FPGEE FPGEE MCQ Exam 5 — Questions and Answers
Question 1: A pharmacist is counseling a patient on how to administer insulin glargine. Which statement is correct?
- It can be mixed with regular insulin in the same syringe
- It must be administered once daily at any consistent time and never mixed (Correct answer)
- It should be given 30 minutes before meals
- It requires refrigeration at all times even after opening
Correct answer: It must be administered once daily at any consistent time and never mixed
Insulin glargine is a peakless basal insulin given once daily and cannot be mixed with other insulins because altering its pH destroys its slow-release properties.
Question 2: Which vitamin deficiency is MOST likely in a strict vegan who has not taken any supplements for 5 years?
- Vitamin A
- Vitamin D
- Vitamin B12 (cobalamin) (Correct answer)
- Vitamin K
Correct answer: Vitamin B12 (cobalamin)
Vitamin B12 is found almost exclusively in animal products; strict vegans are at high risk of B12 deficiency leading to megaloblastic anemia and neuropathy.
Question 3: A drug follows first-order kinetics with a half-life of 6 hours. Approximately how long until steady-state is reached with regular dosing?
- 6 hours
- 12 hours
- 30 hours (Correct answer)
- 60 hours
Correct answer: 30 hours
Steady-state is achieved after approximately 4–5 half-lives; 5 × 6 hours = 30 hours.
Question 4: Which antifungal mechanism involves binding to ergosterol and forming pores in the fungal cell membrane?
- Azoles (fluconazole)
- Echinocandins (caspofungin)
- Polyenes (amphotericin B) (Correct answer)
- Allylamines (terbinafine)
Correct answer: Polyenes (amphotericin B)
Amphotericin B and other polyenes bind directly to ergosterol in the fungal membrane, forming pores that cause leakage of intracellular contents.
Question 5: Under the Drug Quality and Security Act (DQSA), which category of compounders is regulated directly by the FDA as an outsourcing facility?
- 503A pharmacies compounding for individual patients
- 503B outsourcing facilities producing large-scale sterile preparations (Correct answer)
- Hospital inpatient pharmacies
- Compounding pharmacies registered with state boards only
Correct answer: 503B outsourcing facilities producing large-scale sterile preparations
503B outsourcing facilities voluntarily register with the FDA, allowing large-scale compounding of sterile preparations without patient-specific prescriptions under federal oversight.
Question 6: A patient receiving vancomycin for MRSA bacteremia has a trough level of 8 mg/L. What is the appropriate clinical action?
- Decrease the dose to avoid toxicity
- No change needed; level is within therapeutic range
- Increase dose or frequency to achieve AUC/MIC ≥ 400 (Correct answer)
- Switch to linezolid immediately
Correct answer: Increase dose or frequency to achieve AUC/MIC ≥ 400
Current ASHP/IDSA guidelines recommend AUC-guided vancomycin dosing targeting AUC/MIC ≥ 400; a trough of 8 mg/L suggests subtherapeutic exposure for serious infections.
Question 7: Which electrolyte abnormality is MOST commonly associated with loop diuretic therapy?
- Hyperkalemia
- Hypernatremia
- Hypokalemia and hypomagnesemia (Correct answer)
- Hyperphosphatemia
Correct answer: Hypokalemia and hypomagnesemia
Loop diuretics inhibit the Na-K-2Cl cotransporter in the thick ascending limb, causing substantial urinary losses of potassium and magnesium.
FPGEE FPGEE MCQ Exam 5
A pharmacist is counseling a patient on how to administer insulin glargine.
Which statement is correct?