Lideta Pharmacy model competency exam

1. In deciding what drugs are appropriate for its formulary, the hospital must consider a
drug efficacy, associated workload, and acquisition cost. Several new antifungal IV drugs
(drug A, drug B, drug C, and drug D), all with equal efficacy, have recently become
available. Currently the hospital stocks drug E, which has been available for several
years. Data for the medications is as follows:
Drug Cost/day (ETB) Dosing frequency Treatment duration
(days)
A 2.50 QID 14
B 2.25 Once daily 14
C 5.00 BID 7
D 2.25 BID 7
E 2.25 QID 7
N.B ETB= Ethiopian birr
The most appropriate choice for the hospital is
A. Drug B C. Drug D
B. Drug A D. Drug C and Drug E
2. In establishing a professional relationship with a patient , which of the following
principle s is the least compatible with the philosophy of pharmaceutical care
A. Autonomy and veracity C. Confidentiality
B. Nonalefience D. Paternalism
3. Mulugeta is, a 17 year old male with a highly resistant form of testicular cancer, is in a
hospital for treatment. He is an intelligent, articulate young man. His parents are
insisting that the physician treat him with the latest experimental therapy, but he does
not want to undergo the treatment. If the physician goes ahead and gives the
experimental therapy what ethical principle will have been violated the most
A. Autonomy C. Confidentiality
B. Nonmalefience D. Justice and Veracity
4. The term ‘’perspectives” in the context of Pharmacoeconomic study refers to the
A. Source funding for the conducting Pharmacoeconomicananlysis
B. Approach the researcher takes to analyze the research problem and Approach the
researcher uses to limit confounding factors

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 C. Stakeholder whose intersest is most represented in the study conclusion
D. Method used to facilitate communication of the study results in a journal publication
5. Which of the following would be the most effective method to prevent ‘’inventory
shrinkage ‘’ due to internal theft within the pharmacy
A. Assigning g the responsibility of ordering and receiving of inventory to one employe
B. Implementing an employee bag check program at the end of shifts
C. Hiring uniformed security guard to monitor the pharmacy exits and Offering
incentives such as employee discounts on merchandise
D. Installing mirrors and security cameras strategically throughout the pharmacy
6. Which best describes the principle of Respect for Persons in the Code of Ethics?
A. Respect and honour the intrinsic worth and dignity of every patient.
B. Actively and positively serve and benefit the patient and society.
C. Protect patients and society from harm.
D. Be a responsible and faithful custodian of the public trust.
7. Given that:
i. ascorbic acid (Vitamin C), in an aqueous mixture decomposes by first orderkinetics
and
ii. the half-life of ascorbic acid in this mixture at shelf temperature is 8 months,
What is the acceptable shelf-life of ascorbic acid in aqueous solution assuming that it is
unacceptable when its initial concentration is reduced by 1/8?
A. 0.2 month C. 1.5 months
B. 0.5 month D. 3.0 months
8. Which of the following situations is considered professional misconduct?
A. Failing to provide a prescription delivery service
B. Offering a store coupon for purchasing OTC merchandise
C. Failing to keep records on dialogue regarding all non-prescription drugs
D. Returning a previously dispensed drug to stock for reuse
9. Which of the following statements is TRUE?
A. Conformers can be distinguished by physical methods such as boiling point
B. Meso-compounds have chiral carbon atoms and are therefore chiral
C. The D-prefix means the compound rotates plane of polarized light to the right
D. Cis- and trans-isomers are diastereomers
10. Rx
2
 o Chalk 1.5 g
o Light kaolin 2.5 g
o Alum 10 mg
o Concentrated chloroform water 0.25 mL
o Purified water 10 mL

The inclusion of the alum in the above formulation is to

A. Flocculate the kaolin

B. Peptise the chalk and act as a preservative
C. Act as an astringent
D. Act as a chelating agent
11. All of the following statements concerning thelyophilization of parenteral product are
correct , except
A. There is minimal loss of Activity in heat labile materials
B. The liquid must be frozen to below the eutectic temperature
C. The solute usually forms an amorphous glass and Water is removed from the frozen
mixture by sublimation
D. The eutectic temperature is the freezing point of the drug solution
12. Which of the following statement is false regarding tablet formulation
A. Diluents are fillers to add bulk to the tablet
B. Lubricants help the patient to swallow the tablet more easily
C. Binding agents may be added dry or in solution
D. Disintegrants draw water into the tablet causing it to burst
E. Glidants promote the flow of materials during compression
13. Factors that determine bioequivalence of two brands of a drug include the
A. Taste of the preparation
B. Physical physical appearance of the preparation
C. Pharmacokinetic parametrs of the preparations
D. Cost of the preparations and Package size of the preparation
14. Which ONE of the following statements about capsules is NOT true?
A. Liquids can be filled into capsules made from soft or hard gelatin
B. Capsules should be stored in areas of low humidity and Soft gelatine capsules may
have an antifungal preservative added to the capsule shell

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 C. In general, increasing the packing density results in a decrease in dissolution rate
D. In general, the bioavailability of a powdered drug from a hard gelatine capsule is less
than that of the same drug in a compressed tablet
15. Particle size and crystal structure are generally important factors in bioavailability from
oral dosage forms when:
A. The drug is relatively insoluble in water (less than 1%)
B. The molecular weight of the drug is high (exceeds 1000)
C. The drug is administered as a solution
D. The characteristics of the drug are such that it is not absorbed from the
gastrointestinal tract
16. Certain tablets contain micronised drug particles because:
A. Coarse particles irritate the gastrointestinal tract
B. They have higher bioavailability
C. Tablets prepared from this form disintegrate more rapidly
D. They are intended to act locally and enhance pinocytosis
17. A prescription calls for 0.1% chlorhexidine hydrochloride in an oil-in-water emulsion
cream base. Which ONE of the following is the MOST suitable emulgent for the
preparation of the base?
A. Sodium lauryl sulphate
B. Wool alcohols
C. Cetrimide
D. Sodium stearate and Calcium oleate
18. Stearyl alcohol, cetyl alcohol, cholesterol and other related compounds are used as
A. Solvents for steroidal drug prescriptions
B. Preservatives in small volume parenteral preparations
C. Primary emulsifiers for oil in water preparations
D. Stabilizers in emulsion formulations
19. Which of the following statements is true regarding the use of monoclonal antibody drug
therapies
A. Flu-like symptoms commonly occur at the start of therapy
B. T cells are stimulated and will initiate a host rejection process
C. Adalimumab is a murine –derived immunoglobulin monoclonal antibody product

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 D. Use of chimeric monoclonal antibodies is associated with increased immunogenicity
and Use of Fc fragments avoids raising an immune response against the GAB part
20. A pharmacist is required to produce a litre of a sodium chloride solution of such a
strength that when 20 mL is diluted to 100mL with water, the resulting concentration
will be 0.9% w/v. The only available sodium chloride is in the form of tablets each
containing 2.25 g. The number of tablets required is
A. 45 C. 9
B. 20 D. 4.5
21. The bioequivalence of two tablets containing an identical amount of the same drug
manufactured by different companies is best determined by measuring
A. Their disintegration times and their dissolution times
B. The serum concentrations of drug after ingestion
C. The drug content of each tablet
D. The rate at which each drug is excreted
22. A new cardiac glycoside has been developed for oral and intravenous (IV) administration.
The drug has an elimination half-life of 24 hours and an apparent volume of distribution
(Vd) of 3 L/kg. Theeffective drug concentration in plasma is 1.5 ng/mL. Toxic effects of
the drug are observed at drug concentrations above 4 ng/mL. The drug is 75%
bioavailable after an oral dose.Calculate an oral maintenance dose to be given once a day
for a 65 kg male patient (age 68 years) with congestive heart failure and normal renal
function. The aim is to achieve an average plasma concentration of 1.5 ng/mL. The dose
should be
A. 0.125 mg C. 0.203 mg
B. 0.180 mg D. 0.270 mg
23. A suitable method for the sterilisation of a solution of a thermolabile drug for ophthalmic
use is
A. Heating with a bactericide at 100 °C for 30 min
B. Aseptic filtration through a membrane filter of 4 micron pore size
C. Autoclaving at 121 °C for 15 min
D. Aseptic filtration through a membrane filter of 0.2 micron pore size
24. An extemporaneous prescription order calls for 200ml of a 1 in 5000mlsolution of a
medicine. A busy pharmacy professional prepared it by taking 5ml of a 4%w/v stock

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 solution and 195 ml of the appropriate diluent. Which one of the following is not correct
statement on the strength of the finished product.
A. A 1 in 5000 ml solution contains 1gm in 5000ml.
B. Two hundredml of this solution will contain 40mg which is equal to 1ml of a 4% w/v
stocksolution.
C. The solution prepared by the pharmacy professional is five timesstronger than what
has been prescribed.
D. Two hundred ml of this solution will contain 20mg which is equal to 1ml of a 5% w/v
stock solution
25. A client presented an ordinary prescription that calls for 20 diazepam 10 mg.and 10
paracetamol 500 mg. tablets to a pharmacy. The pharmacy professionaldispensed both
medicines with appropriate instructions for use. Which one of the following is not true
statement.
A. Diazepam is a psychotropic medicine that should be prescribedby using prescription
paper for narcotic and psychotropic medicines.
B. ThePrinciples and Processes of Medicines Good Dispensing Practicepharmacy
professionals should not dispense such medicines based on ordinary prescriptions or
verbal requests.
C. Diazepam is a narcotic medicine that should be prescribed by using prescription
paper for narcotic and psychotropic medicines.
D. Paracetamol is non-narcotic drug and can be dispensed with verbal requests
26. Appropriate quality control procedures to ensure product and patient safety in the
pharmacy don’t include which of the following?
A. Adhering to guidelines for cold chain management and maintaining a regular
cleaning schedule for dispensary surfaces
B. Cleansing counting trays and automated counting machines
C. UsingTALLman lettering on all prescription labels
D. Regulating the pharmacy’s indoor climate where medications are stored
27. Which of the following is not a benefit of performing medication reconciliation activities
in a hospital setting
A. Reduction of medication errors
B. Reduction of inventory pilferage

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 C. Reduction of preventable adverse effects and Assessment of patient adherence to
therapy
D. Enhanced accuracy of patient allergy information
28. The mother of a 6 year old child presents to the pharmacist with a written prescription
for amoxicillin that was ordered by the physician 3 days earlier. She states that her child
was diagnosed with otitis media and the symptoms have remained the same over the
past 3 days. Which of the following is the most appropriate pharmacist response?
A. Fill the prescription as written
B. Indicate a need to contact the prescriber before filling the prescription at this time
C. Fill the prescription for a quantity that is the ordered amount less three days supply
D. Explain at this late date , antibiotic therapy will likely be ineffective for the child
E. Refuse to fill the prescription as the antibiotic order is no longer current
29. Which of the following statements is true regarding the MedlinePlus web site for drug
information? The service
A. Provides the compilation of clinical practice guideline for health care professionals
B. Provides systematic reviews that are based solely on evidence from primary studies
C. Has an emphasis on providing patient/consumer information on a wide variety of
health topics
D. Is limited by its availability only through paid subscription by health care
professionals and is limited by lag to publication and updating of patient therapy
related information
30. AtoSeid is a licensed pharmacist working in his private Pharmacy. His wifeassists him
although she is not pharmacy or health care professional. On a dayAtoSeid was out of
the Pharmacy, she dispensed an expired gentamicinkept on the shelf for a patient. Which
of the following good practice by AtoSeid
A. Allowing non-professionals to dispense medicinesis not illegal.
B. Expired medicines should can be stored in a dispensing room and be reported to the
concerned regulatory body timely.
C. Dispensing expiredmedicines is illegal.
D. It is not necessary to check the expiry date of the stockregularly
31. AtoMisganaw went to a pharmacy with a prescription for nitroglycerin sublingual
tablets. The pharmacy worker repackaged the prescribed number of tabletsin paper
envelops and dispensed with appropriate instructions for use. Someother day,
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 AtoMisganaw consulted the pharmacy professional about decreasingefficacy of the
medicine dispensed. Which one of the following could be the possible reason for the
complaint of AtoMisganaw
A. Nitroglycerin is not a volatile medicine and possible to use paper envelops for
dispensing
B. It should be packaged in tightly closed containers (bottles) because it is not a volatile
medicine
C. The use of paper envelops for repackaging leads to a reduced efficacy of
nitroglycerin, which could bea possible reason for the complaint of AtoMisganaw.
D. The drug interaction may be the possible reason for the complaint
32. A 27 year old patient presents to a community pharmacy for the first time and tells the
pharmacist that he experienced an allergy to a penicillin product as a child. His
symptoms includes, wheezing and facial swelling, which results in hospitalized care.
Which of the following is the most important reason for the community pharmacist to
document this type of information in a patients medication profile record
A. To provide drug allergy information to the patient’s insurance provide
B. To encourage the patient to fill future prescriptions at the pharmacy and To advertise
relevant pharmacy products or services to appropriate patients
C. To enhance continuity of patient care regardless of the prescriber
D. To provide a record of cognitive services for insurance rembursement
33. A male patient that had chlamydial infection and dyspepsia came to a pharmacywith a
prescription for tetracycline capsules and an antacid (magnesiumMedicines Good
Dispensing Practicehydroxide suspension). Because the dispenser was busy, no
instruction aboutthe usage was given to the patient. After two weeks, the patient
consulted his prescriber for no improvement of the chlamydial infection although he
wastaking both medicines together for the specified duration. From the above case which
one is not true?
A. Tetracycline and antacid were prescribed for chlamydial infectionand dyspepsia,
respectively.
B. Loss of the efficacy of tetracycline was possiblydue to its interaction with magnesium
hydroxide, which decreases theabsorption of tetracycline when taken together.
C. Instruction on howto take medicines is important for avoiding such type of medicine
interactions.
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 D. Loss of the efficacy of tetracycline was possibly due to its poor absorption from GIT
and less activity against chlamydial infection
34. The pharmacy professional received a prescription with the followinginformation:
o Tabs Ibuprofen 400mg
o Mitte 60
o One t.i.d.
o The pharmacy professional dispensed 60 tablets of ibuprofen 400mg andwrote a label
that the patient should take three tablets daily with or after food.
From the above information which one of the following is can be false
A. The prescription was to take one tablet three times a day and theinformation on the
label is not clear.
B. Accordingly, the patient may take threetablets at a time, which may lead to an
occurrence of adverse effects or loss ofPrinciples and Processes of Medicines Good
Dispensing Practiceefficacy.
C. Understanding the meaning of Latin abbreviations that may appearon the
prescription papers is important.
D. Accordingly, the patient may take one tablet at a time, which may lead to decreased
occurrence of adverse effects or loss of Principles and Processes of Medicines Good
Dispensing Practice efficacy.
35. A community pharmacist would like to begin a diabetic education program for local
patients newly diagnosed with type 2 diabetes mellitus. Beneficial information for this
group includes all of the following , EXCEPT
A. Strategies to minimize cardiac risk factors
B. Facts on diabetes and its complications and Use of vigorous glucometers
C. Appropriate dietary recommendations
D. Techniques for the mixing of insulin’s
36. Lugol's Solution contains 5% of iodine, and the usual dose of the solution is 0.3 mL three
times a day. The amount of iodine contained in the daily dose of the solution is
A. 450 mg C. 45 mg
B. 150 mg D. 30 mg
37. A pharmacist has to prepare an aqueous solution containing 1 g of benzalkonium
chloride in 2 L, by diluting a 10% solution. How many mL of water will be required?
A. 190 B. 200
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 C. 1800 D. 1990
38. How much ichthammol would be required to be added to a 5% w/w ichthammol in yellow
soft paraffin ointment to prepare 200 g of a 17.5% w/w ichthammol in yellow soft paraffin
ointment?
A. 12.5 g C. 20.2 g
B. 13.3 g D. 26.3 g
39. How many grams of chlorbutol (for ear wax treatment) are required to make 500 mL of
an aqueous solution of such a concentration that 25 mL diluted to 100 mL with water
will give a 1:2000 solution?
A. 10 C. 1.25
B. 2.5 D. 1
40. The method of ionization of mass spectrometry which results in well-established
diagnostic fragmentation patterns that are useful in the identification of compounds of
unknown structure is:
A. Atmospheric pressure chemical ionization (APCI) or Chemical ionization
B. Electron impact ionization
C. Electrospray ionization
D. Fast atom bombardment ionization
41. A 29-year-old woman has had stage 1 hypertension for the past 2 years that has been
well controlled (BP range of 100–110/60–65 mm Hg) on lisinopril 10 mg once daily. She
has successfully implemented lifestyle modifications, losing 14 kg (31 lb) and obtaining
a body mass index of 21 kg/m2. She informs you she is going to start trying to get
pregnant. What changes should be instituted with her antihypertensive therapy at this
time?
A. Discontinuing lisinopril and monitoring BP closely with lifestyle modifications
B. Discontinuing lisinopril and initiating methyldopa
C. Continuing lisinopril because her BP is well controlled
D. Reducing lisinopril dose to 2.5 mg daily and maintaining lifestyle modifications
E. Discontinuing lisinopril and starting HCTZ
42. A 65-year-old postmenopausal woman has a history of hypertension, dyslipidemia, and
chronic stable angina. Her current medications are atenolol 50 mg PO daily, simvastatin
40 mg PO at bedtime, and SL nitroglycerin as needed. She has allergies/intolerances to

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 aspirin (angioedema) and enalapril (cough). Which of the following should be added to
her drug regimen to reduce her risk for cardiovascular events?
A. Clopidogrel C. Niacin
B. Dipyridamole D. Nifedipine
43. A 68-year-old man with a history of hypertension, dyslipidemia, and chronic obstructive
pulmonary disease was recently diagnosed with chronic stable angina. His current
medications are chlorthalidone 25 mg PO daily, atorvastatin 40 mg PO at bedtime,
salmeterol one inhalation every 12 hours, fluticasone MDI two puffs twice a day, and
albuterol MDI one to two puffs every 4 hours prn. His vital signs are a heart rate of 86
beats/min and blood pressure of 150/90 mm Hg. In addition to sublingual nitroglycerin,
what is the most appropriate change to his drug therapy?
A. Start propranolol
B. Start ranolazine and amlodipine
C. Start isosorbidemononitrate
D. Start verapamil
44. A 58-year-old woman presents to the ED complaining of dizziness. ECG reveals an
irregularly irregular rhythm with no visible P waves and an undulating baseline. She
has a past medical history of hypertension and heart failure (left ventricular ejection
fraction 30% [0.30]). Her blood pressure in the ED is 105/65 mm Hg, and her heart rate
is 145 beats/min. Which one of the following is the most appropriate treatment?
A. Immediate direct current cardioversion
B. Amiodarone 300 mg IV administered over 1 hour
C. Digoxin 0.25 mg IV, repeated every 2 hours up to a total dose of 1.5 mg
D. Diltiazem 0.25 mg/kg IV bolus followed by 5 mg/hour IV continuous infusion
45. A 12-year-old girl with asthma presents to the emergency room with complaints of cough,
dyspnea, and wheezing after visiting a riding stable. Which is the most appropriate drug
to rapidly reverse her bronchoconstriction?
A. Inhaled fluticasone
B. Inhaled beclomethasone
C. Inhaled albuterol
D. Intravenous propranolol
46. A 45-year-old woman has had recurrent episodes of atrial fibrillation. She is receiving
phenytoin and quinidine to control the atrial fibrillation. She is also taking a low dose of
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 diazepam for insomnia and estrogen replacement therapy. You learn today that she has
been receiving ciprofloxacin for a urinary tract infection. The reason for her appointment
today is that she has been having ringing in the ears, headache, nausea, and blurred
vision. She tells you that she is also having trouble hearing the television. You suspect
drug toxicity. The most likely agent is
A. Ciprofloxacin C. Phenytoin
B. Quinidine D. Diazepam

47. A 44-year-old man with Type-2 diabetes presents to the ambulatory care clinic
for follow-up. He was diagnosed with diabetes 6 months ago and was started on
oral medication then. His blood sugar has been under good control with a
hemoglobin A1c of 6.7%. He has not had any hypoglycemic episodes. His only
complaint is that despite daily exercise and eating healthier, he has gained
26.6kg in the last 6 months. What medication is most likely to cause his weight
gain?
A. Acarbose C. Glyburide
B. Exenatide D. Metformin
E. Pioglitazone
48. M/r Samson is taking insulin for the first time. As a physician you prescribed 20
units NPH and 5units regular insulin at breakfast, and 10 units NPH and 5 units
regular insulin at dinner. After a few days, he begins to notice this approximate
pattern in his blood sugar measurements: 8 A.M. (fasting), about 110; noon
(before lunch), about 120; 5 P.M. (before dinner), about 55; bedtime, about 115.
When her blood sugar is about 55, he feels shaky and sweaty, but this goes away
if he has something to eat. Which of the following regimen changes would you
recommend to him?
A. Decrease his dinner regular insulin
B. Decrease his morning NPH insulin
C. Stop evening insulin and add a sulfonylurea at bedtime
D. Have him eat a larger lunch
E. Move his evening NPH insulin from supper time to bedtime

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49. A 37-year-old female with mild arthritis presents to the clinic for follow-up. She
states that she is doing much better because of doubling her dose of ibuprofen.
Some days, she even triples her dose throughout the day. The physician warns
the patient about peptic ulcers and bleeding from taking too much ibuprofen. She
is offered alternatives, but the patient refuses because the ibuprofen works so
well. What is the most appropriate therapy for this patient to prevent peptic
ulcers?
A. Bismuth C. Lansoprazole
B. Famotidine D. Misoprostol
E. Pirenzepine
50. A 58-year-old man with a history of occasional GERD resents to the clinic with
diarrhea for the past 3 months. He has not been sick and feeling quite well
otherwise. Further history uncovers that 3 months ago, he switched the type of
antacid he uses for reflux. He stopped the antacid and calls back 1 month later,
saying he has not had diarrhea since then. Which of the following antacids was
most likely causing the patient’s diarrhea?
A. Aluminum hydroxide C. Calcium carbonate
B. Bismuth D. Magnesium hydroxide
E. Sodium bicarbonate
51. A 65-year-old man was brought to the hospital with complaints of pain in lower
abdomen and not having passed urine for 16 hours. The bladder was found to be
full. His son informed that he was depressed for the last 2 years and only the day
before a doctor had given him some medicine. Which of the following drugs is he
most likely to have received:
A. Alprazolam C. Trazodone
B. Sertraline D. Amitriptyline
52. A manic patient has been brought to the hospital with nonstop talking, singing,
uncontrolablebehaviour and apparent loss of contact with reality. Which of the
following is the most appropriate drug for rapid control of his symptoms:
A. Lithium carbonate B. Phenobarbitone

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 C. Haloperidol D. Valproic acid
53. A 10-year-old boy with generalized tonic seizures is seen by his dentist at a
routine checkup. The dentist observes that the patient has an overgrowth of gum
tissue. The patient was most likely receiving which of the following agents?
A. Ethosuximide C. Primidone
B. Clonazepam D. Phenytoin
E. Zonisamide
54. An adult male living in nonmalarious area has to visitan area where chloroquine
resistant P. falciparum isprevalent. He is intolerant to mefloquine and his G-6PD
status is unknown. Select the drug that you will prescribe for prophylaxis of
malaria:
A. Primaquine
B. Doxycycline
C. Amodiaquine
D. Quinine
55. You are treating a patient of deep vein thrombosis with warfarin. What value of
International normalized ratio (INR) will you attempt by adjusting dose of the
anticoagulant for an adequate therapeutic effect:
A. 1.2 – 1.5 C. 1.5 – 2.0
B. 1.3 – 1.7 D. 2.0 – 3.0
56. The following regimen is preferred for nonsurgical termination of pregnancy in
the first 7 weeks:
A. Intravenous oxytocin infusion
B. Intramuscular carboprost
C. 200mg Intravaginal mifepristone followed by intraamnioticdinoprost
D. 600mg Oral mifepristone followed by 400ug oral misoprostol on the third day
57. 21-year-old man presents to the ambulatory care clinic with an erythematous,
swollen, painful left elbow. History is significant for untreated impetigo on his
left forearm. A joint aspirate reveals gram-positive cocci in clusters. The
physician begins empiric treatment with vancomycin while the organism is

14
 cultured. It is found to be methicillin susceptible. Methicillin is not widely used,
but which of the following is an equivalent drug that could be used to treat this
man’s infection?
A. Amoxicillin C. Oxacillin
B. Ampicillin D. Penicillin G
E. Penicillin V
58. A 34-year-old man with a history of recurrent tuberculosis on a multidrug
regimen, including isoniazid. He presents to his primary care physician
complaining of paresthesias of his hands and feet. What is the most likely
explanation for this finding?
A. Diabetes mellitus
B. Lumbar disc disease
C. Peripheral neuritis
D. Spinal cord compression
59. A 24-year-old woman comes to the emergency department presenting with flank
pain and high fever. The pain and fever have been associated with dysuria and
increased frequency of urination. She is diagnosed with pyelonephritis and placed
on IV antibiotics. After a couple of days, she develops ringing in her ears and feels
unbalanced on her feet. What antibiotic was she most likely given?
A. Ceftriaxone
B. Gentamicin
C. Trimethoprim–sulfamethoxazole
D. Tetracycline
60. A 32-year-old G2P1001 woman at 36 weeks gestation presents to the emergency
room with a high fever. The fever started 2 days ago and has progressively
worsened. It has been associated with chills, nausea, vomiting, and full body
aches. The resident suggests starting trimethoprim–sulfamethoxazole as part of
the empiric coverage of her infection until blood cultures return. What side effect
would be a contraindication to starting trimethoprim–sulfamethoxazole in a
pregnant woman?

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 A. Discoloration of teeth
B. Gray baby syndrome
C. Kernicterus
D. Ototoxicity
61. Mood disorders are being more widely managed with anticonvulsants. Which of
the following is FALSE with regard to anticonvulsants used in this fashion?
A. Carbamazepine is useful in the management and prophylaxis of manic
episodes
B. Sodium valproate is a useful treatment for rapid-cycling bipolar mood
disorder at doses of 500 – 3000 mg per day
C. Clonazepam and sodium valproate are both effective for the treatment of
depressive episodes
D. Clonazepam is effective in manic episodes and has advantages over other
benzodiazepines because of its long half-life
62. Metoclopramide is often given together with oral aspirin for the treatment of
acute migraine attacks. The rationale behind the use of metoclopramide is that
it will
A. Slow down the absorption of the analgesic
B. Hasten the absorption of the analgesic
C. Constrict cerebral blood vessels
D. Provide a sedative effect
63. The use of pethidine in the management of chronic pain is discouraged because
it
A. Cannot be administered orallyand Inhibits cytochrome P450 and therefore
has the potential to cause drug interactions
B. Is the opioid analgesic most likely to cause dependence
C. Has a toxic metabolite that can accumulate and cause seizures if a patient has
compromised renal function
D. Has a long half-life and unpredictable pharmacokinetics

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64. Theophylline has a very narrow therapeutic index. This drug has severe dose
related toxicity (seizures and arrhythmias) which may occur without preceding
milder symptoms of toxicity (vomiting and diarrhoea).Theophylline
concentrations are raised by a number of commonly used drugs. Three such drugs
are
A. Ranitidine, aspirin, captopril
B. Cimetidine, diazepam, flucloxacillin
C. Erythromycin, cimetidine, nitrazepam
D. Erythromycin, ciprofloxacin, cimetidine
65. The following points should be included in your counseling advice to a person
using topical sunscreen agents to prevent sunburn EXCEPT
A. While sunscreens under optimal conditions may be effective at preventing
sunburn, they may be less effective at preventing skin cancer
B. Chemical sunscreens are less effective than avoidance of sun exposure and
physical protection
C. Water immersion, sweating and infrequent application can make a 15+ broad
spectrum sunscreen less effective
D. Barrier sunscreens are less effective than chemical sunscreens
66. What advice would you NOT give to a patient prescribed rifampicin capsules for
long term treatment?
A. This medicine may make your urine a red-orange colour
B. This medicine may affect tests of liver function
C. This medicine requires regular monitoring of your blood cell counts
D. This medicine may darken the color of your iris
67. Levodopa is often the drug of choice in the treatment of parkinsonism. The
rationale for the use of this drug is based upon which of the following?
A. A deficiency of noradrenaline in the subcortical regions of the brain
B. Dopamine does not readily pass the blood-brain barrier
C. Tyrosine hydroxylase is a rate-limiting enzyme

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 D. Peripheral nerves are deficient in methylating enzyme and Dopamine excess
occurs in Parkinson's disease
68. Which ONE of the following statements about dose and response is CORRECT?
A. Loop diuretics have a dose response curve that reaches a maximum after a
few increments of dose and Thiazide diuretics have a steep and prolonged
dose response curve
B. If one drug has greater therapeutic efficacy than another then it is more
potent
C. If one drug is more potent than another drug then it can achieve a therapeutic
effect of greater magnitude
D. The therapeutic index is the maximum tolerated dose divided by the
minimum effective dose
Case study
Patient Name =Samson Tadesse
Address= Addis Ababa, Age=34, Height=180 cm, Sex= Male, Weight= 85 kg,
Allergies= No known allergies
Diagnosis
Presenting Complaint:
▪ Primary
o Arrhythmia, Hypertension and Angina
▪ Secondary
o Elevated cholesterol

Medication History:
▪ Ciprofloxacin 500 mg =1 bid
▪ Flecainide 100 mg =1 bid
▪ Amiodarone 200 mg= 1 daily
▪ Glyceryltrinitrate skin patch 10 mg/24 h = 1 daily
▪ Simvastatin 20 mg =1 daily
Pharmacist's Notes

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 • Aluminium hydroxide prn over-the-counter
• Vitamin C over-the-counter
• Psyllium
Answer question 66-70 depending on the above case
69. Simvastatin is effective in lowering:
A. LDL cholesterol and HDL cholesterol
B. LDL cholesterol and plasma triglycerides
C. Plasma triglycerides and HDL cholesterol
D. LDL cholesterol, plasma triglycerides and HDL cholesterol
70. Use of the antiarrhythmic flecainideprescribed is limited because of which ONE
of the following side effects?
A. Aplastic anemia
B. Anorexia and Thrombocytopenia
C. Irreversible paresthesia
D. Exacerbation of arrythmia
71. Which ONE of the following should be regularly monitored for amiodarone
toxicity?
A. Prostate specific antigen (PSA)
B. Thyroid function tests (TFT)
C. International normalised ration (INR)
D. Serum creatinine and Urinary cortisol
72. Mr Samson complains of bilateral shoulder and hip muscle pain. Which ONE of
the following tests is MOST appropriate to investigate his symptoms?
A. Complete blood count
B. Liver function tests
C. Thyroid function tests and Electromyogram
D. Creatine kinase
73. Which ONE of Mr Samson medications is MOST likely to be implicated in his
muscle pain?
A. Amiodarone

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 B. Simvastatin
C. Flecainide
D. Ciprofloxacin
74. A pharmacist has received information regarding a new drug to treat
hypertension. The information is based on a 2 month, placebo controlled,
randomized study of 1000 adults that showed a statistically significant average
decrease in systolic pressure from 160mm Hg to 141 mm Hg and in diastolic
pressure from 98 mm Hg to 86 mm Hg. The most common adverse reactions were
stomach upset and dizziness. Which of the following is the most significant
limitation of this study?
A. The study size was too small to asses efficacy
B. The patients didn’t achieve guideline targets for hypertension
C. Blood pressure is a surrogate outcome and Placebo is not an appropriate
comparator
D. Long term efficacy and safety were not assessed
75. In a study comparing 2 drugs treatment regimens, a type II error occurs when
A. The statistical conclusion is that there is no difference between the
treatment regimens when a difference does not actually exist
B. The statistical conclusion is that there is no difference between the
treatment regimens when a difference actually does exist
C. The P level is > 0.05
D. The drug treatment studied are not appropriate comparator for the the
disease
E. The exclusion criteria are too restrictive

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