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Diagnostic Procedures Flashcards

7 cards from real PEBC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient on lithium therapy has a serum lithium level of 1.8 mmol/L. The therapeutic range is 0.6–1.2 mmol/L. Which symptom is most consistent with lithium toxicity?

    Answer: Coarse tremor, ataxia, and confusion

    Serum lithium > 1.5 mmol/L indicates serious toxicity, manifesting as coarse tremor, ataxia, confusion, and in severe cases, seizures or coma.

  2. Which test is the gold standard for diagnosing pulmonary embolism?

    Answer: CT pulmonary angiography (CTPA)

    CT pulmonary angiography is the preferred and gold standard imaging modality for diagnosing pulmonary embolism due to its high sensitivity and specificity.

  3. A patient's stool culture is positive for Clostridioides difficile toxin. Which test characteristic makes the PCR assay preferred over enzyme immunoassay (EIA) for toxin detection?

    Answer: Higher sensitivity for detecting toxin genes

    PCR-based testing detects the toxin gene with higher sensitivity than EIA toxin detection, reducing the rate of false-negative results in C. difficile infection diagnosis.

  4. A pharmacist is counselling a patient about their INR result of 1.1 while on warfarin for atrial fibrillation (target INR 2.0–3.0). Which is the most likely cause of a subtherapeutic INR?

    Answer: Increased dietary vitamin K intake

    Vitamin K competes with warfarin's mechanism, and a high dietary intake of vitamin K–rich foods reduces warfarin's anticoagulant effect, leading to a subtherapeutic INR.

  5. A patient is referred for a bone mineral density (BMD) test. Their T-score at the femoral neck is −2.6. How should the pharmacist interpret this result?

    Answer: Osteoporosis

    A T-score of −2.5 or lower is diagnostic of osteoporosis per WHO criteria; a T-score of −2.6 meets this threshold.

  6. Which laboratory result is a contraindication to initiating metformin therapy?

    Answer: eGFR 28 mL/min/1.73m²

    Metformin is contraindicated when eGFR < 30 mL/min/1.73m² due to the risk of lactic acidosis from drug accumulation; caution is advised at eGFR 30–45.

  7. A neonatal screen returns positive for phenylketonuria (PKU). Which confirmatory diagnostic test is required?

    Answer: Serum phenylalanine and tetrahydrobiopterin (BH4) loading test

    Confirmatory diagnosis of PKU requires elevated serum phenylalanine levels and a BH4 loading test to differentiate classic PKU from BH4-responsive forms and BH4 deficiencies.