Dispensing medications in multi-dose vials to inpatient units
Dispensing medications in multi-dose vials to inpatient units
In molecular biology, the acronym SNP stands for?
single nucleotide polymorphism
Which drug is indicated for influenza Type A:A. RibavirinB. AcyclovirC. SaquinavirD. Zanamivir
Zanamivir
Which of the following was an impetus for the change from apprenticeship to university-based education of pharmacists in the United States?A. Abraham Flexner's report which declared that pharmacy was not a professionB. The American Association of Colleges of Pharmacy's recommendation of the general adoption of a 4 year Bachelor of science in Pharmacy degreeC. The Passage of the Durham-Humphrey amendment to the Food, Drug, and Cosmetic ActD. The creation of the Board of Pharmaceutical Specialties (BPS)
B. The American Association of Colleges of Pharmacy's recommendation of the general adoption of a 4 year Bachelor of science in Pharmacy degree (not sure)
Which formulation excipient is the most likely to slow drug release from a tablet?A. LactoseB. Sodium starch glycolateC. Silicon dioxideD. Magnesium stearate
C. Silicon dioxide