Random Flashcards by Whitney Kangwa

Which of the following has a long period of latency?
a. HIV-1
b. HIV-2
c. HIV-1C
d. All of the above

HIV-2

How well did you know this?

Not at all

Perfectly

Which of the following has strong affinity for CD4 receptor?
a. CCR5
b. CXCR4
c. GP120
d. GP41

GP120

How well did you know this?

Not at all

Perfectly

Which subtype of HIV is commonly found in Zambia?
a. HIV-1 subtype C
b. HIV-1 subtype G
c. HIV-1 subtype H
d. HIV-1 subtype D

HIV-1 subtype C

How well did you know this?

Not at all

Perfectly

In which of the following is the risk of HIV transmission lowest?
a. Men having sex with sexual partners
b. Women having sex with women
c. Protected sexual intercourse with partner on combination antiretroviral therapy
d. Vaginal and anal unprotected

Protected sexual intercourse with partner on combination antiretroviral therapy

How well did you know this?

Not at all

Perfectly

Which of the following body fluids have the least possibility of transmitting HIV?
a. Preseminal fluids
b. Breast milk
c. Saliva
d. Vaginal fluids

Saliva

How well did you know this?

Not at all

Perfectly

Which of the following has the highest risk of progression to full blown AIDS in an HIV infected person?
a. Seborrhoeic dermatitis
b. Pneumocystis (jirovecii) pneumonia
c. Hepatitis B and current IV drug use
d. Pulmonary tuberculosis

Pneumocystis (jirovecii) pneumonia

How well did you know this?

Not at all

Perfectly

Which subtype of HIV is not commonly found in Zambia?
a. HIV-1 and HIV – 2 subtype B
b. HIV-2
c. HIV-1 subtype E
d. HIV-1 subtype C

HIV-1 subtype E

How well did you know this?

Not at all

Perfectly

Which of the following drug is a nucleotide reverse transcriptase inhibitor?
a. Saquinavir
b. Tenofovir
c. Lamivudine
d. Didanosine

How well did you know this?

Not at all

Perfectly

Which of the following will cause severe peripheral neuropathy?
a. Lamivudine
b. Stavudine
c. Tenofovir
d. Zidovudine

How well did you know this?

Not at all

Perfectly

Which of the following test is required before using abacavir?
a. Tropism
b. HLA*B5701
c. Hypersensitivity
d. CYP2C9

How well did you know this?

Not at all

Perfectly

Which of the following has the highest genetic barrier to developing resistance?
a. Zidovudine
b. Abacavir
c. Didanosine
d. Emtricitabine

How well did you know this?

Not at all

Perfectly

Which of the following shows higher viral suppression and fewer discontinuations?
a. Stavudine, lamivudine plus nevirapine
b. Zidovudine,lamivudine plus efavirenz
c. Tenofovir, emtricitabine plus dolutegravir
d. Tenofovir, emtricitabine plus atazanavir

How well did you know this?

Not at all

Perfectly

Which one of the following is considered high risk exposure?
A. Penetrative sexual assault
B. Large bore needle
C. Deep extensive injury
D. All of the above

How well did you know this?

Not at all

Perfectly

Which drug should be avoided in patients with Creatinine Clearance less than 50 ml/min?
A. Abacavir sulphate
B. Tenofovir alafenamide
C. Tenofovir disoproxil fumarate D.Zidovudine

How well did you know this?

Not at all

Perfectly

What is the preferred PEP regimen for an adult patient?
A. TDF + XTC + DTG
B. TDF + XTC + ATV-r
C. TDF + XTC + LPV-r
D. TDF+ XTC + EFV400

How well did you know this?

Not at all

Perfectly

Who is the Berlin patient?
A. Ray Brown
B. Thomas Ray Brown
C. Timothy Ray Brown
D. Adam Castillejo

How well did you know this?

Not at all

Perfectly

Who is the London patient?
A. Adam Gupta
B. Anthony Jackson
C. Adam Castillejo
D. Diana Gibb

How well did you know this?

Not at all

Perfectly

What are AIDS defining Illnesses?

AIDS defining Illnesses are certain serious and life-threatening diseases that occur in HIV-positive people due to severe immunocompromised system. The diseases include such as Pneumocystis (jirovecii) pneumonia, Kaposi sarcoma, HIV encephalopathy.

How well did you know this?

Not at all

Perfectly

How would you manage a patient with AIDS defining illness in the package of care available in our setting?

Ensure the client is on HAART (Highly Active Antiviral Therapy).
If new or already on treatment, assess factors that may lead to treatment failure such as non-adherence to treatment or resistance.
If any, manage the underlying diseases and symptoms, decrease the risk of complications and infections.
Supportive care such as painkillers to manage pain.
Preventive measures such as counselling on the importance of ART adherence and vaccination.

How well did you know this?

Not at all

Perfectly

What strategies are available to prevent HIV/AIDS progression?

Early diagnosis of HIV and initiation of ART if found positive
Early diagnosis of opportunistic infections
Adherence to treatment
Support groups e.g. adolescent support groups
Taking prophylactic medications – TPT, Septrin
Regular hospital visits to monitor CD4 and VL

How well did you know this?

Not at all

Perfectly

Which of the following are members of mycobacterium tuberculosis complex
a. M. bovis
b. Micobacterium avium complex (MAC) F
c. M. africanum
d. M. tuberculosis

How well did you know this?

Not at all

Perfectly

Which member of mycobacterium complex is endemic to West Africa and infected patients are more likely to be HIV-positive?
a. M. bovis
b. Micobacterium avium complex (MAC)
c. M. africanum T
d. M. tuberculosis

How well did you know this?

Not at all

Perfectly

Which of the following TB diagnosis test may not be ideal in areas where all the population is vaccinated against TB
a. Microscopical
b. Radiology
c. Skin Test T
d. Mantoux Test T

C
D

How well did you know this?

Not at all

Perfectly

Disease that may cause water depletion include:
a. Hypertension
b. Heart failure
c. Diarrhoea T
d. Diabetes mellitus T

C
D

How well did you know this?

Not at all

Perfectly

Drugs that may cause dilutional hyponitramia include: a. prednisolone b. vincristine T c. carbamazepine T d. Diclofenac

B C

Drugs known to cause hypernatremia include: a. Amphotericin B b. Hydrocortisone T c. Spironolactone d. Oral contraceptives T e. Frusemide F

B D

Drugs known to cause hypokalaemia include: a. ACE-inhibitor b. Frusemide T c. Prednisolone T d. Amphoterine B T

B C D

Clinical features of hypokalaemia include: a. Shortened action potential F b. ST-depression T c. Prolongation of PR-interval T d. Shortened resting membrane potential F

B C

Drugs that may cause hypocalcaemia include: a. frusemide T b. thiazide diuretics F c. Phenytoine T d. phenorbarbitone T c. Lithium F

A C D

Drugs that require monitoring of CrCl include: a. Ethambutol T b. Rifampicin F c. Gentamycin T d. Paracetamol F e. Tenofovir T

A C E

Which of the following liver enzymes are specific to the liver? a. AST F b. ALT T c. AP F d. GGT T

B D

Which cardiac biomarker is more specific? ( Best choice) a. Total CK B b. Troponin T c. Myoglobin d. LDH

Cellular and biochemical response in cryptococcal meningitis include: a. predominantly polymorphonuclear leucocytes F b. predominantly mononuclear leucocytes T c. CSF glucose is greater than 50% F d. CSF proteins are greater than 0.4g/L T

B D

Regarding sodium loading with normal saline pre and post amphotericin-B therapy: a. Prevent fever F b. Prevent hypotension T c. Prevent chills and vomiting F d. Prevent nephrotoxicity T

B D

Which one of the following side effects of Amphotericin B is not infusion related? a. Nausea and vomiting F b. Headache F c. Hypokalamia T d. hypotension F e. Thrombophlebitis T

C E

PM is hospitalized with pulmonary oedema secondary to congestive heart failure. Patient is started on enalapril 2.5 mg daily and Furosemide 40mg iv If PM was hypertensive, a goal BP value will be: a. < 140/90 mmHg b. < 130/80 mmHg c. < 120/80 mmHg d. <150/80 mmHg 2. Mr EL is hypertensive and has just suffered ischemic stroke. The best pharmacotherapy combination will be: a. Atenolol and bendroflumethiazide b. Nifedipine and Atenolol c. Enalapril and hydrochlorothiazide T d. Ramipril and bendroflumethiazide T

1.c 2. c,d

Which of the following organism(s) are likely to cause meningitis in neonates? a. N. meningitides F b. Heamophylus influenzae type B F c. Group B streptococci T d. streptococcus pnemoniae F

Which type of bacterial meningitis should an adjunctive steroid therapy be used? A. community acquired meningitis regardless aetiology T B. hospital acquired meningitis with unknown aetiology F C. community acquired meningitis with known aetiology only F D. None of the above F

Which type of meningitis should those who came into contact with the patient be given prophylaxis? A. pneumococcal F B. streptococcal F C. Meningococcal T D. None of the above F

A 4-week-old premature infant presents on the hospital neonatal unit with poor feeding, fever and increasing drowsiness. Lumbar puncture reveals 1200 WBC/uL (80% of which are polymorphs), and low glucose and elevated protein levels. No organisms are seen on a Gram-stained smear of the CSF. The diagnosis is acute purulent meningitis Questions 1. What are the likely aetiological agents? The most common causative organisms 2. Which other investigations other than CSF culture might help in establishing the aetiological diagnosis? 3. What empiric antibiotic therapy should be commenced? Why add Amoxicillin or ampicillin to children and the immunocompromised?

1. in neonates is Group B Streptococci. However, other less common bacteria includes E. coli and Staphylococcus aureus 2. FBC – Elevated White blood cells indicates infections Differential White blood Count: Chec == High C reactive Proteins = Elevated (Proteins >3 indicates inflammation) CSF biochemistry (biochemical changes/ cellular response) – e.g 3. To cover Listeria monocytogenes which do not respond to cepharosporins

Activated charcoal is..................type of physical antidote A. Bulky food B. Adsorbent C. Demulcent D. Diluents

Which of the following is an example of a prodrug? A. Imipramine B. Paracetamol C. Codeine D. Diclofenac

when calculating average monthly consumption, three months consumption or 6 months consumption can be used. A. Three months consumption can be used when data is consistent B. Six months consumption when data is inconsistent C. Both A and B are correct D. Both A and B are wrong

Which of the following has the highest risk of HIV transmission? a. Receptive anal intercourse b. Presence of Herpes Simplex virus infection c. Current IV drug use d. Hemophilia disorders

1. Which one of the following treatment plans could be used safely when the patient is presenting with a haemoglobin count of 7g/dl? a. Use of prophylactic co-trimoxazole in antiretroviral therapy b. Use of doxorubicin in karposis sarcoma c. Use of Vancomycin in Urosepsis d. Use of ganciclovir for cytomegalovirus retinitis

A 65-year –old man with history of depression presents with difficulty in falling or staying asleep. He takes his medicine at bed time. Which one of the following antidepressants would be the cause of his insomnia? a. Imipramine b. Amitriptyline c. Phenelzine d. Maprotiline

A 40-year-old pregnant woman in her seventh month presents to her gynecologist for her monthly routine checkup .Upon physical exam her BP is 158/95 mmHg and urinalysis reveals proteinuria. Which of the following would you consider? a. No need for antihypertensive treatment since the SBP is <160 mmHg b. Start lisinopril c. Start Telmisartan + Hydrochlorothiazide d. Start Labetalol

The nurse in the neonatal intensive care unit (NICU) contacts you for advice .A 3kg baby has been prescribed vancomycin for neonatal sepsis. Which one of the following statements is TRUE regarding administration of vancomycin in this baby? a. Reconstitute with sterile water for injection and administer directly into a large peripheral or central vein a bolus. b. Reconstituted with sterile water for injection and administer orally. c. Prior to administration, the patency of the IV catheter should be tested with a flash of heparinated water. d. Reconstituted solutions are stable at 2-8oc for at least 4 days.

Which one of the following drugs could be safely used in a patient with GFR of less than 30 ml/min/1.73m2 admitted with sepsis? a. Co-trimoxazole b. Ceftriaxone c. Imipenem d. Gentamicin

Which one of the following could result in a patient who abruptly stops a dosage regimen of high dose prednisolone therapy? a. Acute renal failure b. Weakness, fatigue, weight loss etc c. Oral candidiasis d. Sudden drop in hemoglobin

MK is a 46 year old man who presents to the outpatient department with severe attack of gouty arthritis. His serum urate concentration was substantially elevated. Which one of the following is TRUE about treatment for MK’s acute gouty arthritis? a. Treatment should be instituted 7 days after resolution of the acute episode. b. Allopurinol is not recommended because of long half life of its metabolite oxypurinol. c. Sulfinpyrazone is an example of a xanthine oxidase inhibitor and is preferred for prophylactic treatment of gouty arthritis. d. Low oral doses for Colchicine (0.5 -0.6 mg bd daily) could be appropriate for prophylactic therapy.

Which one of the following constitutes the 4FDC regimen currently used as first line for tuberculosis in Zambia? a. Isoniazide + Rifampicin + Pyrazinamide + Ethambutol b. Isoniazide + Rifampicin + Pyrazinamide + Pyridoxine c. Isoniazide + Rifampicin + Pyrazinamide + Ethionamide d. Isoniazide + Rifampicin + Cycloserin + Ethambutol

Which one of the following hypoglycemic drugs is appropriate in an obese diabetes type 2 patient? a. Tolbutamide b. Glibenclamide c. Glipizide d. Metformin

Which one of the following drugs will NOT be largely affected by hypoalbinaemic states? a. Ceftriaxone b. Furosemide c. Warfarin d. Imipenem

JJ is a 20-year-old patient admitted with alcohol withdrawal symptoms. He has history of alcohol abuse. Which of the following drugs could be recommended for JJ’s symptoms? a. Risperidone b. Trihexyphenidyl c. Diazepam d. Fluphenazine

Mr. BZ, a 40 –year-old banker, presents to the OPD following onset of chest pain about 2 hours earlier while he was working around his house. He had tried several doses of sublingual glyceryl trinitrate GTN but his pain did not resolve. He had become increasingly breathless and sweaty, with a tight crashing pain across his chest and left shoulder. His past medical history was documented as “angina”. He was noted to be obese (wt > 110kg).His drug history on admission was recorded as GTN, Nifedipine and Isosorbide mononitrate. On examination his blood pressure was found to be 150/110 mmHg with heart rate of 112 bpm. Routine tests were done and a diagnosis of acute myocardial infarction (AMI) was made. Mr. BZ was initially prescribed dose of each of the following drugs; • Morphine 5mg • Metoclopramide 10mg • Aspirin 300mg • Clopidogrel 300mg 12. IM injections should generally be avoided in patients suffering with AMI. What would be the preferred route of administration for Mr. BZ’ morphine? a. Intravenously b. Orally c. Transdermal patch d. Subcutaneous injection 13. What is the rationale for aspirin and clopidogrel administration during AMI? a. Clopidogrel helps minimize the GI adverse effects of aspirin. b. The combination reduces mortality and morbidity associated with MI c. Dual therapy allows Aspirin antithrombotic effect (takes 72 hours) to set in then clopidogrel is withdrawn. d. The combination is more effective in reducing the risk of bleeding due to MI. 14. Which one of the following drugs would not be considered appropriate antithrombotic therapy at this stage of Mr. BZ’s AMI? a. Clopidogrel b. Aspirin c. Alteplase d. Etamsylate 15. Which of the following is NOT a beneficial effect of morphine in AMI? a. Analgesic b. Vasodilating c. Anxiolytic d. Drowsing

12. A 13. B 14.D 15.D

MJ is a 7 year-old- boy diagnosed with infected eczema by a dermatologist in the out-patient specialist clinic. He presents with inflamed red patches on the inside of elbows and wrists, around the back of his neck and behind his knees. 16. Which one of the following drugs would NOT be appropriate treatment for MJ’s infected eczema? a. Flucloxacillin b. Clarithromycin c. Erythromycin d. Colistin 17. Which one of the following statements is TRUE about use of topical corticosteroids for MJ’s infected eczema? a. Topical corticosteroids are contraindicated in MJ. b. Steroid cream should not be applied to the areas of eczema where the skin has been broken by scratching. c. A highest potency steroid used for a longer period of treatment would be appropriate. d. Steroid treatment should be started and continued until 48 hours after symptoms subside then stepped down. 18. The dermatologist is considering addition of an emollient to the treatment. As a pharmacist, which one of the following would you recommend? a. White petroleum jelly b. Calamine lotion c. Crotamiton cream d. All of the above

16.D 17.B 18.A

A 64-year- old male patient with history of hypertension and diabetes mellitus presents to the OPD with severe ankle oedema. Which one of his current medication below would you highly suspect? a. Atenolol b. Amlodipine c. Cardiac aspirin d. Metformin

Which one of the following anti-infectives should be avoided in a neonate presenting with jaundice in neonatal sepsis? a. Ampicillin b. Cloxacillin c. Ceftriaxone d. Gentamicin

Mr. P is a 46 –year-old man admitted (Day 2) to the unit you are part of as a pharmacist in a medical ward. He presents with haematemesis, melaena and marked ascites. He is a known patient of alcoholic liver disease. On admission, a diagnosis of bleeding esophageal varices was made and the bleeding was promptly arrested. Medication history shows that Mr. P has been on Furosemide 80 mg bd. 21. A registrar in your firm wishes to add another diuretic. Which one of the following would be appropriate? a. No need for another diuretic just reduce on salt intake b. Add triamterene c. Add Spironolactone d. Telmisartan, hydrochlorothiazide combination 22. What long term drug for prevention of rebleeding would you recommend for Mr. P? a. Spironolactone tablets b. Propranolol tablets c. Vitamin k injections d. Tranexamic acid tablets 23. Which one of the following actions will NOT be appropriate for prevention of hepatic encephalopathy in Mr. P? a. Addition of diazepam to calm him b. Addition of Lactulose for his constipation c. Addition of Omeprazole for GI bleeding d. Addition of Neomycin for empiric treatment of infection

21. C 22.B 23.A

JJ is a 20-year-old male hospitalized at the ophthalmic ward. His current medications are; Fusidic acid eye drop 1 drop bd in affected eye Latanaprost eye drop 1 drop od in affected Acetazolamide tablets 125mg bd Timolol eye drops 0.5% 1 drop in affected area 24. Which one of the following condition/s are being treated in JJ’s eye? a. Glaucoma and bacterial infection b. Allergic conjunctivitis c. Glaucoma and tear deficiency d. Tear deficiency and fungal infection 25. Which one of the following requires monitoring with Latanaprost treatment? a. Severe nausea and vomiting b. Thinning and shortening of eye lashes c. Blood pressure d. Changes to eye coloration

24.A 26.C

JS is a 25-year-old female who is admitted to the emergency department. PMH asthma DH Salbutamol inhaler two puffs three times daily Beclometasone 200 μg/puff inhaler two puffs twice daily PC chest tightness, exhaustion O/E pulse >110 bpm Respiration rate >25 breaths/minute Diagnosis exacerbation of asthma JS was hospitalized and the following therapy started: Oxygen 60% Salbutamol nebulizer 2.5 mg four times daily Hydrocortisone intravenous 200 mg every 6 h Cefuroxime intravenous 750 mg every 8 h Clarithromycin tablets 500 mg twice daily Beclometasone inhaler two puffs twice daily 26. Which one of the following is the rationale for using Salbutamol nebulizer with oxygen? a. To maintain arterial oxygen saturation above 90%. b. Aggressive treatment is required. c. Salbutamol may mask symptom severity. d. The bioavailability of Salbutamol increases. 27. Which one of the following is TRUE about Salbutamol? a. Is a long acting selective B2 agonist. b. Incompatible with Beclometasone. c. First treatment of choice for acute severe asthma. d. Causes more palpitations than isoproterenol 28. Which one of the following is NOT a goal of treatment for CKD? a. Relieve symptoms. b. Avoid conditions that might worsen renal failure. c. At end stage, allow the disease process to resolve physiologically. d. Implement regular dialysis treatment at the most appropriate time.

26.A 27.C 28. C

Which one of the following statements is TRUE about albumin solutions? a. It is unnecessary to monitor cardiovascular and respiratory functions. b. Albumin 5% could be indicated in paracentesis of large volume ascites. c. Albumin solution used usually after acute illness to correct plasma-volume deficits in edematous states. d. No need to hydrate the patient when administering 25% solution.

29.C

Preliminary results of the phase 1 clinical trial involving the investigational HIV drug SF2000 were recently disseminated to the public by investigators at the National Health Research Conference held in October in Lusaka. In drug development, phase 1 clinical trials typically involve: a. Care evaluation of the dose-response relationship and measurement of the pharmacokinetics of the investigational new drug in a small number of normal volunteers b. Double-blinded evaluation of the new drug in hundreds of patients with the target disease by specialist researchers c. Evaluation of the investigational new drug under conditions of actual use in several thousand patients with the target disease d. Collection of information regarding late-appearing drug toxicities from data previously studied in preliminary pre-clinical (phase 0) trials.

30.A

A patient is brought as an emergency case at UTH Adult Hospital for treatment of suspected drug overdose. The identity of the drug is unknown, but it is observed that when the urine pH is acidic, the renal elimination of the drug is increased and much greater than when the urine pH is alkaline. The overdosed drug is probably a: a. Strong acid b. Weak acid c. Weak base d. Strong base

A 45-year old man with duodenal ulcer due to Helicobactor pylori infection was treated with Pantoprazole, Clarithromycin and Amoxicillin combination. Which of the following is the most accurate description of the mechanism of Pantoprazole’s therapeutic action? a. Activation of prostaglandin E receptors b. Formation of protective coating over the ulcer bed c. Inhibition of Helicobactor pylori’s mechanism of protein synthesis d. Irreversible inactivation of the ATPase proton pump in parietal cells

A 4-year old boy of Ndola was brought to Author Davison Children’s hospital emergency department after accidentally ingesting some wild mushrooms growing in the bush at home. His symptoms included hallucinations and coma; elevated body temperature; hot, dry, flacky skin; moderate tachycardia; dry mouth and eyes with mydriasis. The most likely cause and explanation for these symptoms is: a. Ingestion of amphetamine-like substance contained in the wild mushroom b. Ingestion of organophosphate substance contained in the wild mushroom c. Ingestion of an antimuscarinic substance contained in the wild mushroom d. Ingestion of phenylephrine-like substance contained in the wild mushroom

Mulobezi district in Western Province recorded a high incidence of deaths due to carbon monoxide poisoning. As the District Pharmacist conducting health promotion and sensitization of communities in the district on the dangers associated with using charcoal-fuelled braziers in poorly ventilated rooms, you inform that carbon monoxide poisoning is results from: a. Bronchial irritation resulting in bronchospasm and pulmonary oedema b. Depression of the CNS resulting in seizures, coma and cardiorespiratory collapse c. Impaired oxygen delivery resulting in tissue hypoxia and multi-organ failure d. Interference with neuronal transmission resulting in muscle weakness and respiratory failure

In macrocytic anaemia presenting with early signs of neuropathy, which one of the following drugs will probably be required? a. Erythropoietin b. Folic Acid c. Iron dextran d. Vitamin B12

In managing a patient with essential hypertension and diabetes, which of the following antihypertensive drugs is least likely to aggravate hyperglycaemia? a. Angiotensin converting enzyme inhibitors b. Thiazides c. Beta-receptor blockers d. Calcium channel blockersA

A drug that acts by inhibiting phosphodiesterase enzyme and is used in the treatment of erectile dysfunction in men is: a. Finasteride b. Sildenafil c. Tamarind d. Mifeprostone

Which one of the following drugs often causes tachycardia and tremors as side effects when used in Asthmatic patients? a. Salbutamol b. Cromolyn sodium c. Ipratropium bromide d. Prednisolone

Though opioids are among the drugs most preferred for management of severe pain, they remain highly regulated in Zambia. Which pharmacological effect of opioids is known to lead to dependence and abuse potential among users? a. Cough suppression b. Sedation c. Euphoria d. Analgesia

A 65-year old man admitted to Livingstone Central Hospital with bacteraemia is to be treated with empirical combination antibiotic therapy for three days while awaiting culture and sensitivity results. The inclusion of the aminoglycoside Gentamicin in the empirical antimicrobial drug therapy will provide coverage against: a. Bacterioides fragilis b. Klebsiella pneumoniae c. Methicillin-resistant Staphylococcus aureus d. Neisseria meningitidis

In a patient receiving Digoxin for congestive heart failure, conditions that may increase the sensitivity of the heart to effects of digoxin and precipitate the appearance of digoxin toxicity include the following EXCEPT: a. Hyperkalaemia b. Hypo magnesemia c. Hyper calcemia d. Hypokalaemia

A 24-year old woman comes to the community pharmacy with a prescription for Ciprofloxacin oral tablets to treat a urinary tract infection. A contraindication of the use of Ciprofloxacin in this patient is a history of: a. Deep vein thrombosis b. Glucose-6-phosphate dehydrogenase (G6PD) deficiency c. Gout d. Tendinitis

In the management of HIV/AIDS in Zambia, Cotrimoxazole is used for prophylaxis of opportunistic infection resulting from: a. Treponema pallidum b. Pneumocystis jiroveci c. Mycobacterium avaium-intracellulare d. Crytococcus neoformans

A 65-year old woman with endometrial carcinoma is being treated as an outpatient at Cancer Diseases Hospital. She has come for her first cycle of platinum-based chemotherapy regimen. To prevent chemotherapy-induced nausea and vomiting, this patient is likely to be given which of the following: a. Promethazine b. Cisapride c. Ondansetron d. Famotidine

A patient diagnosed with smear-positive mycobacterium tuberculosis is commenced on Pyrazinamide, Isoniazid, Rifampicin and Ethambutol with supplementary Vitamin B6. Provided that his disease responds well to the treatment regimen and the organism shows sensitivity to the drugs, it would be appropriate after 2 months to: a. Change his treatment regimen to prophylaxis with Isoniazid b. Discontinue Pyrazinamide and Ethambutol c. Monitor amylase activity d. Stop the supplemental Vitamin B6.

A 22-year-old female carrying a preterm pregnancy (33 weeks) is in labour. Which one of the following drugs can be given to the mother to promote foetal lung maturation? a. Betamethasone injection b. Hydrocortisone injection c. Metyrapone injection d. Triamcinolone injection

Which route of administration is most likely to subject a drug to a first-pass effect? a. Intravenous b. Inhalational c. Oral d. Sublingual

At the MSL laboratory, identical doses of a capsule dosage form (“X”) and a tablet dosage form (“Y”) of the same drug were compared on a broad concentration-time plot with respect to peak serum concentration, time to peak concentration, and area under the curve (AUC) after oral administration as shown in the figure below. This comparison was made to determine which of the following attributes? a. Potency b. Bioequivalence c. Efficacy d. Therapeutic Index

One of the drugs commonly used to treat mycobacterium tuberculosis infection induces microsomal cytochrome P450 enzymes in the liver. Which drug is this? a. Isoniazid b. Rifampicin c. Pyrazinamide d. Ethambutol

Which of the following drugs recommended for the lowering of blood cholesterol levels inhibits the synthesis of cholesterol by blocking 3-hydroxy-3-methylglutaryl-coenzyme A in the liver? a. Lovastatin b. Clofibrate c. Gemfibrozil d. Cholestyramine

Which one of the following anaesthetics is useful for local (topical surface) administration only? a. Bupivacaine b. Etidocaine c. Benzocaine d. Lignocaine

The plasma concentration of a drug is found to be 30mg/L after 2 hours after ingestion and the apparent volume of distribution is 80L, its half-life is 40 hours, and the clearance of the drug is 35L/day, respectively. What was the most approximate dose ingested? a. 2.4g b. 3.6g c. 4.8g d. 6.4g

Which antimalarial drug causes dose-dependent toxic effects which include flushing, sweaty skin, dizziness, nausea, diarrhea, tinnitus, blurred vision, and impaired hearing? a. Artesunate b. Pyrimethamine c. Quinine d. Atorvaquone

Which one of the following drug binds to a CCR5 receptor of CD4 cells blocking the entry of HIV? a. Abacavir b. Tenofovir c. Enfuvirtide d. Maraviroc

25 year old, female, government employee presents with intermittent fever and chills for seven days, relieved temporarily by paracetamol; headache, myalgia, body malaise and vague abdominal pain. She has a one day history of diarrhea. She denies travel to remote area. Unremarkable PE except for T = 38.6o . What laboratory examination would be the most helpful test before starting any antibiotics? a. Complete blood count b. Urinalysis c. Immunochromatographic test (Typhi Dot) d. Blood culture and sensitivity

Which one of the following statements is false regarding the management of complications of malaria? a. Hypoglycemia: quinine can induce insulin release which can aggravate hyperglyceamia b. Pulmonary edema: unknown reason why patients develop this, so ventilator support should be given c. Acidosis: give bicarbonate d. Renal failure: require dialysis.

According to the 2018 Zambia Consolidated Guidelines for Prevention and Treatment of HIV, the preferred PEP ARVs include: a. TDF + XTC + EFV b. TDF + XTC + DTG c. TDF + XTC + LPV/r d. TDF + XTC + ATV/r

TC a 40 year old Laboratory Scientist comes into your pharmacy for consultation following a needle prick he experienced a week ago. His HIV test is negative and would want to know when the repeat test would be. What would be the appropriate advice for TC? a. Repeat test at 3 weeks, 3 months and 6 months post exposure b. Repeat test at 3 weeks, 6 months and 9 months post exposure c. Repeat test at 6 weeks, 3 months and 6 months post exposure d. Repeat test at 6 weeks, 6 months and 9 months post exposure

Which one of the following statements is false a. A woman taking PrEP who subsequently becomes pregnant and remains at substantial risk of HIV infection should be considered for PrEP b. A pregnant or breastfeeding HIV negative woman whose partner is HIV positive should be considered for PrEP c. An HIV positive woman who is trying to conceive whose partner is HIV negative should be considered for PrEP d. An HIV negative man who is constantly having condom bursts whenever he meets his clients should be considered for PrEP

PrEP should be taken a. For life b. For a minimum of 14 days in women and 21 days in men to achieve maximal protection from HIV acquisition before engaging in high risk sexual exposure. c. For a minimum of 7 days in women and 21 days in men to achieve maximal protection from HIV acquisition before engaging in high risk sexual exposure. d. For a minimum of 21days in women and 7 days in men to achieve maximal protection from HIV acquisition before engaging in high risk sexual exposure.

D New guidelines, 7 days in both men and women

. During resuscitation, adrenaline is given at a dose of 1 mg at commencement of CPR. After how many compressions can it be repeated if there is no pulse? a. 15 compressions b. 25 compressions c. 10 compressions d. 30 compressions

AB presents to you with acute kidney injury. After taking a drug history, you discover that AB is on cART (TDF/XTC/DTG), Enalapril, Paracetamol and Benylin for a dry cough. After further investigation, AB admits taking an unknown herbal supplement to boost her immunity. Which laboratory parameter can be used to determine the extent of kidney damage in this patient? a. Albumin b. Protein c. Creatinine d. Alanine transferase 63. For the same patient in question 62. above, what drugs would you advise the prescribers to withdraw? a. TDF/XTC/DTG, Enalapril, Paracetamol, Benylin cough syrup and the herbal supplement b. Only the herbal supplement c. Enalapril, Paracetamol, DTG and XTC d. TDF, Enalapril and the herbal supplement

62. C 63. D

A 19 year old boy weighing 50 Kg presents with fever of 39.90C, convulsions and severe headache. On examination, it is discovered that he has malaria falciparum and RDT +++. What antimalarial can be used treat his condition? a. Coartem 80/480 mg tablets x 3 doses b. Artesunate 240 mg I.V x 3 doses over 7 days c. Artesunate 120 mg I.V x 4 doses over 3 days d. Artesunate 80 mg I.V x 4 doses

Dopamine has different effects at different doses. The following statements are false except: a. 5-15 µg/Kg/min I.V may increase renal output and stimulate vasoconstriction b. 1-5 µg/Kg/min I.V may increase renal output and renal blood flow c. 1-5 µg/Kg/min I.V may increase renal blood flow, cardiac output, heart rate and cardiac contractility d. 5-15 µg/Kg/min I.V may increase renal blood flow, cardiac out, heart rate and contractility.

H.B is a 32-year-old man weighing 48kg with an LVEF of less than 25% who presents to Internal Medicine today for follow-up of his recent HF hospitalization. His blood pressure is 120/85 mm Hg and his pulse is 70 beats/minute. His current medications include Lisinopril 10 mg every day, metoprolol succinate 150 mg every day and furosemide 20 mg every day. You have reviewed his chart and noted that these are the maximal tolerated doses of lisinopril and metoprolol owing to dizziness and near syncope with higher doses. Today his laboratory results show that his SCr is 60 mmol/L and his potassium level is 3.5 mEq/L and his RBS is 14mmol/L. An additional diagnosis of Type 1 diabetes is made after further investigations which revealed a glycosylated Hb of 14%. 66. What is the appropriate insulin dosage for HB? a. 48 units b. 32 Units c. 24 Units d. 25 Units 67. Owing to the low ejection fraction, what loading dose of Digoxin would you recommend for HB? a. 2.5mg b. 2.5µg c. 0.25µg d. 0.125µg 68. Which one of the following drugs would you consider adding to HB’s current regimen? a. Carvedilol b. Aldosterone c. Labetalol d. Hydrochlorothiazide

66. C 67. D 68. B

All of the following drugs are not used in HIV-1/2 infection except? a. Atazanavir b. Lopinavir c. Efavirenz d. Nevirapine

The following PIs are recommended for use in HIV/TB co-infection for patients on Rifampicin except? a. Atazanavir b. Lopinavir c. Darunavir d. Raltegravir

PM is newly diagnosed HIV 1 & 2 co-infection. What is the first line regimen you would commence him on? a. TDF/3TC/EFV b. TDF/3TC/DTG c. TDFC/3TC/LPV-r d. TDF/3TC/RAL

72. HK, male, is newly Diagnosed HIV positive. What first line regimen would you recommend for HK? a. TDF/3TC/DTG b. TDF/3TC/EFV c. TDF/3TC/LPV-r d. TDF/3TC/NVP 73. After 9 months of treatment, HK is confirmed to have HIV treatment failure while on the regimen above. What would be the preferred second line you would recommend? a. TDF/3TC/ATV-r b. TDF/3TC/LPV-r c. AZT/3TC/LPV-r d. AZT/3TC/RAL 74. If HK was anaemic, what modification would you make to the regimen chosen in 73 above? a. AZT/3TC/ATV-r b. RAL/3TC/LPV-r c. TDF/3TC/LPV-r d. TDF/3TC/ATV-r

73. A 74. C 75. C

DM, 6 months old baby presents to OPD with sunken eyes, irritability, dry mouth, skin tugor, diarrhea and vomiting. What would be the first thing to consider in managing this patient? a. Rehydration therapy b. Culture and sensitivity c. Metronidazole plus Norfloxacin d. Zinc sulphate.

Which of the following I.V fluids is used in the management of cholera? a. Normal saline b. Dextrose saline2q c. Ringers lactate d. Dextrose 5%

In the management of Kaposis sarcoma, which one of the following drugs may be used as premedication? a. Deflazacort b. Prednisolone c. Triamcinolone d. Hydrocortisone

Which one of the following anti-TB drugs would be implicated in CNS adverse effects a. Isoniazid b. Pyrazinamide c. Ethambutol d. Rifampicin

What microorganisms are most likely to be implicated in neonatal meningitis? a. Pseudomonas Aeruginosa b. Neisseria Menengitidis c. E. coli d. Group B streptococci

Which TB drug causes retro-bulber neuritis? a. Kanamycin b. Ethambutol c. Streptomycin d. Levofloxacin

Mr H is started on PEP on 30/11/18. On 21/12/18 Mr H had unprotected sexual intercourse with a known HIV positive Patient who is not on treatment. After counselling Mr H regrets his actions and promises not to expose himself again. When is Mr H expected to stop taking ARVs? a. After 28 day (on 28/12/18) since Mr H is already on PEP b. On the 18/01/19 c. 6months after the last exposure d. 4 weeks after the first exposure

Mr A is a 30 year old man who present to the hospital with a severe cough and he is diagnosed with severe pneumonia with CURB 65 score of 5. The patient disclose that he is HIV positive and is on treatment since 2015 on TDF/3TC/EFV regimen but stopped taking ARV drugs about a year ago. The doctor asks for your intervention as a pharmacist, what would you recommend? a. To continue on the same regimen (TDF/3TC/EFV) and check for possible treatment failure after 3 months b. To start the recommended first line drugs TDF/3TC/DTG and check for possible treatment failure after 3 months c. To change to the recommended second line drugs AZT/3TC/LPV/r and check for possible treatment failure d. To change to the recommended second line drugs TDF/3TC/ATV/r and check for possible treatment failure

After 2months on cART and before the viral load and resistance test results are out, Mr A comes back to the hospital and is found to be having renal impairment with CrCl of 32ml/min and his doctor makes a decision to change his ARV drugs to ABC/3TC based regimen. What is the appropriate dose for Abacavir and lamivudine should be given? a. ABC 300mg od and 3TC 150mg od b. ABC 300mg od and 3TC 100mg od c. ABC 300mg bd and 3TC 150mg od d. ABC 300mg bd and 3TC 50mg bd

Which one of the following statements is not true regarding ARVs normal dosages in adult patients? a. Abacavir 300mg tablet can be dosed at double strength 600mg once a day b. Nevirapine 400mg ER tablet is dosed one a day c. Neverapine 200mg IR can be dosed at double strength 400mg once a day d. Lopinavir/ritonavir 200mg/50mg is only dosed twice a day and in HIV/TB coinfection treatment the dose is doubled.

Which one of the following carbepenem antibiotics has a high propensity to induce seizures and should be avoided in meningitis? a. Ertapenem b. Doripenem c. Meropenem d. Imipenem

Ceftriaxone is a once-daily drug for almost all indications except in? a. Meningitis b. Septicaemia c. Pyelonephritis d. Nosocomial infection

Which one of the following antibiotics does not have activity against pseudomonas aeruginosa? a. Cefepime b. Ertapenem c. Piperacillin/tazobactam d. Aztreonam

Which one of the following is true regarding ophthalmic antihistamines? a. Pheniramine and Tetrahydrozoline are the only two nonprescription ophthalmic antihistamines available. b. Ophthalmic antihistamines are available only in combination with Naphazoline. c. Ophthalmic antihistamines may cause burning, stinging, dry eyes, or mydriasis. d. Ophthalmic antihistamines may produce rebound congestion if used in excess or for extended durations.

The definition of a surfactant (an ingredient in toothpaste) can best be described by which one of the following statements? a. It prevents drying of the preparation. b. It removes debris by its detergent action and causes foaming, which is usually desired by the patient. c. It physically removes plaque and debris. d. It determines the texture, dispersiveness, and appearance of the product.

Which one of the following cleansing products would a pharmacist recommend for a patient with inflammatory acne? a. An abrasive facial sponge and soap used 4 times a day b. Aluminum oxide particles used 2 times a day c. Sulfur 5% soap used 2 times a day d. Mild facial soap used 2 times a day

If a patient needs a second application of an Over - The-Counter (OTC) Pyrethrin pediculicide shampoo, how many days after the first application should this be done? a. 4-5 b. 6 c. 7-10 d. 14-21

Which one of the following treatments for personal articles infested with head lice would not be effective? a. Placing woolen hats in a plastic bag for 2 weeks. b. Using an aerosol of Pyrethrins with Piperonyl Butoxide sprayed in the air of all bathrooms. c. Machine-washing clothes in hot water and drying them using the hot setting on the dryer. d. Dry-cleaning woolen scarves.

Which one of the following should not be mentioned by a Pharmacist when when educating patients about acne? a. Eliminating all chocolate and fried foods from the diet. b. Cleansing skin gently 2-3 times Daily. c. Using water -based noncomedogenic cosmetics. d. Not squeezing acne lesions.

A 15-year-old male patient has been using Benzoyl Peroxide 5% cream faithfully every day for the past 2 months with no apparent side effects. Which one of the following can not be said about this patient? a. He has been using this product for a long enough time to determine if the dose and dosage form are going to have any benefit. b. He should use this product no more frequently than every other day because of its irritating properties. c. This starting dose and dosage form are useful, especially if he has dry skin or it is winter time. d. His scalp hair may look bleached i f the product comes in contact with it.

The role of the pharmacy regulator (The Health Profession’s Council Zambia) is: a. To protect, promote and maintain the health, safety and wellbeing of members of the public in order to uphold standards and public trust in pharmacy. b. To raise the standing of the profession and to protect the interests of its members. c. To promote pharmacy and to advance science, practice, and education in pharmacy. d. To protect the interests and rights of members of the pharmacy profession.

Which one of the following is true about the functions of Zambia Medicine Regulatory Authority? a. Control of drug trafficking. b. Licensing of pharmacists. c. Confiscation of drugs not authorized to dispense. d. Registration of pharmacy training schools

What makes pharmacists unique in the health care team? a. Pharmacists advise patients on how take their medicines. b. Pharmacists are experts on communicating with patients and other health care professionals. c. Pharmacists have access to a vast amount of knowledge on medicines and the actions of drugs. d. Pharmacists are experts on medicine formulation and use and can apply this to patient care.

Empathy has many positive effects on a pharmacist’s relationships with patients. What are some of the benefits in a patient- pharmacist’s relationship? a. The patient comes to trust you as someone who cares about their welfare. b. The patient may not understand their own feelings more clearly. c. It helps alleviate the patient’s sense of isolation, which often accompanies an illness experience. d. It reduces the patient’s own problem-solving ability.

Law can be defined as; a. A codified belief system b. A codified set of events c. A codified rules of conduct d. A codified set of regulations

Which one of the following demonstrates the importance of morals? a. To guide society respond to unethical behavior b. To guide our interactions with others, friends and family, in our work place and professional behavior c. Guides society from going against the law. d. Improves our personality development.

The district medical officer has asked for your input in the performance assessment of their facilities. Using HMIS, which of the following is correct under DRUGS SUPPLIES MANAGEMENT? a. 0 means product was ever out of stock b. 1 means the product was stocked out for 1 month c. 2 means product was stocked out for 2 weeks d. 3 means the district supplied 3 times in the month

In line with question 1 above, the following drugs make the list of essentials that need assessment as you conduct performance assessment: a. Doxycycline tablets b. Amoxicillin suspension c. 4FDC d. All of the above

In assessment of rational prescribing, the Pharmacist generates information that can help in supplies logistics and chain management. Which of the following drug classes are used in HMIS for assessment of rational prescribing? a. Antibiotics b. Anti-TB drugs c. ARVs d. All of the above

Medical stores limited (MSL) is mandated to store and distribute drugs that are procured by the Ministry of Health and its partners. How does MSL deliver their commodities? a. Every 2 weeks b. Monthly c. Quarterly d. By schedule

In line with Question 104, which of the following would lead to overestimation of orders? a. Stock on hand b. Issued instead of dispensed to patients data c. Losses d. Grant procured stocks

Stock on hand is one of the most important data items for decision making. What is the best source for this information? a. Stock card b. R&R c. Physical check d. Dispensing tool

107. Following the end of October 2018, you had a stock of 7 of the most critical essential medicine at your level 1 hospital Pharmacy. On this particular day, you still have stock outs. What’s the best course of action in this stock out period? a. Inform DMO b. Inform PMO c. Inform MSL d. Inform the DC 108. In line with question 107 above, you have been called by senior management who indicates to you that some money has been secured for procurement of drugs. What is your next step? a. Collect the money and buy drugs b. Collect quotations for procurement c. Make requisition for procurement d. Make inquiry list for procurement 109. Who is legally mandated to procure your drugs in question 108 above? a. Pharmacist b. Stores officer c. Procurement officer d. Hospital administrator 110. In line with Question 107 above, while conducting physical check before procurement activities, you discover that another hospital sent you some stock of a particular ARV drug. How do you best account for this? a. Record as received from that facility b. Record as adjustment c. Record as loss d. Record as found during count

107. A 108. C 109. C 110. B

After the procurement process, documentation makes part of the most important steps in process of receiving drugs. What is the 1st step in this process? a. Enter GNR and use receipt # on SCC b. Enter SCC and use receipt # on GRN c. Enter in SCB first d. Enter in dispensing too first

Which statement would best describe one of the differences in ARV and Essential drugs logistics systems? a. ARV estimated consumption data is more accurate because it uses issues data b. Orders for ARVs are delivered earlier than ARVs c. ARVs follow a pull system while Essential drugs follow a push system d. None of the above

On a weekend of the 9th November, 2018 you received a call from you the Principal Pharmacist in charge of your Hospital Pharmacy that MSL was delivering the delayed orders you had make the previous month. On arrival you find 2 MSL drivers and the Stores assistant waiting for you. 113. The following would be the best 1st step in receiving drugs from MSL: a. Greet the drivers b. Verify that truck lock is not tempered with c. Verify the quantities match with delivery note d. Verify quantities match with issued invoice 114. Which of the documents MAY NOT be necessary for your activity? a. Invoices b. Dispatch note c. GRN d. None of the above 115. What document is best for easy and accurate verification of received quantities? a. Invoice b. Dispatch note c. GRN d. None of the above 116. After verification of the quantities received against your chosen document, of the following listed actions, which one is suited in case of soiled boxes of drugs? a. Report in the next order b. Fill in a report detailing the incidence and send with next order c. Fill in report detailing the incidence and send with the drivers d. Fill in report detailing the incidence and send with the drivers with the affected box

113. A 114. A 115. B 116. D

Most rural districts receive drugs on behalf of the ART facilities under the DMO. If you were the District Pharmacist and you have one facility not having received ARVs when other facilities under you received., what would be your next step? a. Request the facility to contact MSL immediately and request your office for assistance b. Inform MSL on behalf of facility and request facility to place requisition from other facilities c. Place emergence order on behalf of facility d. None of the above

In line with question 117, who is responsible for the delivery of drugs to your health centers? a. Organize yourself b. Request Provincial medical office c. Show MSL where to deliver d. Any of the above

Performance assessment for facilities is often accompanied by technical support for the facilities that may belong to centralized system of pharmaceutical management. If you were picked as peer assessor, what would you be looking to assess to evaluate financial, administration and management systems in relation to logistics and management information systems? a. Human resources output b. Human resource application of LMIS components such as inventory control c. A is correct d. All of the above

How useful is the stock status for MSL? a. The stock status report is a quick way to look at inventory of essential medicines b. Other medical products may not be indicated c. This report, like the Inventory Valuation Report only includes available items d. All of the above

Which of the following would be an appropriate regimen for empirical treatment of ventilation hospital acquired pneumonia? A. Amoxicillin plus Azithromycin B. Levofloxacin C. Ceftriaxone plus Levofloxacin D. Vancomycin plus Levofloxacin

A 30-year-old female taking medication for tuberculosis and oral contraceptives comes to the Gynecology OPD with compliant of amenorrhea. Laboratory tests shows positive pregnancy test. which one of the following drugs most likely to explain her current state? A. Pyrazinamide B. Rifampicin C. Streptomycin D. Ethambutol

Mr.G takes isoniazid as part of his treatment regimen for Tuberculosis. When he presents his prescription he asks you why he has also been prescribed pyridoxine. Which one of the following adverse effects of isoniazid can be prevented by the prophylactic use of pyridoxine? A. Agranulocytosis B. Peripheral neuropathy and psychosis C. Skin rash D. Hepatitis and peripheral neuropathy

which of the following is the first principle of treatment of poisoning .A Removal of unabsorbed poison from the body .B Stabilization of vital functions .C Administration of antidote .D Removal of absorbed poison from the body

The following means can be used to submit the ADR report except .A Phone call to ZAMRA. .B Using WEBDRA mobile app .C Using Medsafety mobile app. .D Reporting online using ZAMRA website

Organophosphorus compounds inhibit .A Acetylcholine .B Acetylcholine eaterase .C Cytochrome oxidase . D Sulphydryl enzymes

which of the following antidote -drug pairing is correct .A Acetaminophen-n-acetyl cysteine .B Benzodiazepines-flumezanil .C both A and B are correct .D both A and B are incorrect

Pralidoxime is the antidote of A Mercury .B Lead .C Organophosphorus .D phorsphorus

Three essential data items needed when reporting include the following except .A Received data .B Losses and adjustments .C Stock on hand .D Consumption data

.........is not seen in organophosphate poisoning .A Lacrimation .B Salivation .C Mydriasis .D Diarrhoea

Adjustments are part of the consumption data .A True .B False

Which one of the following cells are responsible for insulin secretion? A. D-cells B. I-cells C. B-cells D. D-cells

Which sulfonyurea has the shortest duration of action? A. Tolbutamide B. Glibenclamide C. Glipizide D. Dobutamine

The following are secretagogues except A. Glibenclamide B. Glimepiride C. Metformin D. Nateglinide

Which one of the following drugs is less likely to cause hypoglycemia? A. Nateglinide B. Repaglinide C. Metformin D. Glimepiride

Which drug is likely to be coadministered with insulin? A. Glibenclamide B. Glimepiride C. Tolbutamide D. Metformin

Which of the following drugs works by inhibiting DIPEPTIDYL PEPTIDASE-4? A. Metformin B. Glibenclamide C. Repaglinide D. Saxagliptin

Which of the following pathogens is most likely to cause fungal meningitis in immunocompromised host? A. C.gatti B. C.neoformans C. Dermatophytes D. Pneumococus

Which statement is true regarding cryptococcal meningitis? A. It is the most common meningitis in patients whose CD4 cell count is above 350 cell/microliter B. It is always present in people living with HIV infection C. Cryptococcal neoformans is the most common cause. D. 90% of cases are due to Cryptococcal gatti

How many treatment phases are involved in the management of cryptococcal meningitis? A. 1 B. 2 C. 3 D. 5

Which one of the following drugs is a core or backbone in cryptococcal meningitis management? A. Fluconazole B. Ketoconazole C. Amphotericin B D. Itraconazole

Which of the following statements describes the mechanism of action of fluconazole? A. It works by inhibiting transpeptidation process by binding to penicillin binding proteins. B. It inhibits 14-alpha dymenthalase enzyme, thereby blocking the synthesis of elgosterol. C. It creates artificial poles with the fungal cell membrane leading to lysis and death of the fungi. D. Works by blocking protein synthesis through interaction with 60s ribosomal unity

The preferred combination of drugs in intensive phase of cryptoccal meningitis treatment is.... A. Amphotericin B and Fluconazole B. Amphotericin B and Itraconazole C. Fluconazole and Flucytocin D. Amphotericin B and Flucytocin

Which one of the following is true regarding Amphotericin B? A. It works best when reconstituted in Dextrose normal saline B. 0.9% sodium chloride solution is preferred for its dilution. C. It should always be reconstituted in non-electrolytes fluids

The following combination of antibiotics is advisable except..... A. Gentamycin plus Cefotaxime B. Amikacin plus cloxacillin C. Ceftriaxone plus Doxycycline D. Gentamycin plus cloxacillin

Which one of the following is an example of a monobactam? A. Vancomycin B. Ceftaroline C. Aztreonam D. Carbapenems

The following is true regarding monobactams except... A. The have the best activity against pseudomonas aeruginosa B. They are cell wall synthesis inhibitor C. The have excellent activity against a wide range of gram negatives bacilli D. The have best activity against staphylococcus aureus

Which one of the following antibiotics is an example of cyclic lipopeptide? A. Daptomycin B. Linezolid C. Vancomycin D. Quinupristin dalfopristin

A doctor orders 10000 mcg of a drug for a patient. The drug is available at 4mg/tablet. How many tablets should a nurse administer? A 3.5 tabs B. 2.53tabs C. 2.5tabs D. 3.1tabs

A drug was given by a constant infusion rate of 60mg per hr. If clearance of the drug is 10ml per minute, calculate the steady concentration assuming one compartment model. A. 0.1mg/L B. 100mg/mL C. 100mg/L D. 0.1mg/dL

Which of the following is an example of an anaerobe? A Pneumococcus B. Meningococcus C. Peptostreptococcus D. Chlamydia.

The recommended fluid for dilution of Amphotericin is.... A. Dextrose normal saline B. Normal saline C. 5% dextrose D. 50% dextrose

Which of the following cells are responsive for secretion of glucagon? A. Beta cells B. Alpha cells C. F cells D. Delta cells

Which of the following pathogens is the most common cause of pneumonia? A. Pneumococcus B. Streptococcus group D C. Staphylococcus Aeureus D. Legionella

The example of rapid acting insulin is.... A. Lispro B. Glargin C. Regular Insulin

Which of the following glucose transporters transport glucose into insulin secreting cells? A. GLUT 4 B. GLUT 3 C. GLUT 2 D. GLUT1

Which one of the following is an amylin analogue? A. Pramlintide B. Exenatide C. Nateglinide D. Repaglinide

Which one of the flowing is an example of a long acting insulin? A. Glargine B. Aspart C. Lispro D. Regular

Which statement is true regarding Legionella? A. It is a gram negative bacilli B. It is a gram positive pathogen C. It is a major cause of both typical and atypical Pneumonia D. It is a fungal

Which of the following class of drugs work by binding to PPARY? A. Beguanides B. Sulfonylureas C. Meglitinides D. Thiazolidinediones

…………..is an example of a drug whose major adverse effect is lactic acidosis A. Glipizide B. Glibenclamide c. Metformin D. Insulin

Which one of the following is an Incretin mimetic? A. Saxagliptin B. Exenatide C. Arcabose D. Metformin

Hyperinsulinemia is more likely to occur with of the following drugs? A. Metformin B. Phenformin C. Glibenclamide D. Acarbose

Which statement best describes the mode of action of SULFONYLUREAS? A. Works by reducing glucose absorption through glucosidase inhibition B. Binds to ATP-potassium sensitive pump leading to increase in intracellular cations. C. They sensitize insulin peripheral receptors D. Binds to PPAR-gama

Which one of the following is the second generation sulphonylurea? A. Glipizide B. Tolbutamide C. Tolbutamine D. Chlorpropamide

During a major ward round, a team comprises of Doctors, Nurses, Pharmacists. Physiotherapists come across D.M male 37 RVD-R on second line (AZT/3TC/LPV/r) with CD4 of 77 cells Per microliter and unknown viral load who was being treated for first line susceptible TB meningitis based on AFB. Gene expert and CSF culture D.M also developed severe pancytopenia 6 months after he was switched to second line from TDF/3TC/EFV with (WBC 0.9 x 10^-9.Red cells-1.5x 10^-9.HB-6g/dl.Plateletes-50 and Neutrophils were 1 x 10-9),other parameters include serum creatinine of 1010 micromoles/L with 25 mmol/L of Urea and Kidney ultrasound confirmed CKD. D.M weight is 200 lb. 17. Which one of the following drugs is likely to be the cause of his pancytopenia? A. LPV/r B. 3TC C. EFV D. AZT 18. Assuming his CKD was caused by his first line ART regimen, the drug to be suspected is…………. A. 3TC B. EFV C. NPV D. TDF 19. The consultant asked the Pharmacist how his TB meningitis would be managed. Which set of drugs constitute the appropriate and effective regimen for Mr.D.M? A. Isoniazid Pyrazinamide/Levofloxacin Clofaximine B. Isoniazid Ethambutol Rifampin Pyrazinamide C. Rifampicin Ethambutol Pyrazinamide Bedaquiline D. Levofloxacin Moxifloxacin Ethambutol Pyridoxine 20. What would be his current LPV/r dose if TB treatment was initiated? A. 400mg 100mg B. 600mg/150mg C. 800mg 200mg D. 1000mg/250mg 22. Based on his creatinine clearance, what dose of 3TC is D.M supposed to be receiving? A. 50mg OD B. 150mg OD C. 50 BID 25. Which one of the following is true regarding cotrimoxazole in D.M? A. It is not necessary as his viral load is unknown B. It is needed to prevent Kaposi sarcoma as he is at high risk C. It is needed to prevent toxoplasmosis D. It is needed to prevent invasive candidiasis 23. The pharmacist was asked to come up pharmaceutical care plan regarding his TB treatment. Which of the following would be the best option concerning this patient? A. Isoniazid 450mg/Pyrazinamide 2g/Ethambutol 1.4g Rifampicin 600mg/day B. 4 tablets of 4FDCs/day C. 5 tablets of 4FDCs/day D. Isoniazid 450mg Rifampin 600mg Pyrazinamide 2g Ethambutol 400mg/day 26. Which one of the following drugs will require dose adjustment in Mr.D.M above? A. Ethambutol B. Rifampin C. Isoniazid D. Zidovudine 27. The consultant makes a plan to treat his pancytopenia using filgrastim which is given at 5 mcg/kg/day SC. What dose will Mr. D.M receive? A. 150 mcg/day SC B. 200 mcg/day SC C. 460 mcg/day SC D. 900 mcg day SC 28. Double strength cotrimoxazole can protect an immunosuppressed patient from the following except.... A. Toxoplasmosis B. PJP C. Salmonella D. Kaposi sarcoma 29. Among the anti-TB susceptible drugs, which one is the most hepatotoxic? A. Streptomycin B. Pyrazinamide C. Ethambutol D. Isoniazid RIP lowest to highest 30. The following are risks factor which can predispose Mr.DM to Isoniazid induced peripheral neuropath except............................... A. Alcohol B. AIDS C. Rifampin D. Gender

Pancytopenia is diagnosed when white blood cell, red blood cell, and platelet counts are low 17. D 18. D 19. B 20. C 22. B 25. C 23. 26. A 27. C 28. D 29. B 30. D

33.year-old man with fever and severe headache for 2 days was brought into emergence room at University Teaching Hospital Examination revealed fully conscious man in pain, neck stiffness. and photophobia Positive Kemig's and Brudzinski's sign. The patient was treated empirically 34. Which of the following drug would be given to a post meningococcal meningitis patient at discharge if he was treated with benzyl penicillin? A. Amoxicillin B. Phenoxymethylpenicillin C. Rifampin D. Isoniazid 35. Meningitis caused by pseudomonas can be treated with the following agents except...... A. Meropenem B. Imipenem cilastatin C. Ertapenem D. Pipelacillin tazobactam 36. The following can be used to treat infections caused by anaerobes except........................ A. Moxifloxacin B. Metronidazole C. Ertapenem D. Levofloxacin 37. The third generation cephalosporins are clinically used to empirically treat the following infections but.............................. A. Cellulitis B. Pneumonia C. Gonorrhea D. Urinary tract infection

34. C 35. C 36. D 37. A

The following drugs work by inhibiting angiotensin converting enzyme except...... A. Losartan B. Enalapril C. Captopril D. Lisinopril

The most common cause of urinary tract infection is..... A. Enterococcus B. Klebsiella C. E. coli D. Listeria

The following antibiotics have excellent activity against listeria monocytogenes except... A. Gentamycin B. Ampicillin C. Vancomycin D. Ceftriaxone

M.K male 68 was brought to emergency department at UTH in serious condition. His wife stated that he was okay previously till 4 days ago when he became very ill with high fever, productive cough and the sputum looks reddish (rusty) in color, he also was complaining of difficulties in breathing said his wife, further questions were asked to his wife, she responded and some of the things she mentioned about M.K were; he smokes a packet of cigarette a day and am his second wife. Vitals were; temperature 38'c, BUN 162 mg/dl, confused, blood pressure 77/45 and respiratory rate of 33bpm. 1. Which of one of the following is a risk factor associated with MK's pneumonia? A. His rusty colored sputum B. He is a polygamist C. His daily smoke routine D. His weight 2. Which one of the following is true regarding his treatment at emergency? A. MK was well treated and no interventions required B. The dose and administration of Azithromycin was wrong C. MK was not well treated according to his severity of the disease D. The Amoxicillin dose was supposed to be doubled 3. What is the score severity assessment for Mr. MK's Pneumonia? A 2 B. 3 C.4 D.5 E.6 4. Which one of the following is the likely causative organism for his pneumonia? A. Mycoplasma pneumoniae B. Legionella – foul smelling C. Pseudomonas aeruginosa-GREEN and H. influenza D. Pneumococcus -RUSTY COLOUREd Anaerobes- foul smelling sputum 5. The following inotropic agent is the preferred for MK's BP correction... A. Dobutamine B. Adrenaline C. Dopamine D. None of the above 6. Which one of the following combinations is the best choice for Mr. MK pneumonia treatment? A. Amoxicillin and Azithromycin B. Cefotaxime and Azithromycin C. Benzyl penicillin and Amoxicillin D. Cephalexin and Doxycycline 7. The doctor prescribed dopamine, 400mg/500ml concentration to be given at 8 drops per minute and slowly increase by 2 drops until maximum dose is reached. Assuming 1 ml-20 drops, what is the dose Mr. MK receiving each minute? A. 250mcg/minute B. 300mcg/minute C. 350mcg/minute D. 320mcg/minute 8. Assuming Mr MK weighs 70KG and the maximum dose for dopamine (400mg 500mls) to control his blood pressure 15meg KG minute. What drops minute is equivalent to Mr. MK's maximum dose? A. 26 drops/minute B. 25 drops minute C. 26.5 drops/minute D. 26.25 drops minute 9. What is Mr. MK's maximum dose per hour following the conditions in question 8 above? A 1050meg/hour B. 63000mcg/hour C. 43000mcg/hour D. 64000mcg hour

1. C 3. E 4. D 5. B 6. B 7. D 8. D 9. B

A 32-year-old man presents to an outpatient clinic with a 5-day history of productive cough, purulent sputum, and shortness of breath. He is diagnosed with community-acquired pneumonia (CAP). It is noted that this patient has a severe ampicillin allergy (anaphylaxis). Which would be an acceptable treatment for this patient? A. Levofloxacin B. Ciprofloxacin C. Penicillin VK D. Nitrofurantoin

A 22-year-old woman presents with a 2-day history of dysuria with increased urinary frequency and urgency.A urine culture and urinalysis are done. She is diagnosed with a urinary tract infection caused by E. coli. Which agent should be avoided in the treatment of her UTI? A. Levofloxacin B. Cotrimoxazole C. Moxifloxacin D. Nitrofurantoin

Dysuria means pain or burning that occurs when you pee (urinate) C

Which drug is correctly matched with the appropriate adverse effect? A. Levofloxacin—hyperkalemia B. Nitrofurantoin—pulmonary fibrosis C. Cotrimoxazole—hepatic encephalopathy D. Methenamine—nystagmus

Cotrimoxazole provides activity against which organism? A. MRSA B. Pseudomonas aeruginosa C. Anaerobes D. Mycoplasma

A 55-year-old man presents to primary care clinic with an erythematous and tender abscess on his left thigh. He has a history of MRSA skin infections. Which is an appropriate antibiotic for empiric treatment? A. Ciprofloxacin B. Cotrimoxazole C. Pyrimethamine D. Cephalexin

Which is a common adverse effect of cotrimoxazole? A. Hyperkalemia B. Pulmonary fibrosis C. Tendon rupture D. Blood glucose disturbances

A 21-year-old marathon runner reports to the clinic with acute Achilles tendon rupture. The nurse noted that the patient recently took an antibiotic for community-acquired pneumonia. Which antibiotic may have contributed to tendon rupture? A. Amoxicillin/clavulanate B. Cefdinir C. Levofloxacin D. Minocycline

A 70-year-old woman with acute cystitis presents to the Family Medicine clinic for assessment. She has a past medical history of hypertension and chronic kidney disease. The team recommends initiation of nitrofurantoin for cystitis. After reviewing her antimicrobial therapy, which actions should be taken prior to clinic discharge? A. Continue current therapy and counsel on gastrointestinal effects of nitrofurantoin. B. Change nitrofurantoin to alternative agent due to chronic kidney disease. C. Reduce nitrofurantoin dose due to impaired renal function. D. Counsel patient regarding neuropathy associated with short-term therapy.

B. The key issue with the antibiotic recommendation is that nitrofurantoin should not be administered in patients with poor kidney function. Adjusting the dose and continuing the current regimen are not acceptable modifications. Neuropathy is more common with therapy greater than 1 month.

A. Patients taking a fluoroquinolone should apply sunscreen and take precautions to minimize risk of phototoxicity. Adjusting the timing of the dose or taking with food or additional water does not change the risk of an event.

What is the main benefit for prescribing methenamine for treatment of a urinary tract infection? A. Safe to use in patients with hepatic failure. B. Available in intravenous and oral formulations. C. Broad spectrum of activity. D. Minimal development of resistance.

D. Methenamine does not select for resistance. Due to its conversion to formaldehyde, this compound is the least likely compound to select for resistant isolates. Methenamine should be avoided in patients with hepatic failure. This agent is only available as an oral formulation, and it has a narrow spectrum of activity.

Which of the following combinations represents optimal pharmacotherapy of heart failure? a. Furosemide, Clonidine, Hydrochlorothiazide and Propranalol b. Furosemide, Iisinopril, Digoxin and Carvedilol c. Carvedilo, Verapamil, Amlodipine and Digoxin d. Dobutamine, Milrinone, Furosemide and Nitroylycerin

Persons on insulin therapy should be advised to rotate their injections sites for the following reasons: a. Reduces the risk of infection b. Reduces the risk of lipoatrophy c. Reduces the risk of lipo hypertrophy d. Reduces the risk of generalized myalgia e. None of the above

Which one of the following is the leading cause of PUD in H pylori-negative patients. a. Mineralcorticoids b. NSAIDs c. DMARDs d. Antibiotics e. None of the above

Which of the best choice for the treatment of acute gouts arthritis attack? a. Probenecid 500mg now followed by 500mg twice daily b. Indomethacin 50mg now followed by 50mg three to four times daily c. Allopurinol 100mg once daily d. Colchicin 0.6mg every hour until resolution of symptoms, development of diarrhea or a cumulated dose of 8mg is reached. e. None of the above

All of the following represents methods used to decrease the GIT toxicity associated with NSAIDS except: a. Changing patients from a non selective cyclo-oxigenase inhibitor to a type II specific inhibitor such a celecoxib b. Adding a proton pump inhibitor such as omeprazole to the patient’s NSAIDs c. Adding misoprostal to the patient’s NSAIDs d. Instructing the patient to take his/her NSAIDs at night when acid secretion is limited e. None of the above

After receiving chlorpromazine for a week, Mr. Wills develops urine retention. Which drug effect is responsible for this adverse reaction? a. Adrenergic b. Extrapyramidal c. Antiadrenergic d. Anticholinergic e. None of the above

After taking haloperidol for a few months, Ms. Atkins develops wormlike movements of the tongue and slow aimless, involuntary movements of her arms. What is the most likely cause of these signs a. Development of Parkinson’s disease b. Hypersensitivity to haloperidol c. Neurologic effects of haloperidol d. Pre existing dementia e. None of the above

A 30 year old male with known TB infection and taking medication since 1 month comes to the Eye OPD with complaint of visual disturbances including decreased visibility and slight color blindness. If these symptoms are due to his drug treatment, which one of the following drugs is most likely the cause of his symptoms? a. Streptomycin b. Ciprofloxacin c. Ethambutol d. Rifampicin e. Kanamycin

A 35 year old male recently diagnosed with tuberculosis and is started on medication. After a few days he comes to the emergency department a few hours after taking a meal at McDonald’s with severe pain in the big toe. Blood tests show a very high uric acid level. Which of the following drugs most likely caused these symptoms? a. Streptomycin b. Rifampicin c. Isoniazid d. Amikacin e. Pyrazinamide

A 35 year old female taking medication for tuberculosis and oral contraceptives comes to the Gynaecology OPD with complaint of amenorrhea. Laboratory test shows a positive pregnancy test. Which one of the following drugs most likely caused her to become pregnant? a. rifampicin b. Pyrazinamide c. Streptomycin d. Ethambutol e. Isoniazide

1. Insulin that has been stored in a refrigerator should be allowed to reach room temperature prior to administration in order to? a. Allow proper mixing b. Minimize painful injections c. Prevent frosting or clumping d. Delay systemic absorption e. Prevent change in clarity

When mixing rapid-or short acting insulin with intermediate or long acting insulin, which insulin in the list below should be drawn up first? a. Regular b. NPH c. Lente d. Ultralente e. Glargine

Uniform dispersion of insulin suspension can be obtained by: a. Vigorous shaking the vial b. Rolling the vial gently between the hands c. Warming the vial in a microwave d. Packing the vial in dry ice e. Keeping the vial at room temperature

Diabetes mellitus is the leading cause of which of the following complications? a. Pancreatitis b. Fatty liver c. Blindness d. Stroke e. Deafness

Metformin should be withheld for 48 hours prior to and 48 hours after any procedure requiring the use of parenteral iodinated contrast media due to the potential for this adverse drug event? a. Optic neuritis b. Metabolic alkalosis c. Lactic acidosis d. Purple toe syndrome e. Tinnitus

C.T. is a 23 year old HIV-positive female who presents with shortness of breath and fever. Physical exam reveals a temperature of 380C , HR of 100 bpm and decreased breath sounds in the left lower lobe of the lungs. Chest xray is positive for infiltrates in the left lung. She is diagnosed with PCP pneumonia. She has no history of opportunistic infections and no on medications at this time. Her CD4+ count is 13 cells/mm3 and viral load is 17 190 copies/ml. 16. What is the treatment of choice for CT.’s PCP a. Trimethoprim-sulphamethoxazole 2 tabs PO q8h for 21 days then I tab PO qd b. Trimethoprim-sulphadoxine 2 tabs PO q8h for 21 days then 1 tab PO qd c. Trimethoprim-sulphamethoxazole 2 tabs PO q8h for 14days then 1 tab PO qd d. Azithromycin 500mg PO on day one, then 250mg qd indefinitely e. Doxycycline 100mg PO bid for 7 days then 100mg PO qd 17. Should C.T. receive any other prophylaxis against opportunistic infections? a. Yes, against MAC: azithromycin 1200mg PO weekly b. Yes, against thrush fluconazole 100mg PO qd c. Yes against toxoplasmosis. Pyrimethamine 1 tab qd d. Yes against CMV: Valgancyclovir 450mg PO qd e. No Six weeks later C.T presents to the HIV clinic for follow up. Her CD4+ count 12 cells /mm3 And viral load is 40 202 copies/ml. 18. Should C.T be started on HIV therapy a. Yes, her CD4+ count is less than 350 cells/ mm3 and she has had an opportunistic infection b. Yes, her viral load is greater than 55 000 copies/ml c. Yes, her western blot was positive for HIV d. Yes, all patient with HIV should be treated as soon as the diagnosis is made e. No 19. C.T wishes to be started on HIV therapy. Which of the following would be appropriate regimen according to Zambian guidelines a. Zidovudine + efevirenz + nelfinavir b. Zidovudine + stavudine + indinavir c. Emitricitabine + lamivudine + Efavirenz d. Tenofovir + Emtricitabine + Efavirenz e. Emitricitabine + lamivudine + Nevirapine

16. A 17. A 18. A 19.D

Which of the following lab parameters should be monitored for the patient receiving Tenofovir + Emtricitabine + Efavirenz ? a. Haemoglobine and creatinine clearance b. Alanine transaminase and creatinine clearance c. Aspartate transaminase and creatinine clearance d. Full blood count only e. Renal function only

Empiric therapy for meningitis for patients up to 1 month of age includes a. Vancomycin and ampicillin b. Aminoglycoside and ampicillin c. Ceftriaxone and Vancomycin d. Vancomycin and aminoglycosides e. Ampicillin and Ceftriaxone

When treating penicillin-allergy patients for endocarditis___________________ may be used for therapy. a. Vancomycin b. Erythromycin c. Cefazoline d. Meropenem e. Nafcillin

Patients presenting with acute bronchitis without risk factors should be treated empirically with a. Supportive care b. Clarythromycin c. Cefuroxime d. Ciprofloxacin e. Erythromycin

Empiric therapy for patients with hospital acquired pneumonia should include a. Tobramycin and gentamycin b. Cefotaxime and cefepime c. Vancomycin and gentamicin d. Gentamicin and cefepime e. Cefepime and vancomycin

The use of antimotility agents in infectious diarrhea is a. Discourage, due to the potential to cause toxic megacolony b. Encouraged to due increased cure rates c. Discouraged due to increased reinfections d. Discouraged due to lack of efficacy e. Encouraged to due decreased reinfection

The definite outcomes of Pharmaceutical care include the following EXCEPT: A. Cure of a disease, B. Elimination or reduction of a patient's symptomatology C. Preventing a disease or symptomatology D. Definite diagnosis

To produce specific therapeutic outcomes for the patient, the Pharmacist has three major functions in the provision of Pharmaceutical Care: the following is/are the function(s): A. Identifying potential and actual drag-related problems B. Resolving actual drug-related problems C. Preventing potential drug-related problems D. All the above options

What is the basis of pharmaceutical care? A. Responsibility and accountability to patient for the outcome of their drug therapy. B. Not maintenance of patients at the highest possible level of functional and psychosocial well- being through optimal management of drug therapy. C. Lack of continuity of care between different practical settings D. Prevention of potential drug-related problems

Why is it important for the Pharmacist to evaluate past medical history for a patient? A. The treatment for the previous condition may be the reason for the current problem or may interfere with the proposed treatment for the current condition B. It is always the cause of the current condition C. So that the same medication can used again D. To know how serious it was and as part of routine history taking

Why is it important for the Pharmacist to evaluate medication history for a patient? A. So as not to use the same medication B. Because the patient has developed resistance C. The past medication could have caused the current problem or may interact with the proposed medication for the current problem D. In case the patient has medication left so that new medications are not prescribed

What influence does social history of a patient have on drug selection? A. Drug selection may depend on one’s lifestyle B. It has no influence on pharmaceutical care C. Both A and B are correct D. Only option B is correct

What kind of a drug-related problem is it if a patient has a medical problem that requires drug therapy but is not receiving a drug for that indication? A. Untreated indication B. Improper drag selection C. Sub-therapeutic dosage D. Failure to receive medication

If a patient has a medical problem that is the result of not receiving a medication due to economic, psychological, sociological, or pharmaceutical reasons, is said to have what kind of a drug-related problem? A. Untreated indication B. Improper drag selection C. Sub-therapeutic dosage D. Failure to receive medication

What does adverse drug reaction entail as a drug related problem? A. The patient has a medical problem that is the result of a drug-drug, drug-food, or drug-laboratory test interaction. B. The patient is taking a medication for no medically valid indication. C. The patient has a medical problem that is being treated with too much of the correct medication. D. The patient has a medical problem that is the result of an adverse drug reaction or adverse effect.

Which one of the following is not a drug related problem? A. Drug interactions B. Drug use without indication C. Treatment failures D. Pharmacovigilance

Which of the following is NOT one of the aims of pharmacovigilance? A. To improve patient care and safety B. To promote rational and safe use of medicines C. To contribute to the assessment of benefit, harm, effectiveness and risk of medicines D. Only A and B are correct

Which of the following is NOT an element of adverse event reporting? A. Identifiable patient B. Identifiable reporter C. A suspect drug D. None of the above

Pharmaceutical Care reflects a systematic approach that makes sure that the patient gets all of the following EXCEPT: A. the right medicines B. the right dose C. the right time and for the right reasons. D. Only A and B are correct

Which of the following is true about Pharmaceutical Care and what is required of a Pharmacist? A. The Pharmacist works in concert with the patient and other healthcare providers to optimize the care B. The Pharmacist only with a Physician who looks after the patient C. The Pharmacist does not need concert from a patient when there is need to change medication D. There is no need for the Pharmacist to document their intervention

Which of the following elements is NOT part of the overall goal of Pharmaceutical Care? A. Optimization of the patient's health-related quality of life B. Achieving positive clinical outcomes C. Being realistic with economic expenditures D. Safety profile of medicines

The following is/are principle(s) of pharmaceutical care: A. A professional relationship must be established and maintained B. Patient-specific medical information must be collected, organized, recorded, and maintained C. Patient-specific medical information must be evaluated and a drug therapy plan developed mutually with the patient D. All the above

One of the principles of pharmaceutical care is for the Pharmacist to review, monitor, and modify the therapeutic plan as necessary and appropriate, in concert with the patient and healthcare team. What does this principle entail? A. The pharmacist is responsible for monitoring the patient's progress in achieving the specific outcomes according to strategy developed in the drug therapy plan. B. The pharmacist coordinates changes in the plan with the patient and the patient's other healthcare providers as necessary and appropriate in order to maintain or enhance the safety and/or effectiveness of drug therapy C. The pharmacist helps minimize overall healthcare costs. D. All the above

Which of the following combinations should be avoided? A. Niverapine + Rifampicin B. Niverapine + Rifabutin C. Rifampicin + Isoniazid D. A and B

Patient TM has the following haemogram: Hb 9g/dL (13-16), MCV 60ft (70-100), MCHC 260 (320-360). What type of anaemia does patient TM? A. Microcytic hypochromic anaemia B. Microcytic hyperchromic anaemia C. Microcytic normochromic anaemia D. Macrocytic hypochromic anaemia

Which one of the following is a typical symptom of vaginal thrush? a. a foul smelling vaginal discharge b. intermenstrual bleeding c. lower abdominal pain d. vaginal itching

Mrs TK aged 31 years old visits the pharmacy one Saturday afternoon; she appears embarrassed and asks to talk to the pharmacist somewhere private. After appropriate questioning, it seems that she has vaginal thrush. During the consultation, she confirms that she does not take any other medication, has no existing medical conditions, and is not pregnant or breastfeeding. Assuming Mrs TK has had a previous episode of vaginal thrush about a year ago (diagnosed by a doctor), which one of the following non-prescription medicines is the most appropriate treatment option for Mrs TK? a. Dual action Clotrimazole cream 1% w/ b. Dermatological Spray (Clotrimazole 1%w/v c. Clotrimazole 1% w/w; Hydrocortisone 1% w/w d. Clotrimazole cream 10% w/w

Mrs JM, a woman aged 29 visits the community pharmacy and would like you to recommend something for the headaches that she has been getting recently. You ask her to describe the headache and she explains that the pain is across her forehead and around the back of the head. The headaches usually occur during the daytime and have been occurring several times a week, for several weeks. There are no associated GI symptoms, no nasal congestion and no medicines are being taken, apart from a compound OTC product containing Aspirin, which she has been taking for her headaches. 23. What type of headache is Mrs. JM likely to be suffering from? a. Tension headaches b. Classic migraine headaches. c. Common migraine d. temporal headache

MT is a 16 year old female; she is a prima-gravida at 24 weeks of gestation. This morning she came in complaining of severe headache, nausea and that she vomited once before coming to the hospital. Other complaints included; blurred vision and pain in the upper part of the abdomen. She tells the Obstetrician that she was well until 2 days ago when she started feeling tired and headache. On examination her BP is 158/116 mmHg pulse is 100/min and urinalysis shows protein 3+. Family history: Her mother died of hypertension 2 years ago and her elder sister had the same problem 2 years ago. 2.4 What is the diagnosis for MT? 1. Severe pregnancy induced hypertension (PIH) 2. Severe chronic hypertension 3. Severe pre-eclampsia A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 3 only 25. What risk factors does MT have for pre-eclampsia? 1. Age 2. Family history 3. Prima gravidity A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 1 only 26. What signs and symptoms does MT have for impending eclampsia? 1. Epigastric tenderness 2. Blurred vision 3. Nausea and vomiting A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 1 only 27. Which drug(s) would you recommend for MT in view of her diastolic BP? 1. Hydralazine 2. Frusemide 3. Lisinopril A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 1 only 28. Which drug(s) would you recommend for MT in view of her signs and symptoms of impending eclampsia? 1. Phenobarbitone injection 2. Magnesium sulphate injection 3. Diazepam A. 1, 2, 3 B. 1, 2 only C. 2 only D. 1 only 29. . The Clinical Pharmacists recommends use of labetalol in place of methyldopa. What is the benefit in using labetalol compared to other beta receptor blockers? 1. It blocks alpha-1 receptors on the uterus causing an increase in utero perfusion 2. It stimulates alpha-1 receptors on the placenta causing an increase in placental perfusion 3. It blocks alpha-1 receptors on the placenta causing an increase in placental perfusion A. 3 only B. 1, 2 only C. 2, 3 only D. 1 only

24. D 25. A 26.A 27. D 28. C 29. A

A 60-year old hypertensive woman is currently being treated with Nitroglycerin, Carvedilol, Furosemide, Nifedipine, Ramipril, Aspirin, and Digoxin. She is admitted with a diagnosis of stage C heart failure 30. Which agent is most likely to be discontinued in this patient? A. Nifedipine B. Carvedilol C. Aspirin D. Digoxin 31. Which of the following best represents the goals of therapy for this patient? A. Treat under lying causes such as hypertension, cigarette smoking, lipid disorders B. Discourage the use of alcohol intake, illicit drug use, and dietary salt intake C. Control the metabolic syndrome D. All of the above 32. Because of proven beneficial effects on cardiac remodelling, a particular group of agents is now indicated as first - line therapy in HF patients. Which of the following is representative of this group of drugs? A. Lisinopril B. Prazosin C. Carvedilol D. Furosemide

A D A

PM, a 48-year-old bus driver, was identified by his doctor as having a resting average blood pressure of 162/92 mmHg after three clinical encounters. If he is prescribed antihypertensive, which of the following drug may require baseline renal function test before administration? A. amlodipine B. Enalapril C. propranolol D. nifedipine 34. A patient develops breast enlargement 6 six weeks after initiating medications, which of the following drug is likely to be associated with such a side effect? A. Nifedipine B. Enalapril C. Dipyridamole D. Spironolactone

B D

Which of the following ingredients has neither specific antitussive nor expectorant nor bronchodilator action, but is commonly present in proprietary cough formulations: A. Ambroxol B. Chlorpheniramine C. Guaiphenesin D. Noscapine

Bronchodilators are useful in cough: A. Only when cough is nonproductive B. Only when cough is associated with thick sticky secretions C. Only when reflex bronchoconstriction is associated D. Irrespective of nature of cough or associated features

The following antiasthma drug is not a bronchodilator: A. Ipratropium bromide B. Theophylline C. Formoterol D. Sodium cromoglycate

The most prominent and dose related side effect of salbutamol is: A. Rise in blood pressure B. Muscle tremor C. Hyperglycaemia D. Central nervous system stimulation

The following class(es) of drugs are clinically beneficial in bronchial asthma: A. Histamine H1 receptor antagonists B. Platelet activating factor (PAF) antagonists C. Leukotriene (cys LT1) receptor antagonists D. All of the above

Select the fastest acting inhaled bronchodilator: A. Ipratropium bromide B. Formoterol C. Salbutamol D. Salmeterol

Inhaled salbutamol is useful in bronchial asthma for: A. Aborting/terminating asthma attacks B. Round the clock prophylaxis of asthma C. Status asthmaticus D. All of the above

Select the correct statement about salmeterol: A. It is a long acting selective β2 agonist bronchodilator B. It is a bronchodilator with anti-inflammatory property C. It is a β blocker that can be safely given to asthmatics D. It is an antihistaminic with mast cell stabilizing property

Methylxanthines exert the following action(s) at cellular/molecular level: A. Intracellular release of Ca2+ B. Antagonism of adenosine C. Inhibition of phosphodiesterase D. All of the above

Choose the correct statement about theophylline: A. Its use in asthma has declined because of narrow safety margin B. Its dose needs to be reduced in smokers C. It acts by increasing the formation of cAMP D. Its plasma half-life is longer in children compared to that in adults

Select the antiasthma drug which cannot be administered by inhalation: A. Theophylline B. Ipratropium bromide C. Budesonide D. Terbutaline

Select the most appropriate drug for regular prophylactic therapy in a 10 year old child who suffers from exercise induced asthma: A. Oral salbutamol B. Oral theophylline C. Inhaled sodium cromoglycate D. Inhaled salmeterol

Select the drug that is neither bronchodilator nor anti-inflammatory, but has antihistaminic and mast cell stabilizing activity: A. Sodium cromoglycate B. Ketotifen C. Beclomethasone dipropionate D. Chlorpheniramine

H.B. is a 59 year old black male recently diagnosed with peptic ulcer disease (PUD) on endoscopy. Tissue biopsy is positive for H. pylori. Which of the following is the ideal therapeutic regimen for H. pylori related PUD for H.B? A. Omeprazole, Bismuth, Tetracycline, Furazolidone B. Omeprazole, Amoxicillin, Clarithromycin C. Omeprazole, Amoxicillin D. Omeprazole, Bismuth Clarithromycin, Furazolidone 49. If H.B in question 57 does not respond to his appropriate medication chosen above, which of the following would be the best choice? a. Clarithromycin should be replaced by tetracycline b. Clarithromycin should be replaced by metronidazole c. Clarithromycin dosage should be increased d. Clarithromycin should be replaced by Furazolidone 50. Anti-infectives that are used in the triple-therapy regimens to eradicate Helicobacter pylori include: i. metronidazole ii. clarithromycin iii. telithromycin 1. 1,2,3 2. 1 & 2 only 3. 2 only 4. 3 only

B B 2

Which one of the following is a side-effect of pioglitazone? A. liver dysfunction B. renal impairment C. Hyperkalaemia D. tardive dyskinesia

When mixing rapid-or short acting insulin with intermediate or long acting insulin, which insulin in the list below should be drawn up first? A. Regular B. NPH C. Lente D. Glargine

Uniform dispersion of insulin suspension can be obtained by: A. Vigorous shaking the vial B. Rolling the vial gently between the hands C. Warming the vial in a microwave D. Packing the vial in dry ice

Diabetes mellitus is the leading cause of which of the following complications? A. Pancreatitis B. Blindness C. Stroke D. Deafness

Acute kidney injury is defined when one of the following criteria is met except: A. Serum creatinine rises by ≥ 26μmol/L within 48 hours B. Serum creatinine rises ≥ 1.5 fold from the reference value, which is known or presumed to have occurred within one week C. Urine output is < 0.5ml/kg/hr for >6 consecutive hours D. Kidney damage or GFR <60 ml/min/1.73m2 present on at least 2 occasions for ≥3 months

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause all of the following adverse effects on the kidney except: A. Crystalluria B. Glomerulonephritis C. Acute tubular necrosis D. Interstitial nephritis

In relation to anaemia in Chronic kidney disease (CKD), which of the following statements is false: A. Affects most people with CKD stages 1 and 2. B. A normochromic and normocytic pattern is usually seen. C. Haemoglobin levels fall to around 8g/dL by end stage renal disease. D. The principal cause results from damage to peritubular cells leading to inadequate secretion of erythropoietin

In relation to renal replacement therapy, which of the following drug characteristics do not favour clearance by dialysis? A. Low molecular weight B. Low protein binding C. Large volume of distribution D. High water solubility

Regarding ACEI therapy in CKD, which one of the following statements is false? A. Measure serum concentrations of potassium and GFR before starting ACEI therapy B. ACEI therapy should not normally be started if the pre-treatment serum potassium concentration is above > 5mmol/L C. Stop ACEI therapy serum potassium concentration rises above 6.0mmol/L D. ACEI therapy is not contraindicated in CKD patients with bilateral renal artery stenosis.

Regarding urinary tract infection (UTI), which one of the following statement(s) is incorrect? a. presence of leukocyte esterase indicates the absence of white blood cells in urine b. Up to 80% of community acquired UTIs are caused by Escherichia coli c. Treatment courses should be for 7- 10 days and longer in prostatitis d. Pyelonephritis can be life threatening and must be treated aggressively with a broad spectrum cephalosporin, e.g. cefuroxime (+/- gentamicin) or quinolone

Which one of the following organisms is the most prevalent cause of urinary tract infections (UTI)? A. Staphylococcus aureus B. Klebsiella C. E. coli D. Pseudomonas auriginosa

When treating urethritis especially in young women, it is highly recommended to give treatment that also covers: A. E. coli B. Chlamydia trachomatis C. H. influenza D. Staphylococcus aureus

General principles of anti-infective therapy are: A. Clinical judgment of microbiological factors B. Definitive identification of a bacterial infection and the microorganism’s susceptibility C. Optimal route of administration, dose, dosing frequency and duration of treatment D. All of the above

What is the minimal duration of antibacterial treatment? A. Not less than 1 day B. Not less than 5 days C. Not less than 10-14 days D. Not less than 3 weeks

Rational anti-microbial combination is used to: A. Provide synergism when microorganisms are not effectively eradicated with a single agent alone B. Provide broad coverage C. Prevent the emergence of resistance D. All of the above

Which of the following cephalosporin has antipseudomonal activity? A. Cephalexin B. Cefuroxime C. Ceftriaxone D. Ceftazidime

The following beta-lactam drug is combined with cilastatine to prevent its renal metabolism? A. Meropenem B. Imipenem C. Vancomycin D. Aztreanam

Which one of the following is the drug of choice for treating antibiotic induced diarrhea? is: A. Aztreonam B. Vancomycin C. Meropinem D. Imipenem

Which one of the following macrolide has activity against mycoplasma gondii? A. Talithromycin B. Erythromycin C. Clarythromycin D. Azithromycin

What is the anti-malaria drug of choice for treatment of severe malaria? A. Artesunate injection B. Artemether injection C. Quinine injection D. Artemether-lumefantrine

What are the routes of administration for artesunate injection? A. IV only B. IV and IM only C. IV and SC D. Intrathecal

72. What alternative drugs should be used for the treatment of severe malaria? A. Quinine and Artemether B. Premaquine C. Artemether-lumefantrine D. Dihydroartemisin-piperaquine

What are the recommended dosages of Injectable Artesunate for the treatment of severe malaria? A. 2.4 mg/kg body weight IV or IM stat B. 2.4 mg/kg body weight IV/IM if above 20kg at 0, 12, 24hrs and once a day for 6days C. 3.0 mg/kg body weight IV/IM if above 20kg at 0, 12, 24hrs and once a day for 6days D. 2.4 mg/kg body weight IV/IM if below 20kg at 0, 12, 24hrs and once a day for 6days

The Physician makes the consultation to the clinical pharmacist regarding the prophylaxis medication to be given to nursing students who were in contact with a patient diagnosed with meningitis. Which of the following is(are) the likely causative organism(s) 1. Group B Streptococcal 2. S. Pneumoniae 3. N. Meningitidis A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 3 only 75. With reference to question 96 which of the following organism(s) are likely to cause meningitis in neonates? 1. N. meningitidis 2. Group B streptococci 3. Haemophylus influenzae type B A. 1, 2, 3 B. 1, 2 only C. 2 only D. 3 only

D C

What are the benefits of adjunctive steroid therapy use in bacterial meningitis? 1. reduce the rate of mortality 2. reduce hearing loss 3. reducing paralysis and speech loss A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 3 only 77. Regarding adjunctive steroid therapy use: 1. should be initiated 10 to 20 minutes before the use of antibiotics 2. should be initiated with the first dose of antibiotics 3. should be continued throughout antibiotic therapy A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 3 only

A B

In relation to criteria for starting antiretroviral therapy, which of the following is correct? A. CD4 count ≤500 cells/mm3 in adolescents and adults. B. WHO Clinical stage 3 or 4 in adolescents and adults C. CD4 count ≤500 cells/mm3 in pregnant and breastfeeding women. D. Initiate treatment regardless of the CD4 cell count or WHO clinical stage

LK is an HIV patient who recently failed the second-line regimen. Which of his third -line regimen antiretroviral drugs requires a tropism test just prior to commencing treatment? A. Maraviroc B. Etravirine C. Raltegravir D. Darunavir

In relation to highly active antiretroviral therapy, the following combinations of antiretroviral drugs should be avoided except: A. Zidovudine and stavudine B. Stavudine and didanosine C. Tenofovir and didanosine D. Tenofovir and lamivudine

Which of the following antiretroviral drugs blocks the integration of viral DNA into host DNA by binding to the integrase enzyme? A. Raltegravir B. Rilpivirine C. Etravirine D. Atazanavir

Mr DB, a 38 year old HIV sero-positive patient underwent HLA B* 5701 testing prior to starting his antiretroviral therapy and was found to be B* 5701 positive. Which of the following drugs if used in Mr DB is more likely to be associated with hypersensitivity reactions? A. Nevirapine B. Lamivudine C. Abacavir D. Emtricitabine

Mrs CM has HIV infection and coronary heart disease with remarkable hyperlipidaemia. Which of the following protease inhibitors may be most appropriate for her? A. Saquinavir B. Darunavir C. Fosamprenavir D. Atazanavir

With respect to tenofovir, which of the following statements is not correct? A. It can be taken with or without food B. It is a nucleoside analogue reverse transcriptase inhibitor C. It causes renal impairment and hypophosphataemia D. It is mostly eliminated unchanged in the urine

With respect to management of Hepatitis B Virus (HBV) and HIV co-infection, all the statements are true except: A. Hepatitis B surface antigen (HBsAg) should be done at baseline and in patients with unknown HBV status. B. Start TDF-containing regimen regardless of CD4 count C. Patients failing first line TDF- containing treatment should not continue the TDF in their second line therapy to control their HBV infection. D. Discontinuation of combination HBV therapy can be associated with a fatal flare-up of hepatitis.

Which of the following NNRTIs is effective in HIV-2? A. Efavirenz B. Niverapine C. Etravirine D. Lopinavir

Which protease inhibitor is not effective in HIV-2? A. Lopinavir B. Ritonavir C. Darunavir D. Atazanavir

Mr. PM, a 27 year old male presented to his Doctor in E02 ward with vesicles unilaterally around his neck and left eye. He complained of pain he described as stubbing and irritating. On examination, his lymph nodes were enlarged and tender to touch. He was preliminary diagnosed with herpes zoster and was advised to have an HIV test and was later found to be positive, with a CD4 count of 700 cells/µL. The Doctor prescribed Acyclovir 200mg 5 times daily and Acyclovir eye drops, 2 drops to be instilled in the left eye 5 times daily. 89. Mr. PM’s pain can be best managed with: 1. Ibuprofen 2. Codeine with Paracetamol 3. Gabapentin A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 3 only 90. If at all Mr. PM was prescribed TDF + 3TC + NVP, Which classes of pharmacological agents would you advise him to avoid while on this chosen antiretroviral regimen? 1. Rifabutin 2. Rifampicin 3. Phenobarbitone A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 1 only

D C

Following drugs stimulate erythrogenesis EXCEPT: A. Iron dextran B. Vitamin B12 C. Methotrexate D. Folic acid

Choose the drug that depresses erythrogenesis: A. Chloramphenicol B. Ferrous sulfate C. Ferrous fumerate D. Folic acid

All of the following drugs are used for iron deficiency anemia EXCEPT: A. Ferrous sulfate B. Folic acid C. Ferrous gluconate D. Ferrous fumarate

Which of the following drugs is indicated for parenteral iron therapy? A. Ferrous sulfate B. Iron sucrose C. Ferrous lactate D. Ferrous fumarate

Indicate the drug which increases absorption of iron from intestine: A. Cyanocobalamin B. Folic acid C. Ascorbic acid D. Erythropoetin

Which one of the following drugs is not administered orally? A. Ferrous sulfate B. Iron dextran C. Ferrous lactate D. Ferrous fumarate

Pernicious anemia developes due to deficiency of: A. Erythropoetin B. Vitamin B12 C. Iron D. Vitamin B6

Select the drug used for pernicious anemia: A. Ferrous lactate B. Cyanocobalamin C. Iron dextran D. Ferrous gluconate

Which one of the following is an adverse effect of oral iron therapy? A. Anemia B. Thrombocytopenia C. Headache D. Constipation

Which one of the following drugs is used in aplastic anemia: A. Iron sucrose B. Cyanocobalamine C. Epoetin alpha C. Folic acid

AM is 16 year old prima gravida at 30 weeks gestation age. She goes to the antenatal clinic as usual. Her BP is 160/115mmHg and protein on urinalysis is 3+. She is complaining of nausea, epigastric pain, blurred vision and severe headache. There is positive family history of hypertension. What is the diagnosis for AM? A. Gestational hypertension B. Chronic hypertension C. Severe pre-eclampsia D. Mild pre-eclampsia 103. In reference to question 102 all of the following are risk factors for pre-eclampsia EXCEPT: A. Prima gravida B. Age C. Family history D. Proteinuria 104. With reference to question 102 which set of signs/symptoms are indicative of impending eclampsia? A. Nausea + epigastric pain + blurred vision B. BP +headache + proteinuria C. Proteinuria + BP + nausea D. None of the above 105. With reference to question 102, Which drug would you recommend for AM in view of her diastolic BP? A. Methyldopa B. Hydralazine C. Frusemide D. Nifedipine 106. What would be the benefit of using labetalol in patient AM in 102? A. causes reduction in plentacental perfusion due to beta one receptor inhibition B. causes reduction in placental perfusion due to alpha one receptor inhibition C. causes an increase in placental perfusion due to alpha one receptor inhibition D. causes a decrease in placental perfusion due to alpha one receptor inhibition 107. Which drug would you recommend for patient AM in question 102 in view of the impending eclampsia? A. Magnesium trisilicate B. Parenteral labetalol C. Magnesium sulphate D. Carbamazepine

102. C 103. D 104.A 105. B 106. C 107. C

Oxytocin is used for the following EXCEPT: A. Induction of labour B. Augumentation of labour C. Production and ejection of breast milk D. As a tocolytic

Which one of the following drug combinations is used in pre-term premature rapture of membranes? A. Ciprofloxacin + Metronidazole B. Erythromycin + Metronidazole C. Doxycycline + Metronidazole D. Amoxiclav + Metronidazole

Steroids may be administered in pregnancy between 24 and 34 weeks for the following reasons EXCEPT: A. Foetal lung maturation B. To prevent intraventricular haemorrhage C. To prevent foetal respiratory distress D. Maternal foetal lung maturation

The following are used to induce labour EXCEPT…? A. Mifepristone B. Misoprostol C. Oxytocin D. Catheter

Mr. FT is a 50 year old man. He weighs 95kg and is about 1.6m tall; he smokes at least 20 cigarettes a day and has been smoking for the past 20 years. He drinks moderately. Mr. FT is an international track driver who covers at least 10000km in a week. 3 days ago he started having a sharp pain in the left leg around the calf muscle and he felt the leg being tight and the leg started swelling. He gets a bit of relief when he elevates the affected leg and when he takes aspirin 600mg. Today he comes to the hospital complaining of the same pain and swelling of the left leg and the attending physician decides to give him an injection of diclofenac 75mg IM and makes an impression of deep vein thrombosis (DVT). The physician decides to start Mr. FT on warfarin 10mg OD and enoxaparin 1.5mg/kg SC OD for 5 days. 112. What risk factors does FT have for developing DVT? 1.BMI of about 37 2.Smoking 3.Travelling long distances A.1, 2, 3 B.1, 2 only C.2, 3 only D.1 only 113. Why should FT be prescribed with both warfarin and enoxaparin in the initial phase? 1. Warfarin is prothrombic in the initial phase especially when using a high dose 2. Warfarin has no effect on already formed clotting factors thus takes about 3-5 days to exert effects 3. Enoxaparin causes lysis of the thrombus A.1, 2, 3 B.1, 2 only C.2, 3 only D.3 only 114 What is the therapeutic target INR for FT? 1. 2-3 2. 0.83-1.2 3. None of the above A. 1, 2, 3 B. 1, 2 only C. 2, 3 only D. 1 only 115.If you decide to monitor effects of enoxaparin, which one is the most appropriate parameter to monitor? 1. INR 2. aPTT 3. Activated factor X A. 1, 2, 3 B. 1, 2 only C. 3 only D. 2, 3 only

112. A 113. B 114. D 115. C