Physician Assistant Pharmaceutical Therapeutics 2

Question 1

A patient with CKD stage 3 is started on metformin. Which creatinine clearance threshold requires discontinuation of metformin?

Accepted Answer

< 30 mL/min

Answer

Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to risk of lactic acidosis.

Question 2

Which antibiotic class is most appropriate for empiric treatment of community-acquired pneumonia in an otherwise healthy outpatient with no recent antibiotic use?

Accepted Answer

Macrolide monotherapy

Answer

IDSA/ATS guidelines recommend macrolide monotherapy (e.g., azithromycin) for healthy outpatients with no comorbidities.

Question 3

A 65-year-old on warfarin for atrial fibrillation starts clarithromycin. What adjustment is needed?

Accepted Answer

Reduce warfarin dose and monitor INR closely

Answer

Clarithromycin inhibits CYP3A4 and CYP2C9, reducing warfarin metabolism and increasing INR; dose reduction and close monitoring are required.

Question 4

Which NSAID is preferred in a patient who requires analgesia and has a history of peptic ulcer disease with H. pylori eradication completed?

Accepted Answer

Celecoxib with a PPI

Answer

A COX-2 selective inhibitor combined with a PPI provides analgesia with the lowest GI risk in patients with prior ulcer disease.

Question 5

A patient taking lisinopril develops a dry, nonproductive cough. What is the most appropriate alternative antihypertensive?

Accepted Answer

Losartan

Answer

ARBs (e.g., losartan) do not cause bradykinin accumulation and are the preferred substitute for ACE inhibitor-induced cough.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Pharmaceutical Therapeutics 2