PEBC Diagnostic Procedures 4

Question 1

A patient presents with a serum potassium of 6.2 mmol/L. Which ECG change is expected first?

Accepted Answer

Peaked T waves

Answer

Peaked (tall, narrow) T waves are the earliest ECG manifestation of hyperkalemia, occurring before P wave changes or QRS widening.

Question 2

Which interpretation of a fasting plasma glucose (FPG) result would indicate prediabetes (impaired fasting glucose) according to Canadian guidelines?

Accepted Answer

FPG 5.6–6.9 mmol/L

Answer

A fasting plasma glucose of 6.1–6.9 mmol/L (per Diabetes Canada guidelines) indicates impaired fasting glucose (prediabetes).

Question 3

A 70-year-old patient's serum creatinine is within normal limits but their eGFR is 52 mL/min/1.73m². What does this discrepancy reflect?

Accepted Answer

Age-related decrease in muscle mass leading to lower creatinine production

Answer

Elderly patients have reduced muscle mass and thus lower creatinine production, causing serum creatinine to appear normal despite significantly reduced GFR.

Question 4

A patient is started on methotrexate for rheumatoid arthritis. Which baseline and monitoring tests are essential?

Accepted Answer

CBC, LFTs, serum creatinine, and chest X-ray

Answer

Methotrexate requires baseline and periodic CBC (bone marrow suppression), LFTs and albumin (hepatotoxicity), renal function, and chest X-ray (pulmonary toxicity) monitoring.

Question 5

Which finding on a urinalysis would most suggest a urinary tract infection?

Accepted Answer

Positive nitrite and positive leukocyte esterase

Answer

Positive nitrite (bacterial nitrate reduction) combined with positive leukocyte esterase (pyuria) strongly suggests a bacterial urinary tract infection.

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC Diagnostic Procedures 4