[Jan 30, 2022] Latest NAPLEX Exam with Accurate North American Pharmacist Licensure Examination PDF Questions
Practice To NAPLEX - PracticeVCE Remarkable Practice On your North American Pharmacist Licensure Examination Exam
Certification Path for North American Pharmacist Licensure Examination
North American Pharmacist Licensure Examination is taken by foreign-educated pharmacists who have earned FPGEC Certification. The NAPLEX is just one component of the licensure process and is used by the boards of pharmacy to assess a candidate's competence to practice as a pharmacist.
Below is the North American Pharmacist Licensure Examination Format
- Number of questions: 250
- Length of Examination: 6 hours
- Language: English
- Format: Multiple choices, multiple answers
- Passing score: Scaled 75
NEW QUESTION 38
In a study where Rivaroxaban was compared to enoxaparin to find total VTE following HIP replacement surgery, there were 17 total VTE out of 1513 patients in the Rivaraoaban group and 57 total VTE out of 1473 patient in the enoxaparin group. What is the relative risk reduction of using Rivaroxaban over Enoxaparin?
- A. 29%
- B. 71%
- C. 42%
- D. 14%
- E. 39%
Answer: B
Explanation:
Explanation
Relative risk reduction: 0.71 = 71% Relative risk: (Event rate in rivaroxaban group)/(Event rate in enoxaparin group) = (17/1513)/(57/1473) = 0.2903 Relative risk reduction: 1 - (relative risk) = 1 - 0.2903 = 0.7097 =
0.71.
NEW QUESTION 39
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with
20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every
6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/dl, K
5.0mmol/L, Na 135mmol/L.
LN used 5 on-demand bolus doses from the hydromorphone PCA, how much hydromorphone did the patient get in 24 hours?
- A. 5.3mg
- B. 0.5mg
- C. 4.8mg
- D. 52.8mg
- E. 10mg
Answer: A
Explanation:
0.2 mg/hour basal rate = 0.2mg/hour (24 hours) = 4.8 mg Demand dose of 0.1 mg × 5 = 0.5 mg 4.8 mg + 0.5 mg = 5.3 mg
NEW QUESTION 40
A 23-year-old female presents to your clinic complaining of intermittent throbbing headaches that usually last for several hours and are made worse by the presence of light. She endorses occasional nausea without vomiting during the most severe episodes. Physical examination is unrevealing, and she has no significant past medical history.
Which of the following treatments is considered an abortive therapy for this patient's underlying condition?
- A. Gabapentin
- B. Diltiazam
- C. Sumatriptan
- D. Amitriptyline
- E. Propranolol
Answer: C
Explanation:
Correct:
A. Migraine headaches typically affect females more often than males, and patients most frequently present in their early 20s. Classic symptoms of migraine include throbbing headaches lasting between 2-24 hours in duration, with triggers such as red wine, fasting, stress, and menses. Primary prevention is aimed at the identification and avoidance of triggers. Over the counter NSAIDS can be used if symptoms persist. Failing this, PRN abortive therapy is indicated, including the triptans (e.g. - sumatriptan) and metoclopramide. Choice B - Gabapentin is an anticonvulsant that is considered to be a second-line, prophylactic treatment for recurrent migraine headaches. Its utility is limited by its lengthy side effect profile. Choice C - Amitriptyline, a tricyclic antidepressant, can also be utilized for migraine prophylaxis. However, it will not abort a migraine currently in progress, and extensive side effects limit its use. Choices D + E - Propranolol and diltiazam are beta-blockers and calcium channel blockers, respectively. As with the anticonvulsants and tricyclic antidepressants, these are considered migraine prophylaxis and will not interrupt a migraine once it has begun.
NEW QUESTION 41
Which of the following would be most appropriate to treat stenotrophomonas maltophilia?
- A. Ciprofloxacin
- B. Cefepime
- C. Vancomycin
- D. Sulfamethoxazole/trimethoprim
- E. Meropenem
Answer: D
Explanation:
Explanation
Primary treatment for stenotrophomonas maltophilia is SMX-TMP. Meropenem, ciprofloxacin, and vancomycin have no coverage.
NEW QUESTION 42
A fasting blood glucose level greater than what value is an indicator of type 2 diabetes?
- A. 8 mmol/L
- B. 7 mmol/L
- C. 5 mmol/L
- D. 9 mmol/L
- E. 6 mmol/L
Answer: B
Explanation:
Explanation
A fasting blood glucose level of greater than 7 mmol/L (or greater than 126mg/dL) is an indicator of type 2 diabetes.
NEW QUESTION 43
A 72-year-old woman suffers from a major depressive episode. She has a history of coronary artery disease, atrial fibrillation on anticoagulation therapy, sick sinus syndrome, glaucoma, and chronic obstructive pulmonary disease.
Which of the following medications is most appropriate for the treatment of her depression?
- A. Fluvoxamine
- B. Nortriptyline
- C. Doxepin
- D. Escitalopram
- E. Amitriptyline
Answer: D
Explanation:
Explanation
In older adults, selection of antidepressant medication should be done with various considerations in mind, most notably side effects and risk of drug-drug interactions. The tricyclic antidepressants (TCAs), as discussed on question 50, have various side effects including cardiac conduction abnormalities and drug-drug interactions that make them undesirable for the treatment of depression in older adults. A selective serotonin reuptake inhibitor is more favorable than a TCA in this patient. Fluvoxamine has a high risk for drug-drug interactions, whereas escitalopram does not. Fluvoxamine also has high protein binding, and can therefore interact with anticoagulant medications, such a warfarin. Therefore, of the medications listed, escitalopram is the most appropriate in this patient. In older adults, psychotropic medications should be started at a low dose and titrated up slowly to the lowest effective dose.
NEW QUESTION 44
What is the mechanism of action of the active ingredient found in Zyflo?
- A. 5-lipogenase inhibitor
- B. Leukotriene D4 inhibitor
- C. Long-acting anticholinergic
- D. Ultra-long-acting beta-2 agonist
Answer: A
Explanation:
Explanation
Zileuton is the active ingredient found in the medicine Zyflo; a medicine that works as a 5-lipoxygenase inhibitor. As such, zileuton inhibits leukotrienes (LTB4, LTC4, LTD4, and LTE4) formation, and is used for the maintenance treatment of asthma in patients older than the age of 12. In 2 percent of patients, it raises liver enzymes. Sinusitis and nausea are the most common side effects.
NEW QUESTION 45
A 22-year-old woman adopted a cat. Shortly thereafter, she developed itchy eyes and persistent rhinorrhea.
She was clearly allergic to the pet, but desperately wanted to keep it. She tried taking diphenhydramine, but it had intolerable side effects.
Which of the following is a common effect of this type of medication?
- A. Bradycardia
- B. Decreased intraocular pressure
- C. Xerostomia
- D. Diarrhea
- E. Excessive sweating
Answer: C
Explanation:
Diphenhydramine possesses anticholinergic properties. Xerostomia, or dry mouth, is a common side effect of anti-cholinergic medications, due to anti-muscarinic, parasympatholytic effects. Other adverse reactions may include: * Mydriasis with blurred vision, photophobia * Urinary retention * Constipation * Anhidrosis * Hyperthermia * Tachycardia * Altered mental status A commonly referenced mnemonic for anti-cholinergic toxicity is "mad as a hatter, red as a beet, dry as a bone, hot as a hare, blind as a bat" to reflect confusion, flushing, dry mouth, hyperthermia and mydriasis, respectively.
NEW QUESTION 46
Which of the following beta-blocker is NOT proven to reduce mortality in patients with Systolic CHF?
- A. Bisoprolol
- B. Carvedilol
- C. Nadolol
- D. Metoprolol Tartrate
- E. Metoprolol succinate
Answer: D
Explanation:
Nadolol is not proven to reduce mortality in patients with systolic CHF. The efficacy of nadolol in HF has not been determined. For patients taking nadolol, it should be used with caution in those with compensated heart failure and patients should be monitored for a worsening of the condition. Bisoprolol, carvedilol, and sustained- release metoprolol succinate are the beta-blockers that have been proven to reduce mortality in patients with systolic CHF. These 3 beta-blockers have been effective in reducing the risk of death in patients with chronic HFrEF. Other beta-blockers were found to be less effective. Bucindolol did not exhibit uniform effectiveness across different populations. Metoprolol tartrate was found to be less effective in HF clinical trials.
Reference:
http://circ.ahajournals.org/content/128/16/e240
NEW QUESTION 47
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram
20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock- out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may increase LN's potassium?
- A. Metformin
- B. Ondansetron
- C. Metoclopramide
- D. Hydromorphone
- E. Lisinopril
Answer: E
Explanation:
Lisinopril may increase LN's potassium. One of the warnings/precautions of lisinopril is hyperkalemia. ACE inhibitors block the formation of circulating angiotensin II, which can lead to a decrease in aldosterone secretion that can result in an increase in potassium. Risk factors for hyperkalemia while taking lisinopril include renal impairment, diabetes, and concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium containing salts. Potassium should be monitored closely when taking any of the other agents listed. Hyperkalemia is not listed in the warnings/precautions section for the other medications.
NEW QUESTION 48
A patient with multibacillary leprosy is on dapsone, clofazimine, and rifampin. Which of the following is true regarding the mechanism of action of the medications listed?
- A. Dapsone is bacteriostatic because of its inhibitory effects on myeloperoxidase
- B. Rifampin is bacteriostatic by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase
- C. Dapsone is bacteriostatic because of its inhibitory effects on dihydrofolate reductase
- D. Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase
- E. Clofazimine is bactericidal by directly inhibiting bacterial DNA polymerase
Answer: D
Explanation:
Explanation
A, B - false - dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para- aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C - False - A substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M.
leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D - False - See below. E - True - Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase.
NEW QUESTION 49
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.
Which of the following medication/s should LN be on to prevent the most common side effect of hydromorphone?
- A. Docusate sodium / Senna for Constipation
- B. Dexamethasone for N/V
- C. Insulin Sliding scale for hyperglycemia
- D. Ondansetron for N/V
- E. Docusate sodium / Senna for Constipation and ondansetron for N/V
Answer: E
Explanation:
Explanation
LN should be on docusate sodium/Senna for constipation and ondansetron for N/V. Dexamethasone has an off label use for N/V that is chemotherapy-associated. It is mostly used as an anti-inflammatory or immunosuppressant agent. Hydromorphone does not cause hyperglycemia. The most common side effects of opioids are nausea, vomiting and constipation.
NEW QUESTION 50
What vitamin should the a patient receive to avoid Wernicke- Korsakoff syndrome?
- A. Cyanocobalamin
- B. Thiamine
- C. Folic Acid
- D. Magnesium
- E. Nicotinic Acid
Answer: B
Explanation:
Explanation
Thiamine should be administered to prevent Wernicke's encephalopathy.
NEW QUESTION 51
All of the following may increase triglycerides except:
- A. Fish oil
- B. Bile acid sequestrants
- C. Protease inhibitor
- D. Glucocorticoids
- E. Oral estrogens
Answer: A
Explanation:
Explanation
Agents that can cause elevated triglycerides: oral estrogens, glucocorticoids, bile acid sequestrants, protease inhibitors, retinoic acid, anabolic steroids, sirolimus, raloxifene, tamoxifen, beta blockers (not carvedilol), and thiazides.
NEW QUESTION 52
CJ is a 69-year-old male with a history of diabetes, hypertension and hypercholesterolemia. His fasting lipid profile is TC 530 mg/dL; LDL-C 125; HDL-C 48 mg/dL; and TG 640 mg/dL. His A1c 8.1, calculate creatinine clearance is 65mls/hr, BP 135/80 mm Hg, HR 70 beats /min.
His current medications include metformin 1000mg po bid, lisinopril 20mg daily, sitagliptin 50mg bid and atorvastatin 40mg daily.
What is the best pharmacological agent to initiate on CJ?
- A. Increase atorvastatin to 80mg
- B. Fenofibrate 162mg daily
- C. Niacin 500mg twice daily
- D. Gemfibrozil 600mg twice daily
- E. Fish oil 500mg twice daily
Answer: B
Explanation:
It is reasonable to add triglyceride-lowering medications such as fibrates or niacin to prevent pancreatitis in those with triglyceride levels >500 mg/dL, which applies to this patient as his TG level is 640 mg/dL .
C. is wrong because gemfibrozil should not be initiated in patients on statin therapy because of an increased risk for muscle symptoms and rhabdomyolysis. Fenofibrate may be considered concomitantly with a low- or moderate- intensity statin when triglycerides are above 500 mg/dL,2, however he is on a high intensity statin therapy. For niacin, the IR dose should start at 100 mg TID2 and niacin does not lower triglyceride levels as much as fibrate do.4 Fenofibrates are dose adjusted for renal function lower than 60 mL/min to 54 mg/mL, so this dose is appropriate for this patient because of his renal function being above 60 mL/min. The best option is fenofibrate
162 mg daily, but this needs to be monitored for any symptoms of muscle pain exhibited by the patient, especially as the patient is at a higher risk due to being a diabetic. Fish oil is not a first line agent to treat hypertriglyceridemia.
Reference:
http://circ.ahajournals.org/content/129/25_suppl_2/S1
NEW QUESTION 53
Which of the following is recommended to be monitored in patients on Divalproex Sodium?
- A. Pulmonary function
- B. LFT's
- C. CBC
- D. Serum ammonia
- E. Serum creatinine
Answer: B
Explanation:
Explanation
A, B, C. Hepatotoxicity, including hepatic failure, has been fatal and may more commonly occur in the first 6 months of treatment. Valproic acid and its analogs are contraindicated in patients with known urea cycle disorders. Patients with urea cycle disorders have a genetic enzyme defect leading to an impaired ability to produce urea. Hyperammonemic encephalopathy has been reported following initiation of valproate therapy.
Because of, inhibition of the secondary phase of platelet aggregation, and abnormal coagulation parameters complete blood counts and coagulation tests are recommended before initiating valproic acid therapy and at periodic intervals.
NEW QUESTION 54
Select the class of Anti-diabetic medication that works in the specified organto prevent hyperglycemia. Select all that applies. Fat Tissue (H)
- A. Alpha- Glucosidase Inhibitors
- B. Biguanide
- C. Sulfonylureas
- D. SGLT2 inhibitors
- E. Glucagon-like peptide-1 receptor agonists
- F. DPP4 Inhibitors
- G. Thiazolidinediones
Answer: G
Explanation:
Explanation
Thiazolidinediones Sulfonylureas work in beta cells in the pancreas that are still functioning to enhance insulin secretion. Alpha-Glucosidase Inhibitors stop -glucosidase enzymes in the small intestine and delay digestion and absorption of starch and disaccharides which lowers the levels of glucose after meals. DPP4 blocks the degradation ofGLP-1, GIP, and a variety of other peptides, including brain natriuretic peptide. Glucagon-like peptide-1 receptor agonists work in various organs of the body. Glucagon-like peptide-1 receptor agonists enhance glucose homeostasis through: (i) stimulation of insulin secretion; (ii) inhibition of glucagon secretion; (iii) direct and indirect suppression of endogenous glucose production; (iv) suppression of appetite; (v) enhanced insulin sensitivity secondary to weight loss; (vi) delayed gastric emptying, resulting in decreased postprandial hyperglycaemia. Thiazolidinediones are the only true insulin-sensitising agents, exerting their effects in skeletal and cardiac muscle, liver, and adipose tissue. It ameliorates insulin resistance, decreases visceral fat. Biguanides work in liver, muscle, adipose tissue via activation of AMP-activated protein kinase (AMPK) reduce hepatic glucose production. SGLT2 inhibitors work in the kidneys to inhibit sodium-glucose transport proteins to reabsorb glucose into the blood from muscle cells; overall this helps to improve insulin release from the beta cells of the pancreas.
NEW QUESTION 55
What is the Osmolarity in mOsm/L of 40mEq of KCl in 100ml sterile water? (Molecular weight of KCl is
74.5gm/ mol.)?
- A. 80mOsm/L
- B. 1600mOsm/L
- C. 800mOsm/L
- D. 200mOsm/L
- E. 400mOsm/L
Answer: C
Explanation:
Explanation
40mEq * 1equiv/1000mEq * 74.5g/1equiv = 2.98 gm of KCl in 100ml. Calculate: mOsm/L. 2.98g/100ml *
1mol/74.5g * 2Osm/1mol * 1000mOsm/ Osm * 1000ml/1L = 800mOsm/L
NEW QUESTION 56
A 20-year-old student came to the emergency department with primary complaints of palpitations, low-grade fever, and anxiety for 2 months. She reports that she is irritable and suffers severe mood swings that is interfering with her sleep and relationships (she admits to crying spells and frequent fights with friends and family). She has also lost 12 pounds in the past 2 months with no apparent alteration in her diet or physical activity (though she is happy with her weight loss). She denies any past medical problems, though her friends have always been worried that she eats too little.
Her temperature is 38.0 C (100.4 F), blood pressure is 148/62 mm Hg, pulse is 122/min and regular, and respiratory rate is 28/min. Examination reveals a bruit heard over the anterior neck, fine tremor of the hands, and warm, moist skin. Her eyes and eyelids do not move together during finger following test (with steady head). Laboratory work is sent, including a thyroid panel, but will not be available until tomorrow morning.
Which of the following is the most appropriate initial management at this time?
- A. Methimazole therapy
- B. Iodine therapy
- C. Referral to a surgeon
- D. Propranolol therapy
- E. Diltiazem therapy
Answer: D
Explanation:
Explanation
This patient had hyperthyroidism, though the exact cause of her condition is not currently clear. The immediate treatment should focus on controlling the patient's symptoms for which a non-specific beta-blocker is seemingly an ideal choice. Propranolol therapy can be initiated without any adverse effects while the patient undergoes further workup of her condition. As the treatment for hyperthyroidism varies depending upon the cause of the condition, more definitive therapy should be avoided. Diltiazem (choice A) helps control heart rate but does not have the same antiadrenegenic properties as beta-blockers/ The initial treatment for symptomatic hyperthyroidism is propranolol. Iodine (choice B) can be used in high doses to inhibit thyroid production of T3 and T4. Until it's clear that this patient does not have an exogenous source of thyroid hormone (and until it is clear she is not pregnant), this agent should not be considered. Propylthiouracil (PTU) and Methimazole (choice C) inhibit the organification of iodine to tyrosine residues. If this patient has Graves diseases, this would be an appropriate treatment. Until a diagnosis is made, however, initial therapy should consist of a beta- blocker. Surgical treatment (choice E) of hyperthyroidism is often a reasonable treatment for patients who cannot tolerate medical therapy of radioactive iodine ablation.
NEW QUESTION 57
Which of the following are complication associated with long term use of proton pump inhibitors?
- A. Bone fractures
- B. Helicobacter pylori infection
- C. Clostridium difficile infection
- D. Vitamin B12 deficiency
- E. Hypomagnesemia
Answer: C
Explanation:
Explanation
Use proton pump inhibitors (PPIs) in patients with or who have risk factors for osteoporosis cautiously. PPIs have been associated with a possible increased risk of bone fractures of the hip, wrist, and spine. Daily treatment with a gastric acid-suppressing medication over a long period of time may lead to hypomagnesemia.
Vitamin B12 deficiency has been reported with long term use of PPIs in the literatures. The use of PPIs, may increase the risk of enteric infection by encouraging the growth of gut microflora and increasing susceptibility to organism including Clostridium Difficile. There are recent FDA warnings regarding C.
Diff infection with use of PPIs. H. Pylori infection is not a complication of PPIs. PPIs in combination with certain antibiotics are used to treat H. pylori Infections.
NEW QUESTION 58
Which of these ranges reflects normal serum creatinine levels?
- A. 0.2 - 0.5 mg/dL
- B. 3.5 - 5.0 mg/dL
- C. 1.5 - 2.0 mg/dL
- D. 0.6 - 1.2 mg/dL
- E. 2.4 - 3.2 mg/dL
Answer: D
Explanation:
Explanation
Normal serum creatinine levels are 0.6 - 1.2 mg/dL.
NEW QUESTION 59
JK is a 67 years old African American man who presents to your clinic for his blood pressure management. His past medical history includes Peptic ulcer disease and hypertension. His two BP readings are 160/98, 159/96 and HR 85. He says he has been adherent to his medication and lifestyle. He currently takes 12.5mg Chlorthalidone and Prilosec 20mg daily.
Which of the following is the best strategy to manage his blood pressure?
- A. Add Lisinopril 5mg daily
- B. Add Lisinopril 20mg daily
- C. Add hydrochlorothiazide 25mg daily
- D. Add Norvasc 2.5 daily
- E. Increase chlorthalidone to 25mg daily
Answer: D
Explanation:
As the patient is over the age of 60 and he does not have CKD or diabetes, his goal BP should be SBP < 150 mmHg or DBP < 90 mmHg, and he is not currently at this goal with his medication regimen. Options are to maximize the current medication dosage (option A), or to add a second agent. Since calcium channel blockers like Norvasc are recommended as initial treatment options in African Americans, choosing Norvasc over lisinopril would probably be the more effective option.
Reference:
http://jamanetwork.com/journals/jama/fullarticle/1791497
NEW QUESTION 60
Which of the following Anti-epileptic medication can cause pancreatitis?
- A. Levetiracetam
- B. Valproic acid
- C. Carbamazepine
- D. Phenobarbital
- E. Gabapentin
Answer: B
Explanation:
Explanation
Cases of life-threatening pancreatitis have been reported in both pediatric and adult patients receiving valproic acid or its analogs. Patients should be warned that abdominal pain, nausea, vomiting, and/or anorexia can be symptoms of pancreatitis that require prompt medical evaluation. If pancreatitis is diagnosed, valproate should be discontinued.
NEW QUESTION 61
Your patient, a 25-year-old G1P0 female at 26 weeks gestation presents due to an abnormal glucose tolerance test. One week prior, she was given 50 g of oral glucose and demonstrate a venous plasma glucose level of
156 mg/dL one hour later.
Which of the following is the most appropriate next step of management?
- A. Administer an oral, 3-hour 100 g glucose dose
- B. Advise the patient to follow an American Diabetic Association diet plan
- C. Begin insulin treatment
- D. Repeat the 50 g oral glucose challenge
- E. Order a fetal ultrasound examination
Answer: A
Explanation:
Gestational diabetes is typically asymptomatic but identified via a 1-hour 50g oral glucose challenge administered at 24-28 weeks of gestation. A venous plasma glucose blood level of > 140 mg/dL is suggestive, and must be confirmed with a 3-hour 100g oral glucose tolerance test. After administration of the 100g glucose challenge, at least two of the following are required for diagnosis: (1) fasting glucose > 95 mg/dL, (2) one-hour glucose >180 mg/dL, (3) two hour glucose >155 mg/dL, and (4) three hour glucose > 140 mg/dL. Choice A - To diagnose gestational diabetes, a positive 1-hour 50g oral glucose challenge must be followed up by a three- hour 100g oral glucose challenge. The diagnosis is only confirmed after both challenges are completed and the thresholds are met. Choice C - Following the diagnosis of gestational diabetes, the first step is strict glycemic control (fasting glucose).
NEW QUESTION 62
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