SPEX SPEX Analysis Exam 3

Question 1

A patient taking warfarin is started on fluconazole. What pharmacokinetic interaction should the physician anticipate?

Accepted Answer

Increased warfarin effect due to CYP2C9 inhibition

Answer

Fluconazole inhibits CYP2C9, which metabolizes warfarin, leading to elevated warfarin levels and increased bleeding risk.

Question 2

Which of the following best describes the mechanism of action of metformin in Type 2 diabetes?

Accepted Answer

Inhibits hepatic gluconeogenesis via AMPK activation

Answer

Metformin primarily activates AMPK, which suppresses hepatic gluconeogenesis and improves insulin sensitivity.

Question 3

A 66-year-old man develops acute gout. His renal function is impaired (GFR 25 mL/min). Which agent is most appropriate to treat the acute attack?

Accepted Answer

Low-dose colchicine or corticosteroids

Answer

In patients with renal impairment, low-dose colchicine or corticosteroids are preferred because NSAIDs and standard colchicine dosing carry significant toxicity risks.

Question 4

A patient with schizophrenia develops muscle rigidity, high fever, altered consciousness, and autonomic instability after starting haloperidol. What is the diagnosis?

Accepted Answer

Neuroleptic malignant syndrome

Answer

Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by hyperthermia, rigidity, autonomic instability, and altered mental status.

Question 5

Which class of antihypertensive medications is contraindicated in bilateral renal artery stenosis?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors block efferent arteriolar constriction, reducing GFR in bilateral renal artery stenosis and potentially causing acute renal failure.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX SPEX Analysis Exam 3