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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A 49-year-old man presents to his physician with a 3-day acute attack of gout in four joints of the right foot. The patient has a history of at least three previous gout attacks; in one, a joint aspirate was positive for urate crystals. His history also includes type 2 diabetes mellitus and two calcium oxalate kidney stones.
Laboratory values include creatinine 3.1 mg/dL, uric acid 11.7 mg/dL, and A1C 6.8%. The patient is allergic to aspirin. Vital signs are BP135/82mm Hg and HR 90 bpm and regular.
Current medications are glipizide 10 mg daily and enalapril 20 mg daily.
Which short-term regimen is most appropriate for treating this patient's gout?

A) Celecoxib 200 mg daily
B) Indomethacin 50 mg three times daily
C) Colchicine 0.6 mg hourly
D) Prednisone 40 mg daily

2. A patient with a nasogastric output of 8 L daily and respirations of 10 bpm has the following - laboratory values:

This clinical information is most consistent with which of the following?

A) Compensated metabolic alkalosis
B) Uncompensated respiratory alkalosis
C) Compensated respiratory alkalosis
D) Uncompensated metabolic alkalosis

3. 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) Rifaximin 550mg orally three times daily
C) Vancomycin 125 mg orally four times daily plus metronidazole 500 mg three times daily intravenously
D) Vancomycin 125mg orally four times daily

4. Before initiating thrombolytic therapy in a 58 year old patient who has just sustained an acute anterior MI, which of the following must be ascertained?

A) Medical history, vital sign, duration of chest pain, and current medications
B) Medical history, current medications, and serum electrolytes
C) aPTT, serum electrolytes and duration of chest pain
D) Vital signs, current medications and cardiac enzymes

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

Solutions: