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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:
1. A 53-year-old patient is admitted to the hospital with diarrhea. He has been experiencing five unformed stools daily for 2 days. The patient had a previous admission 6 weeks ago for C.
difficile diarrhea, which was treated successfully with oral metronidazole. Stool tests are again positive for C. difficile toxin A.
On presentation, his vital signs are: BP 128/86 mm Hg, HR 75 bpm, RR 14 bpm, and T37.8°C.
WBC count shows 12,300 cells/ul (80% neutrophils-segs, 10% neutrophils-bands), serum creatinine 1.2 mg/dL, and albumin 3.4 g/dL. The patient has no evidence of colitis, toxic megacolon, or perforation on imaging studies of the abdomen.
What is the most appropriate treatment recommendation for this patient?
A) Rifaximin 550mg orally three times daily
B) Metronidazole 500mg orally three times daily
C) Vancomycin 125 mg orally four times daily plus metronidazole 500 mg three times daily intravenously
D) Vancomycin 125mg orally four times daily
2. A 60-year-old man with heart failure states that he becomes "a bit short of breath" after climbing a flight of stairs. His ejection fraction is 40%. Current medications include lisinopril 5 mg daily, metoprolol XL 100 mg daily, aspirin 81 mg daily, furosemide 40 mg daily, and digoxin
250 mcg daily. All vital signs and laboratory values are stable and within normal limits. Which of the following recommendations would be most appropriate at this time?
A) Add spironolactone 25 mg daily.
B) Increase lisinopril to 10 mg daily.
C) Replace aspirin with clopidogrel 75 mg daily.
D) Add Valsartan 80 mg twice daily.
3. A 48 year old man attends a local pharmacy health fair for a blood pressure check. His blodd pressure on two recent occasions has averaged 138/88 mm Hg.
According to the American Society of Hypertension, what is this patient's blood pressure classification?
A) Stage 1
B) Normotensive
C) Stage 2
D) Prehypertension
4. A 49-year-old patient has been taking pregabalin for the treatment of fibromyalgia for one year with good relief of symptoms. However, this patient recently lost access to health insurance.
Although she experienced excellent relief from pregabalin, she is unable to continue this therapy due to cost.
Which of the following would be the best intervention?
A) Change to gabapentin
B) Change to duloxetine
C) Change to tramaddy
D) Change to amitriptyline
5. A 58-year-old man presents complaining of unsteady gait. Past medical history is significant for diabetes mellitus, gastroparesis, and depression. The patient exhibits a slight shuffling gait, mild limb rigidity, and decreased speed in performing rapid alternating movement. Current daily medications are bupropion, glyburide, metoclopramide, and omeprazole. Which of the following would be the most appropriate initial management for the presenting complaint?
A) Discontinue metoclopramide.
B) Begin ropinirole.
C) Discontinue bupropion.
D) Begin carbidopa/levodopa.
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: B | Question # 3 Answer: D | Question # 4 Answer: B | Question # 5 Answer: A |

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