Question 1

CJ is a 69-year-old male with a history of diabetes, hypertension and hypercholesterolemia. His fasting lipid

profile is TC 530 mg/dL; LDL-C 125; HDL-C 48 mg/dL; and TG 640 mg/dL. His A1c 8.1, calculate creatinine

clearance is 65mls/hr, BP 135/80 mm Hg, HR 70 beats /min.

His current medications include metformin 1000mg po bid, lisinopril 20mg daily, sitagliptin 50mg bid and

atorvastatin 40mg daily.

What is the best pharmacological agent to initiate on CJ?

Options :

A : Increase atorvastatin to 80mg

B : Niacin 500mg twice daily

C : Fenofibrate 162mg daily

D : Gemfibrozil 600mg twice daily

E : Fish oil 500mg twice daily

Answer: C

Question 2

Which of these is an example of postrenal acute kidney injury (AKI)?

Options :

A : Benign prostatic hyperplasia

B : Heart failure

C : Dehydration

D : Renal vein thrombosis

Answer: A

Question 3

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and

NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and

chronic back pain. Post-op day 1, LN’s medication includes Dexamethasone 8mg iv q6h with taper dosing,

Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram

20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for

constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS

with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1mg. lockout every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg

1.5mg/dl, K 5.0mmol/L, Na 135mmol/L. Day 3 post-operation LN’s pain was much better and only used 3

mg of hydromorphone in the 24hrs.

Physician wants to change to oral morphine. What would be your best recommendation?

Options :

A : Morphine SR 10mg po daily and morphine 5mg po q6h prn for breakthrough pain

B : Morphine 60mg ER po daily and morphine 15mg po q6h prn breakthrough pain

C : Morphine 30mg ER po q6hr and morphine 5mg q6h prn for breakthrough pain

D : Morphine 15mg ER po q12hr and morphine 15mg po q6h prn for breakthrough pain

E : Morphine 15mg ER po q12hr and morphine 5mg po q6h prn breakthrough pain

Answer: A

Question 4

A physician orders Dopamine 5 mcg/kg/min. The concentration of the Dopamine IV bag is 400 mg in 250 D5W. The patient’s weight is 168 lbs. Calculate the infusion rate in mL/hr.

Options :

A : 10.2mls/hr

B : 5.2mls/hr

C : 14.29mls/hr

D : 22.4mls/hr

E : 0.17mls/hr

Answer: C

Question 5

Which of the following Anti-epileptic medication can cause pancreatitis?

Options :

A : Carbamazepine

B : Gabapentin

C : Valproic acid

D : Levetiracetam

E : Phenobarbital

Answer: C

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