PACS Medical Terminology & Drug Classifications 3 — Questions and Answers
Question 1: In prior authorization, 'step therapy' requires a patient to:
- Obtain a specialist referral before starting treatment
- Try preferred or lower-cost medications before approving a higher-cost agent (Correct answer)
- Complete a physical therapy program before surgery approval
- Enroll in a disease management program
Correct answer: Try preferred or lower-cost medications before approving a higher-cost agent
Step therapy mandates that patients try and fail less expensive or preferred medications before a plan will approve a costlier alternative.
Question 2: The medical root word 'cardio' relates to which body system?
- Respiratory
- Neurological
- Cardiovascular (Correct answer)
- Gastrointestinal
Correct answer: Cardiovascular
'Cardio' derives from the Greek word for heart and is used in terms like cardiomyopathy, cardiology, and cardiovascular disease.
Question 3: Biologics are a category of drugs that are distinct from small-molecule drugs because they are:
- Derived from living organisms or contain biological components (Correct answer)
- Available only in oral tablet form
- Exclusively used for cancer treatment
- Approved only for pediatric patients
Correct answer: Derived from living organisms or contain biological components
Biologics are complex molecules derived from living cells (bacteria, yeast, mammalian cells) and include monoclonal antibodies, vaccines, and gene therapies.
Question 4: What does 'PRN' mean in prescription directions?
- Every night at bedtime
- As needed (Correct answer)
- Twice daily
- With meals
Correct answer: As needed
PRN is a Latin abbreviation for 'pro re nata,' meaning as needed or as circumstances require.
Question 5: Which suffix indicates surgical removal of an organ or structure?
- -oscopy
- -plasty
- -ectomy (Correct answer)
- -otomy
Correct answer: -ectomy
'-ectomy' means surgical removal, as in appendectomy (removal of the appendix) or mastectomy (removal of breast tissue).
Question 6: Non-formulary drugs in a health plan typically require prior authorization because:
- They are always generic medications
- They are not included on the plan's approved drug list and may have preferred alternatives (Correct answer)
- They require a specialist to prescribe them
- They are only dispensed at specialty pharmacies
Correct answer: They are not included on the plan's approved drug list and may have preferred alternatives
Non-formulary drugs fall outside the plan's covered drug list, so PA is used to evaluate medical necessity before granting coverage exceptions.
Question 7: Antipsychotic medications are primarily indicated for conditions such as:
- Hypertension and atrial fibrillation
- Schizophrenia and bipolar disorder (Correct answer)
- Bacterial infections and sepsis
- Osteoporosis and fracture prevention
Correct answer: Schizophrenia and bipolar disorder
Antipsychotics, including first-generation agents like haloperidol and second-generation agents like quetiapine, treat psychotic disorders and mood stabilization.
PACS Medical Terminology & Drug Classifications 3
In prior authorization, 'step therapy' requires a patient to: