1- 85 year-old woman is taking ferrous sulfate to treat an iron deficiency anemia. Changes in which one of the following pharmacokinetic properties associated with aging can most affect this agent?
A. Absorption.
B. Di
...
1- 85 year-old woman is taking ferrous sulfate to treat an iron deficiency anemia. Changes in which one of the following pharmacokinetic properties associated with aging can most affect this agent?
A. Absorption.
B. Distribution.
C. Metabolism.
D. Renal elimination
**
2- All the following patients are seeing their pediatrician today and are due for immunizations on the basis of the routine schedule. For which one of the following patients would it be best to recommend deferring immunizations until later?
A. 12-month-old boy who recently completed a cycle of chemotherapy for acute lymphocytic leukemia.
B-6-month-old girl receiving amoxicillin for otitis media.
C -12-month-old HIV-positive boy who’s most recent CD4 count was greater than 1000.
D-12-year-old girl completing a prednisone “burst” (1 mg/kg/day for 5 days) for
asthma exacerbation
**
3-18 month-old baby with a history of premature birth and chronic lung disease is admitted to the pediatric intensive care unit with respiratory distress requiring intubation; fever; and a 3-day history of cold-like symptoms. A nasal swab is positive for RSV. Which one of the following is the best intervention?
A. Palivizumab.
B. Corticosteroids.
C. Cefuroxime.
D. Intravenous fluids and supportive care
**
4- A young girl has seizures and tremors, the physician prescribed
oxycarbamazepin after 2 weeks of administration, redness and pruritic rash
A-shift to carbamazepine B-shift to ethsuoxmide C-shift to clozapine
D-keep using oxy
N.B: Ethsuoxmide is the drug of choice for petit mal epilepsy which usually associated with children
**
5- A woman is taking oxycarbamzipine, after 2 weeks of administration, redness and flushing appear... What is the best choice for her?
A/ shift to phenytoin
B/ shift to carbamazepine C/ take clozapine
D/ keep using oxycarbamazipine
N.B: It is normal side effect but in other question (young girl)
answer is shift to ethosuximide
**
6- FDA Fast Track what this means:
a-For drug that shows promising results for life-threatening disease with other drugs available can treat it
b- A drug that shows promising results for life-threatening disease with NO others available can do that
c-A drug that shows cost effectiveness d-A drug with side effects
**
7- A 9-year-old boy has a new diagnosis of ADHD. At school, he is disruptive, talks when the teacher is talking, and runs around the classroom. His parents report extreme difficulty in getting him to do his homework after school. Which one of the following is best for his initial drug therapy?
a. Methylphenidate extended release given once daily.
b. Methylphenidate immediate release given 2 times/day with doses administered 4 hours apart.
c. Guanfacine given at bedtime.
d- Methylphenidate given 2 times/day with doses administered 4 hours apart N.B: ADHD = Attention Deficit Hyperactivity Disorder
**
8- F.A. is a 55-year-old woman with rheumatoid arthritis. On diagnosis 1 year ago, F.A. had an RF titer of 1:64 signs and symptoms of inflammation in the joints of both hands, and about 45 minutes of morning stiffness. She began therapy with methotrexate, and she is presently receiving 15 mg every week, folic acid 2 mg/day, ibuprofen 800 mg 3 times/day, and omeprazole 20 mg/day. At today’s clinic visit, F.A. reports a recurrence of her symptoms. Radiographic evaluation of her hand joints shows progression of joint space narrowing and bone erosion. Which one of the following is the best next step in therapy for F.A.?
A. Administer etanercept. (Trade name Enbrel)
B. Switch to hydroxychloroquine.
C. Add prednisone bridge therapy.
D. Change to leflunomide.
N.B:
- Osteoporosis …. Alendronate Na
- Osteoporosis + Methotrexate …. Leflunomide
- Osteoarthritis ….. Etanercept
- Osteoarthritis + Methotrexate …. Etanercept is the first choice, if not exist choose leflunomide
**
9- 75-year-old woman reports urinary urgency, frequency, and loss of urine when she cannot make it to the bathroom in time. She also wears a pad at night that she changes 2 or 3 times because of incontinence. Her medical history is significant for Alzheimer disease (MMSE 23), osteoarthritis, and hypothyroidism. A urinalysis is negative, her examination is normal, and postvoid residual (PVR) is normal (less than 100 mL).
Which one of the following interventions would be best at this time?
A. Bethanechol.
B. Pelvic floor exercises plus estrogen vaginal cream.
C. Darifenacin.
D. Oxybutynin.
**
10- A hypertensive and diabetic woman , after continuing medication of pioglitazone , it's blood glucose level return to normal and in lab reading, the protein appears ,, she will take which drug to treat hypertension :
a) lisinopril
b) amiloride
N.B: Due to presence of proteinuria we will choose ACEI drugs such as lisinopril as ACEIs reduce proteinuria
**
11- A pregnant woman in her third week she takes levothyroxine 100 mcg, you advise her:
a) Stop the medication immediately
b) Increase the dose of levothyroxine
c) Ask the prescriber to change the medication
d) Continue using the medication as prescribed
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