FPGEE MCQ Exam Flashcards

A patient with severe renal impairment (CrCl < 30 mL/min) requires anticoagulation. Which agent requires the MOST significant dose adjustment?

Answer: Dabigatran

Dabigatran is 80% renally eliminated and is contraindicated in severe renal impairment (CrCl < 30 mL/min).

Which pharmacokinetic parameter is most affected by hepatic enzyme induction by rifampin?

Answer: Oral bioavailability and hepatic clearance

Rifampin induces CYP450 enzymes, increasing hepatic metabolism and reducing oral bioavailability of susceptible drugs.

A prescriber orders aminoglycoside therapy. Which parameter best correlates with aminoglycoside efficacy?

Answer: Peak/MIC ratio

Aminoglycosides exhibit concentration-dependent killing; their efficacy correlates best with the peak concentration to MIC ratio.

Which receptor mechanism is responsible for the therapeutic effect of benzodiazepines in treating anxiety?

Answer: Positive allosteric modulation of GABA-A receptors

Benzodiazepines enhance the effect of GABA at GABA-A receptors by positive allosteric modulation, increasing chloride ion conductance.

A patient on methotrexate presents with mucositis. Which agent is used to rescue from methotrexate toxicity?

Answer: Leucovorin (folinic acid)

Leucovorin (folinic acid) bypasses the dihydrofolate reductase enzyme blocked by methotrexate, restoring folate function.

According to USP , what is the beyond-use date for a high-risk compounded sterile preparation stored at room temperature?

Answer: 24 hours

Under USP , high-risk compounded sterile preparations stored at room temperature must be used within 24 hours.

Which drug class is associated with development of drug-induced lupus erythematosus?

Answer: Hydralazine and procainamide

Hydralazine, procainamide, and isoniazid are classic causes of drug-induced lupus erythematosus.