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Clinical Pharmacy Flashcards

7 cards from real FPGEE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient receiving heparin for DVT develops a 50% drop in platelet count on day 8. What is the most likely diagnosis?

    Answer: Heparin-induced thrombocytopenia (HIT)

    A platelet drop of ≥50% occurring 5–14 days after heparin initiation is the hallmark presentation of HIT.

  2. Which class of medications is first-line for reducing cardiovascular mortality in patients with reduced ejection fraction heart failure?

    Answer: ACE inhibitors or ARBs

    ACE inhibitors (and ARBs as alternatives) are first-line for HFrEF due to proven reductions in mortality and hospitalization.

  3. A pharmacist reviews a prescription for sildenafil in a patient using isosorbide mononitrate. What should the pharmacist do?

    Answer: Refuse to dispense due to a life-threatening interaction

    Concurrent use of PDE-5 inhibitors with any nitrate is absolutely contraindicated due to severe, potentially fatal hypotension.

  4. A patient with type 2 diabetes and established ASCVD is inadequately controlled on metformin. Which add-on agent provides both glycemic control and cardiovascular mortality reduction?

    Answer: Empagliflozin

    SGLT-2 inhibitors like empagliflozin have demonstrated significant reductions in cardiovascular death in patients with established ASCVD.

  5. What is the mechanism by which aminoglycosides cause nephrotoxicity?

    Answer: Accumulation in proximal tubular cells causing necrosis

    Aminoglycosides are taken up by proximal tubular cells where they accumulate and cause tubular necrosis.

  6. A patient on lithium is started on ibuprofen for arthritis pain. Which monitoring parameter is most urgent?

    Answer: Serum lithium level

    NSAIDs reduce renal prostaglandin synthesis, decreasing lithium clearance and raising serum lithium to potentially toxic levels.

  7. Which anticoagulant requires no routine laboratory monitoring for dose adjustment in a patient with normal renal function?

    Answer: Rivaroxaban

    Direct oral anticoagulants (DOACs) like rivaroxaban have predictable pharmacokinetics and do not require routine monitoring in patients with normal renal function.