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1. A pharmacotherapy specialist is evaluating a study that compared the effects of iron sucrose versus sodium ferric gluconate on ferritin levels in patients receiving hemodialysis. A significant difference was found between the groups. This study was conducted in a large academic center in Denmark; the specialist practices at a small rural hospital in Minnesota. Which of the following information in the paper will be most important in determining whether the study's results can be applied to the specialist's practice?
A) Internal validity
B) Inclusion/exclusion criteria
C) Randomization methods
D) Statistical analysis
2. A 13-year-old boy who has asthma, weight 32kg, height 150cm, takes inhaled salmeterol one puff twice daily and inhaled fluticasone 2 puffs twice daily. The patient must stop participation in physical education classes after a few minutes due to shortness of breath. To allow the patient to participate longer, the most effective measure would be to add which of the following?
A) An extra dose of inhaled fluticasone 1-2 hours before class
B) Inhaled albuterol 15 minutes before class
C) An extra dose of inhaled salmeterol 30-60 minutes before class
D) Inhaled cromolyn 30-60 minutes prior to class
3. In a clinical trial, when would "intention to treat" analysis be most appropriate?
A) Crossover design
B) Small sample size
C) High drop-out rate
D) Phase || trial
4. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?
A) A post-distribution digoxin concentration, which indicates significant toxicity
B) A concentration within the desirable range
C) A pre-distribution digoxin concentration, which may be misinterpreted
D) Reflects the effect of furosemide on the renal excretion of digoxin
5. A patient asks for advice relative to an herbal supplement to treat heart failure. The patient is currently NYHA Class III (LVEF 25%) and is adherent to medications, which include digoxin
0.25 mg daily, furosemide 40 mg daily, lisinopril 10 mg daily, carvedilol 6.25 mg twice daily, potassium 20 mEq daily, and simvastatin 40 mg nightly.
The patient has BP of 120/78 mm Hg, HR of 60 bpm, 9 cm JVD, 2+ pitting edema, and has experienced a 2.3 kg weight gain in last 2 days. All laboratory values are within normal limits.
Based on the following information, what is the most appropriate suggestion for the patient?
A) Omega-3-fatty acid
B) Coenzyme Q10
C) L-Carnitine
D) Avoidance of dietary supplements
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: B | Question # 3 Answer: B | Question # 4 Answer: D | Question # 5 Answer: A |
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