FPGEE FPGEE MCQ Exam 2 — Questions and Answers
Question 1: A patient with severe renal impairment (CrCl < 30 mL/min) requires anticoagulation. Which agent requires the MOST significant dose adjustment?
- Warfarin
- Dabigatran (Correct answer)
- Apixaban
- Fondaparinux
Correct answer: Dabigatran
Dabigatran is 80% renally eliminated and is contraindicated in severe renal impairment (CrCl < 30 mL/min).
Question 2: Which pharmacokinetic parameter is most affected by hepatic enzyme induction by rifampin?
- Volume of distribution
- Renal clearance
- Oral bioavailability and hepatic clearance (Correct answer)
- Protein binding
Correct answer: Oral bioavailability and hepatic clearance
Rifampin induces CYP450 enzymes, increasing hepatic metabolism and reducing oral bioavailability of susceptible drugs.
Question 3: A prescriber orders aminoglycoside therapy. Which parameter best correlates with aminoglycoside efficacy?
- Time above MIC
- AUC/MIC ratio
- Peak/MIC ratio (Correct answer)
- Trough concentration
Correct answer: Peak/MIC ratio
Aminoglycosides exhibit concentration-dependent killing; their efficacy correlates best with the peak concentration to MIC ratio.
Question 4: Which receptor mechanism is responsible for the therapeutic effect of benzodiazepines in treating anxiety?
- Blockade of NMDA receptors
- Positive allosteric modulation of GABA-A receptors (Correct answer)
- Inhibition of serotonin reuptake
- Agonism at adenosine receptors
Correct 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.
Question 5: A patient on methotrexate presents with mucositis. Which agent is used to rescue from methotrexate toxicity?
- N-acetylcysteine
- Leucovorin (folinic acid) (Correct answer)
- Mesna
- Dexrazoxane
Correct answer: Leucovorin (folinic acid)
Leucovorin (folinic acid) bypasses the dihydrofolate reductase enzyme blocked by methotrexate, restoring folate function.
Question 6: According to USP <797>, what is the beyond-use date for a high-risk compounded sterile preparation stored at room temperature?
- 24 hours (Correct answer)
- 48 hours
- 72 hours
- 30 days
Correct answer: 24 hours
Under USP <797>, high-risk compounded sterile preparations stored at room temperature must be used within 24 hours.
Question 7: Which drug class is associated with development of drug-induced lupus erythematosus?
- ACE inhibitors
- Hydralazine and procainamide (Correct answer)
- Thiazide diuretics
- Beta-blockers
Correct answer: Hydralazine and procainamide
Hydralazine, procainamide, and isoniazid are classic causes of drug-induced lupus erythematosus.
FPGEE FPGEE MCQ Exam 2
A patient with severe renal impairment (CrCl < 30 mL/min) requires anticoagulation.
Which agent requires the MOST significant dose adjustment?