Question 1
What is the mechanism of action of vilazodone in the treatment of depression?
A) Selective serotonin reuptake inhibitor (SSRI) only
B) Serotonin and norepinephrine reuptake inhibitor (SNRI)
C) SSRI and partial agonist of the 5-HT1A receptor
D) Dopamine reuptake inhibitor
E) MAO inhibitor
Correct Answer: C) SSRI and partial agonist of the 5-HT1A receptor
Explanation: Vilazodone works as a selective serotonin reuptake inhibitor (SSRI) and a partial agonist at the 5-HT1A receptor, which is thought to contribute to its antidepressant effects by enhancing serotonin levels and modulating serotonin receptor activity.
Question 2
Which of the following is true regarding the chickenpox vaccine?
A) It contains live, attenuated varicella-zoster virus
B) It is contraindicated in children under 5 years of age
C) It is effective only when given after exposure to the virus
D) It is given as a single dose in adults
E) It is recommended only in immunocompromised individuals
Correct Answer: A) It contains live, attenuated varicella-zoster virus
Explanation: The chickenpox vaccine contains a live, attenuated form of the varicella-zoster virus and is given to prevent chickenpox. It is typically administered in two doses during childhood and can also be given to adults who haven’t been vaccinated or infected before.
Question 3
Which of the following best describes paroxysmal atrial fibrillation (A. fib)?
A) Atrial fibrillation that lasts continuously for more than 12 months
B) Atrial fibrillation that terminates spontaneously within 7 days
C) Atrial fibrillation that requires cardioversion to terminate
D) Atrial fibrillation with no symptoms or risk of stroke
E) Atrial fibrillation that is associated with heart failure
Correct Answer: B) Atrial fibrillation that terminates spontaneously within 7 days
Explanation: Paroxysmal atrial fibrillation refers to episodes of atrial fibrillation that terminate spontaneously within 7 days. It may recur and requires monitoring and management to prevent complications such as stroke.
Question 4
When counseling a patient on amoxicillin, which of the following is correct regarding its use?
A) Take on an empty stomach and stop the medication once symptoms improve
B) Take with food and complete the entire prescribed course of medication
C) Skip doses if you experience side effects like nausea
D) Take only when you experience symptoms of infection
E) Double the dose if you miss one
Correct Answer: B) Take with food and complete the entire prescribed course of medication
Explanation: Patients taking amoxicillin should be advised to take it with food to reduce gastrointestinal upset and to complete the full course of the medication, even if symptoms improve, to ensure the infection is fully treated and to prevent the development of antibiotic resistance.
Question 5
Which of the following is true regarding the interaction of carbamazepine and the patient’s HLA-B*27 status?
A) Carbamazepine increases the anticoagulant effect of warfarin
B) Carbamazepine is associated with HLA-B*15:02, not HLA-B*27, for serious skin reactions
C) HLA-B*27 testing is required before starting carbamazepine
D) Carbamazepine does not affect warfarin’s efficacy
E) Carbamazepine reduces the risk of adverse effects in patients with HLA-B*27
Correct Answer: B) Carbamazepine is associated with HLA-B*15:02, not HLA-B*27, for serious skin reactions
Explanation: Carbamazepine is associated with HLA-B*15:02, not HLA-B*27, and can lead to severe skin reactions (e.g., Stevens-Johnson syndrome) in certain populations, particularly those of Asian descent. It also induces CYP enzymes, potentially reducing the effect of warfarin.
Question 6
Which of the following is a key role and responsibility of NAPRA (National Association of Pharmacy Regulatory Authorities)?
A) Developing national standards for pharmacy practice and ethics
B) Licensing pharmacists at the provincial level
C) Handling pharmacy complaints at the federal level
D) Enforcing provincial drug laws
E) Overseeing drug pricing across Canada
Correct Answer: A) Developing national standards for pharmacy practice and ethics
Explanation: NAPRA develops national standards for pharmacy practice, ethics, and regulations across Canada, providing guidance to provincial regulatory authorities. It does not directly license pharmacists or enforce provincial laws.
Question 7
What is the main role of the provincial College of Pharmacy?
A) Setting national standards for pharmacy practice
B) Licensing pharmacists and ensuring public safety at the provincial level
C) Developing federal drug policy
D) Setting prices for pharmaceuticals
E) Regulating pharmacy technicians nationwide
Correct Answer: B) Licensing pharmacists and ensuring public safety at the provincial level
Explanation: The provincial College of Pharmacy is responsible for licensing pharmacists, ensuring public safety, regulating pharmacy practice, and addressing professional misconduct within the province.
Question 8
Which of the following best describes the null hypothesis in a clinical trial?
A) The hypothesis that there is no significant difference between the treatments being compared
B) The hypothesis that the new treatment is superior to the control
C) The assumption that the sample size is too small
D) The prediction that all participants will respond to treatment
E) The hypothesis that there is a placebo effect
Correct Answer: A) The hypothesis that there is no significant difference between the treatments being compared
Explanation: The null hypothesis states that there is no significant difference between the treatment and the control group in a clinical trial. The goal of the study is usually to reject or fail to reject the null hypothesis.
Question 9
What is an alpha error (type I error) in clinical research?
A) Failing to detect a real effect (false negative)
B) Detecting an effect that is not real (false positive)
C) Using an insufficient sample size
D) Detecting a real effect but misreporting it
E) Misclassifying study participants
Correct Answer: B) Detecting an effect that is not real (false positive)
Explanation: An alpha error (also known as a type I error) occurs when a researcher incorrectly rejects the null hypothesis, meaning they conclude there is an effect when none actually exists. This is referred to as a false positive result.
Question 10
Which type of spectroscopy is used to detect vapors?
A) Nuclear magnetic resonance (NMR) spectroscopy
B) Infrared (IR) spectroscopy
C) Gas chromatography-mass spectrometry (GC-MS)
D) Ultraviolet-visible (UV-Vis) spectroscopy
E) X-ray crystallography
Correct Answer: C) Gas chromatography-mass spectrometry (GC-MS)
Explanation: GC-MS is a powerful analytical technique that is commonly used to detect vapors. It separates and identifies different compounds in a gaseous state, making it ideal for detecting volatile substances.
Question 11
Which of the following spectroscopic techniques is used for detecting molecular vibrations in vapors?
A) Nuclear magnetic resonance (NMR) spectroscopy
B) Gas chromatography-mass spectrometry (GC-MS)
C) Infrared (IR) spectroscopy
D) Ultraviolet-visible (UV-Vis) spectroscopy
E) X-ray crystallography
Correct Answer: C) Infrared (IR) spectroscopy
Explanation: Infrared (IR) spectroscopy detects molecular vibrations in various phases, including vapors. It measures the absorption of infrared light, which causes vibrational transitions in molecules. This makes it useful for identifying and analyzing gaseous compounds.
Question 12
A patient is diagnosed with pseudomembranous colitis caused by Clostridium difficile. Which of the following is the recommended route of vancomycin administration for this condition?
A) Intravenous
B) Intramuscular
C) Subcutaneous
D) Oral
E) Inhaled
Correct Answer: D) Oral
Explanation: Oral vancomycin is the preferred treatment for Clostridium difficile (C. difficile) infection causing pseudomembranous colitis. Although vancomycin is typically administered intravenously for systemic infections, it must be given orally for C. difficile because the infection is localized in the gastrointestinal tract.
Question 13
Which of the following is true regarding aminoglycosides for treating gram-negative infections in a patient with CrCl < 30 mL/min?
A) Aminoglycosides are contraindicated in patients with CrCl < 30 mL/min
B) Aminoglycoside dosing should be adjusted in patients with CrCl < 30 mL/min to avoid toxicity
C) Aminoglycosides are primarily used for gram-positive infections
D) No dose adjustments are needed for aminoglycosides in renal impairment
E) Aminoglycosides are excreted through the liver
Correct Answer: B) Aminoglycoside dosing should be adjusted in patients with CrCl < 30 mL/min to avoid toxicity
Explanation: Aminoglycosides (e.g., gentamicin, tobramycin) are primarily used for gram-negative infections and are cleared renally. In patients with CrCl < 30 mL/min, dosing must be adjusted to avoid accumulation and toxicity, particularly nephrotoxicity and ototoxicity.
Question 14
Which of the following is a common side effect of aminoglycosides, especially with prolonged use or in patients with renal impairment?
A) Hepatotoxicity
B) Nephrotoxicity, ototoxicity, and neurotoxicity
C) Cardiomyopathy
D) Hyperkalemia
E) Pancreatitis
Correct Answer: B) Nephrotoxicity, ototoxicity, and neurotoxicity
Explanation: Aminoglycosides are associated with significant toxicities, including nephrotoxicity (kidney damage), ototoxicity (hearing loss or balance issues), and neurotoxicity (nervous system effects). These risks are increased with higher doses, prolonged use, or in patients with pre-existing renal impairment.
Question 15
What is the correct NaCl equivalence (E value) calculation for a 0.5% solution with an E value of 0.32 when calculating tonicity?
A) 0.32% NaCl
B) 0.16% NaCl
C) 0.9% NaCl
D) 0.5% NaCl
E) 1.0% NaCl
Correct Answer: B) 0.16% NaCl
Explanation: The NaCl equivalence (E) value is used to calculate the tonicity of a solution. In this case, multiplying 0.5% by the E value of 0.32 gives 0.16% NaCl, which represents the contribution of the drug to the isotonicity of the solution.
Question 16
Which anatomical plane divides the body into anterior and posterior sections?
A) Sagittal plane
B) Coronal plane
C) Transverse plane
D) Axial plane
E) Oblique plane
Correct Answer: B) Coronal plane
Explanation: The coronal plane, also known as the frontal plane, divides the body into anterior (front) and posterior (back) sections. This plane runs vertically through the body.
Question 17
Which of the following best describes transcription?
A) The conversion of mRNA to protein
B) The synthesis of DNA from mRNA
C) The conversion of DNA into mRNA
D) The replication of DNA into new cells
E) The synthesis of tRNA from mRNA
Correct Answer: C) The conversion of DNA into mRNA
Explanation: Transcription is the process where the information in DNA is copied into mRNA, which is then used for protein synthesis during translation.
Question 18
Which of the following happens in response to an infection, increasing cortisol levels?
A) Decrease in adrenal activity
B) Inhibition of the hypothalamic-pituitary-adrenal (HPA) axis
C) Increase in adrenal cortex secretion of glucocorticoids
D) Suppression of cortisol release
E) Increase in cortisol binding globulin
Correct Answer: C) Increase in adrenal cortex secretion of glucocorticoids
Explanation: During an infection, the body’s stress response triggers the adrenal cortex to increase the secretion of cortisol, a glucocorticoid that helps manage inflammation and the immune response.
Question 19
Fluticasone is classified as which type of medication?
A) Antihistamine
B) Adrenocorticosteroid
C) Bronchodilator
D) Beta-agonist
E) Leukotriene receptor antagonist
Correct Answer: B) Adrenocorticosteroid
Explanation: Fluticasone is an adrenocorticosteroid used in inhaled form to treat asthma and allergic rhinitis by reducing inflammation in the airways.
Question 20
Which treatment is safe to use for head lice during pregnancy?
A) Ivermectin lotion
B) Lindane shampoo
C) Malathion lotion
D) Permethrin 1% lotion
E) Oral ivermectin
Correct Answer: D) Permethrin 1% lotion
Explanation: Permethrin 1% lotion is considered safe for use during pregnancy for treating head lice, as it has minimal systemic absorption and effectively eradicates lice.
Question 21
Which of the following is the primary metabolic pathway for lidocaine?
A) O-methylation
B) Hydroxylation
C) N-dealkylation
D) Sulfation
E) Acetylation
Correct Answer: C) N-dealkylation
Explanation: Lidocaine undergoes N-dealkylation in the liver via cytochrome P450 enzymes, primarily CYP3A4 and CYP1A2, during its metabolism. This pathway produces metabolites that are eventually excreted by the kidneys.
Question 22
Which of the following is the recommended topical treatment for tinea pedis (athlete’s foot)?
A) Hydrocortisone 1%
B) Clotrimazole 1% or Miconazole 1%
C) Salicylic acid 2%
D) Bacitracin ointment
E) Silver sulfadiazine
Correct Answer: B) Clotrimazole 1% or Miconazole 1%
Explanation: Clotrimazole 1% and Miconazole 1% are common antifungal creams used to treat tinea pedis, also known as athlete’s foot. They work by inhibiting the growth of fungi.
Question 23
Gel electrophoresis is a technique used to separate DNA based on which of the following factors?
A) Size and shape
B) Size and charge
C) Shape and mass
D) Charge and mass
E) Charge and hydrophobicity
Correct Answer: B) Size and charge
Explanation: Gel electrophoresis separates DNA fragments based on their size and charge. DNA fragments move through a gel matrix in response to an electric field, with smaller fragments moving faster.
Question 24
Which of the following is correct regarding absorption in relation to different drug formulations?
A) Sustained release medications are absorbed faster than solutions
B) Suspensions are absorbed faster than solutions
C) Solutions are absorbed faster than suspensions and sustained release formulations
D) Sustained release formulations are absorbed faster than suspensions
E) Suspensions and solutions have the same absorption rates
Correct Answer: C) Solutions are absorbed faster than suspensions and sustained release formulations
Explanation: Solutions are absorbed faster than suspensions, which are absorbed faster than sustained release formulations. This is because solutions are already dissolved, making them easier to absorb.
Question 25
When counseling a patient on tadalafil (Cialis) for erectile dysfunction, what is the appropriate advice regarding food intake?
A) Take only on an empty stomach
B) Take with a high-fat meal for best results
C) Can be taken with or without food
D) Avoid food, as it reduces the drug’s effectiveness
E) Take with a protein-rich meal
Correct Answer: C) Can be taken with or without food
Explanation: Tadalafil can be taken with or without food as its absorption is not significantly affected by food intake, making it more flexible in terms of meal timing.
Question 26
Why should the combination of risperidone and domperidone be used cautiously, especially in patients with Parkinson’s disease or depression?
A) It enhances dopamine production, worsening depression
B) It increases serotonin levels, causing serotonin syndrome
C) It reduces dopamine excessively, worsening Parkinson’s disease or causing depression
D) It reduces serotonin and dopamine equally, leading to mood stabilization
E) It enhances dopamine receptor activity, worsening schizophrenia
Correct Answer: C) It reduces dopamine excessively, worsening Parkinson’s disease or causing depression
Explanation: Both risperidone (an antipsychotic) and domperidone (a gastrointestinal agent) can reduce dopamine levels. Excessive reduction in dopamine can worsen Parkinson’s disease or cause depression due to decreased dopaminergic activity.
Question 27
Which of the following is the first-line treatment for cellulitis caused by Streptococcus or Staphylococcus aureus?
A) Doxycycline
B) Amoxicillin-clavulanate
C) Vancomycin
D) Cephalexin or Clindamycin
E) Azithromycin
Correct Answer: D) Cephalexin or Clindamycin
Explanation: Cephalexin and clindamycin are common first-line treatments for cellulitis, particularly when caused by Streptococcus or Staphylococcus aureus. Clindamycin is often preferred if there is a concern for MRSA.
Question 28
A patient with a history of upper respiratory tract infections (URTIs) visits the clinic. Which of the following is least likely to be caused by a viral URTI?
A) Rhinorrhea
B) Cough
C) Sore throat
D) High fever
E) Nasal congestion
Correct Answer: D) High fever
Explanation: Viral URTIs typically cause symptoms like rhinorrhea, cough, sore throat, and nasal congestion. High fever is more common in bacterial infections or influenza rather than typical viral URTIs.
Question 29
Which of the following suspensions must be refrigerated to maintain its stability?
A) Ciprofloxacin oral suspension
B) Amoxicillin oral suspension
C) Clindamycin oral suspension
D) Azithromycin oral suspension
E) Nystatin oral suspension
Correct Answer: B) Amoxicillin oral suspension
Explanation: Amoxicillin oral suspension should be refrigerated to maintain its stability and potency. Some suspensions, such as azithromycin, do not require refrigeration.
Question 30
A patient is taking risperidone for schizophrenia and domperidone for gastrointestinal motility issues. Which of the following is a potential risk associated with the combination of these medications?
A) Increased dopamine release
B) Hypercalcemia
C) Hypotension
D) QT prolongation, increasing the risk of arrhythmias
E) Renal toxicity
Correct Answer: D) QT prolongation, increasing the risk of arrhythmias
Explanation: Both risperidone (an antipsychotic) and domperidone (a gastrointestinal prokinetic) have been associated with QT prolongation, which can increase the risk of serious arrhythmias. This combination should be used cautiously, especially in patients with cardiovascular risk factors.
Question 31
Which of the following is NOT a common symptom of opioid withdrawal?
A) Restlessness
B) Diarrhea
C) Sweating
D) Constricted pupils
E) Muscle aches
Correct Answer: D) Constricted pupils
Explanation: Opioid withdrawal typically causes dilated pupils rather than constricted pupils, along with symptoms like restlessness, diarrhea, sweating, and muscle aches. Constricted pupils are usually seen with opioid intoxication.
Question 32
The vomiting center in the brain is primarily located in which of the following areas?
A) Hypothalamus
B) Cerebellum
C) Medulla oblongata
D) Hippocampus
E) Frontal cortex
Correct Answer: C) Medulla oblongata
Explanation: The vomiting center is located in the medulla oblongata, where it coordinates signals from different areas to initiate vomiting. It receives input from the chemoreceptor trigger zone, vagal afferents, and other sources.
Question 33
Ultraviolet (UV) radiation is divided into UV-A and UV-B rays. Which of the following is true regarding the cancer-causing effects of these rays?
A) UV-A rays penetrate deeper into the skin and are more associated with sunburn than cancer
B) UV-B rays are primarily responsible for skin cancer
C) UV-C rays are the primary cause of skin cancer
D) Both UV-A and UV-B rays contribute equally to cancer risk
E) UV-B rays are absorbed by the ozone layer and have no impact on cancer risk
Correct Answer: B) UV-B rays are primarily responsible for skin cancer
Explanation: UV-B rays are more strongly associated with skin cancer, as they cause DNA damage in skin cells. UV-A rays penetrate deeper into the skin and contribute to skin aging and indirect DNA damage, but UV-B rays are the primary carcinogenic component of sunlight.
Question 34
Which of the following is the most common causative agent of upper respiratory tract infections (URTIs)?
A) Streptococcus pneumoniae
B) Rhinovirus
C) Haemophilus influenzae
D) Staphylococcus aureus
E) Mycoplasma pneumoniae
Correct Answer: B) Rhinovirus
Explanation: The most common causative agent of URTIs is rhinovirus, which typically causes the common cold. Other viruses like coronaviruses and respiratory syncytial virus (RSV) can also cause URTIs.
Question 35
What is the first-line treatment for a viral upper respiratory tract infection (URTI)?
A) Amoxicillin
B) Azithromycin
C) Rest, fluids, and symptomatic treatment
D) Ciprofloxacin
E) Corticosteroids
Correct Answer: C) Rest, fluids, and symptomatic treatment
Explanation: The first-line treatment for a viral URTI is symptomatic management, including rest, hydration, and over-the-counter medications for symptom relief (e.g., antipyretics, decongestants). Antibiotics like amoxicillin are not indicated unless there is a bacterial infection.
Question 36
What is the first-line treatment for a bacterial upper respiratory tract infection (URTI) caused by Streptococcus pyogenes?
A) Azithromycin
B) Ciprofloxacin
C) Amoxicillin
D) Doxycycline
E) Levofloxacin
Correct Answer: C) Amoxicillin
Explanation: The first-line treatment for a bacterial URTI caused by Streptococcus pyogenes (such as strep throat) is amoxicillin or penicillin. In case of penicillin allergy, alternatives like azithromycin or cephalosporins may be used.
Question 37
Which of the following bacteria is a common cause of bacterial upper respiratory tract infections (URTIs), including sinusitis and otitis media?
A) Rhinovirus
B) Streptococcus pneumoniae
C) Streptococcus pyogenes
D) Haemophilus influenzae
E) Moraxella catarrhalis
Correct Answer: B) Streptococcus pneumoniae
Explanation: Streptococcus pneumoniae is a leading bacterial cause of URTIs, including sinusitis, otitis media, and pneumonia. Other bacteria, such as Haemophilus influenzae and Moraxella catarrhalis, can also cause URTIs, but S. pneumoniae is one of the most common pathogens.
Question 38
What is the first-line antibiotic treatment for a bacterial upper respiratory tract infection (URTI) caused by Streptococcus pneumoniae?
A) Doxycycline
B) Penicillin
C) Amoxicillin
D) Ciprofloxacin
E) Trimethoprim-sulfamethoxazole
Correct Answer: C) Amoxicillin
Explanation: The first-line treatment for bacterial URTIs caused by Streptococcus pneumoniae is typically amoxicillin or amoxicillin-clavulanate, particularly in cases of sinusitis or otitis media. If there is penicillin resistance or allergies, other antibiotics like macrolides or cephalosporins may be used.
Question 39
A 45-year-old man presents with shortness of breath, wheezing, and a persistent cough. His family history reveals that several relatives have had early-onset emphysema. Laboratory results show decreased levels of alpha-1 antitrypsin. What is the primary function of alpha-1 antitrypsin in the body?
A) Reduces inflammation in the lungs
B) Prevents liver damage
C) Inhibits neutrophil elastase to protect the lungs from damage
D) Increases the production of red blood cells
E) Enhances oxygen exchange in alveoli
Correct Answer: C) Inhibits neutrophil elastase to protect the lungs from damage
Explanation: Alpha-1 antitrypsin is a protein that inhibits neutrophil elastase, preventing it from damaging the alveoli in the lungs. A deficiency in this protein can lead to early-onset emphysema and liver disease.
Question 40
A 30-year-old woman recently received a live attenuated vaccine for measles, mumps, and rubella (MMR). She asks if she will need a booster dose in the future. What is the most appropriate response from the pharmacist?
A) Live attenuated vaccines always require a booster dose
B) Live attenuated vaccines do not usually require a booster dose unless specific immunity wanes
C) A booster is required only in cases of exposure to the virus
D) Live attenuated vaccines require yearly boosters
E) The patient will need a booster dose in six months
Correct Answer: B) Live attenuated vaccines do not usually require a booster dose unless specific immunity wanes
Explanation: Live attenuated vaccines typically provide long-lasting immunity and usually do not require booster doses. However, in some cases (e.g., waning immunity or special populations), a booster may be recommended.
Question 41
Which of the following is an example of a live attenuated vaccine?
A) Influenza (inactivated)
B) Hepatitis B
C) Measles, mumps, and rubella (MMR)
D) Tetanus
E) Diphtheria
Correct Answer: C) Measles, mumps, and rubella (MMR)
Explanation: The MMR vaccine is an example of a live attenuated vaccine. It contains weakened forms of the measles, mumps, and rubella viruses to stimulate an immune response without causing the disease.
Question 42
Which of the following describes the formula for calculating relative risk reduction?
A) 1 minus the relative risk
B) Absolute risk divided by relative risk
C) Risk in the control group divided by risk in the treatment group
D) (Risk in the control group minus risk in the treatment group) divided by risk in the control group
E) Risk in the treatment group minus risk in the control group
Correct Answer: D) (Risk in the control group minus risk in the treatment group) divided by risk in the control group
Explanation: Relative risk reduction is calculated by subtracting the risk in the treatment group from the risk in the control group, then dividing by the risk in the control group.
Question 43
Acetyl-CoA is a critical molecule in metabolism. Which of the following is formed from acetyl-CoA?
A) Glucose
B) Fatty acids
C) DNA
D) Amino acids
E) Glycogen
Correct Answer: B) Fatty acids
Explanation: Acetyl-CoA is involved in the synthesis of fatty acids and also plays a key role in the citric acid cycle, where it contributes to energy production.
Question 44
A 65-year-old man with Parkinson’s disease is on levodopa/carbidopa and entacapone for better motor symptom control. He reports abdominal pain, fatigue, and yellowing of the skin. Laboratory tests show elevated liver enzymes. What side effect of entacapone could be responsible for these symptoms?
A) Pancreatitis
B) Hepatotoxicity
C) Neurotoxicity
D) Cardiotoxicity
E) Nephrotoxicity
Correct Answer: B) Hepatotoxicity
Explanation: Entacapone, a COMT inhibitor used in the treatment of Parkinson’s disease, can cause hepatotoxicity as a rare side effect. Liver function tests should be monitored in patients using this medication.
Question 45
Which bacteria is primarily responsible for bullous impetigo, a skin infection characterized by large, fluid-filled blisters?
A) Streptococcus pyogenes
B) Escherichia coli
C) Staphylococcus aureus
D) Haemophilus influenzae
E) Pseudomonas aeruginosa
Correct Answer: C) Staphylococcus aureus
Explanation: Bullous impetigo is primarily caused by Staphylococcus aureus, which produces toxins that lead to the formation of large blisters on the skin.
Question 46
A newly diagnosed patient with diabetes is brought to the ER. The patient also has schizophrenia, hypertension, and a few other conditions. Which of the following drugs can potentially increase creatinine clearance (CrCl) to more than 180 mL/min?
A) Metformin
B) Lurasidone
C) Lithium
D) Clozapine
E) Atenolol
Correct Answer: C) Lithium
Explanation: Lithium can cause nephrogenic diabetes insipidus, leading to increased creatinine clearance (CrCl > 180 mL/min). This effect is due to lithium’s interference with kidney function, specifically its impact on water and sodium balance.
Question 47
Which of the following is NOT a function of NAPRA (National Association of Pharmacy Regulatory Authorities)?
A) Developing national standards for pharmacy practice
B) Regulating provincial pharmacy licensing
C) Overseeing national pharmacy exams
D) Protecting public safety by establishing pharmacy standards
E) Regulating drug prices (PMPRB)
Correct Answer: E) Regulating drug prices (PMPRB)
Explanation: The Patented Medicine Prices Review Board (PMPRB) regulates drug prices in Canada, not NAPRA. NAPRA focuses on pharmacy standards, public safety, and professional regulation.
Question 48
What is the mechanism of action of galantamine in the treatment of Alzheimer’s disease?
A) Selective serotonin reuptake inhibition
B) Inhibition of glutamate receptors
C) Inhibition of acetylcholinesterase and modulation of nicotinic receptors
D) Dopamine receptor blockade
E) Antagonism of GABA receptors
Correct Answer: C) Inhibition of acetylcholinesterase and modulation of nicotinic receptors
Explanation: Galantamine is an acetylcholinesterase inhibitor and a nicotinic receptor modulator, which enhances cholinergic function by increasing acetylcholine levels in the brain, used in Alzheimer’s disease.
Question 49
What is the mechanism of action of atomoxetine in the treatment of attention-deficit hyperactivity disorder (ADHD)?
A) Selective norepinephrine reuptake inhibition
B) Dopamine receptor agonist
C) Acetylcholinesterase inhibition
D) Gamma-aminobutyric acid (GABA) receptor modulation
E) Monoamine oxidase inhibition
Correct Answer: A) Selective norepinephrine reuptake inhibition
Explanation: Atomoxetine works by selectively inhibiting the norepinephrine transporter, increasing norepinephrine levels in the synaptic cleft, which improves attention and behavior in patients with ADHD.
Question 50
A community health survey was conducted in a town with a population of 50,000 people. The survey found that 1,200 individuals currently have hypertension. What is the prevalence of hypertension in this town?
A) 0.24%
B) 2.4%
C) 24%
D) 4%
E) 12%
Correct Answer: B) 2.4%
Explanation: Prevalence is calculated as the number of existing cases (1,200) divided by the total population (50,000), multiplied by 100.
Prevalence = (1,200 / 50,000) × 100 = 2.4%.