FPGEE FPGEE MCQ Exam 2

Question 1

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

Accepted Answer

Dabigatran

Answer

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?

Accepted Answer

Oral bioavailability and hepatic clearance

Answer

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?

Accepted Answer

Peak/MIC ratio

Answer

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?

Accepted Answer

Positive allosteric modulation of GABA-A receptors

Answer

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?

Accepted Answer

Leucovorin (folinic acid)

Answer

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

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