اول جزء فى الامتحان1. RY is an 85 year old male who lives alone, currently takes 12 different medications. For the past 2 weeks he has telephoned to ask the pharmacist what dose of diuretic he should be taking (this medication looks similar to another tablet that he takes). He calls again today with the same question. After answering his question, the most appropriate pharmacist action should be to:a. call RY’s family doctor to suggest changing the diuretic to something that looks different.b. suggest that RY have the labels on his prescription bottles changed to a bigger font for easier reading.c. recommend that the pharmacy use a blister packaging dosette to dispense RY’s medications.d. suggest that RY write down the answer to his question so that he does not need to phone again.e. recommend that RY have his hearing and vision tested at his next physician visit.2. AD is a 58 year old male with diabetes, angina and erectile dysfunction. His physician consults the pharmacist in order to decide if AD would be a good candidate for sildenafil. The use of sildenafil is CONTRAINDICATED for AD if he takes:a. isosorbide 5-mononitrate.b. metoprolol.c. glyburide.d. ASA.e. enalapril.3. RP has a prescription for famciclovir for shingles (prescribed 2 days ago), and is uncertain about filling it, due to the high cost. Based on the known effectiveness of famciclovir for herpes zoster, benefits that the pharmacist should discuss with RP include:I prevention of acute zoster-associated pain.II faster healing time for rash.III less and shorter duration of post-herpetic neuropathic pain.a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II and III 4. Common etiologic agents of community-acquired pneumonia include:I Escherichia coli.II Haemophilus influenzae.III Mycoplasma pneumoniae.a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II and III5. Iron may decrease the absorption of which of the following medications?a. Ramiprilb. Atenololc. Moxifloxacind. Ibuprofene. Glyburide6. Which of the following medications is the most appropriate choice for treatment of neuropathic rather than nociceptive pain?a. Nabiloneb. Tramadolc. Ibuprofend. Meperidinee. Nortriptyline7. Appropriate auxiliary labelling for clarithromycin suspension includes which of the following?a. Shake well before using.b. Take with plenty of fluids.c. Avoid prolonged exposure to sunlight.d. Keep refrigerated.e. May cause discolouration of urine.8. The pharmacist fills a prescription for sumatriptan 100 mg tablets for a patient with migraine. Appropriate information to provide to the patient includes which of the following?a. If the sumatriptan does not relieve the headache within four hours, ergotamine may be used.b. If no relief is achieved in two hours, sumatriptan may be repeated.c. If the headache is partially relieved with a single tablet, the dose may be repeated after two hours.d. The maximum dosage of sumatriptan 100 mg in any 24 hour period is six tablets.e. If relief is not achieved, no other medication can be used for at least 24 hours.9. JG has been taking metoclopramide 20 mg, po q6h for the past 3 days as part of her chemotherapy regimen. She normally takes 4 doses daily, with each meal and at bedtime. This morning, she forgot to take her morning dose before leaving home for a hospital check-up. When she arrives at the clinic, she asks the pharmacist what she should do about her missed dose, as she expects to be home again around 11:00 am. The pharmacist should advise JG to:a. take the missed dose immediately when she gets home and continue as scheduled.b. take two doses at lunchtime to make up for the missed dose.c. skip the missed dose and take the next scheduled dose at lunchtime.d. skip today’s medication and resume her normal schedule tomorrow.e. space 4 doses into the remaining hours between when JG gets home and her bedtime.10. EK is a 25 year old female who presents to the pharmacy requesting Plan B® (levonorgestrel) for emergency contraception following an episode of unprotected sex 12 hours ago. After speaking with EK, the pharmacist decides she is a good candidate to receive Plan B®. The pharmacist should include all of the following information in counselling EK, EXCEPT:a. the effectiveness of Plan B® in EK’s situation is likely to be better than 90%.b. Plan B® works mainly by dislodging an implanted fertilized egg from the endometrium.c. EK should take two tablets of Plan B® as a single dose.d. side effects may include nausea, vomiting, breast tenderness, cramps and spotting.e. if vomiting occurs within one hour of dosing, a repeat dose may be warranted. 11. All of the following are reasons that elderly patients are more susceptible to drug-induced cognitive changes, EXCEPT:a. they are more likely to take multiple drugs.b. they may have hepatic dysfunction.c. they may have renal dysfunction.d. they are more sensitive to CNS effects of drugs.e. they have increased metabolic rates for producing psychoactive metabolites.12. For a child with asthma, all of the following factors are indicators of poor control, EXCEPT:a. number of visits to the Emergency Room.b. limitations on daily activities.c. awakening at night with asthma symptoms.d. keeping one canister of salbutamol at home and one at school.e. number of parent work days missed due to the child illness.13. Assessment of a patient's asthma control should include all of the following factors EXCEPT:a. immunization status.b. inhalation technique.c. use of inhaled β2 agonist.d. use of inhaled corticosteroid.e. changes in environmental triggers.14. Which of the following liver enzymes is the first to be elevated in a case of an acetaminophen overdose?a. Lactic dehydrogenase (LDH)b. Alanine transaminase (ALT)c. Aspartate transaminase (AST)d. Alkaline phosphatase (ALP)e. Gamma glutamyl transpeptidase (GGT)15. AJ is a 24 year old, married female, who is planning to become pregnant in the near future. AJ has no medical conditions, no allergies, and is not currently taking any medications. What vitamin supplement should the pharmacist recommend to AJ to prevent neural tube defects in her baby?a. Niacinb. Vitamin Dc. Folic acidd. Pyridoxinee. Ferrous sulphate16. Side effects which the pharmacist should monitor in DS, when looking for the effects of excessive topical corticosteroid use, include: I pruritus. II telangiectasias. III striae.a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II and IIICOMPETENCY 2: Professional Collaboration and Teamwork17. FR is a 70 year old female client who presents to the pharmacist, complaining of nausea, diarrhea and dizziness for the past three days. Her medication profile includes: ASA, digoxin, enalapril, and amiodarone. She denies any recent diet changes and the only change to her medications was the addition of amiodarone last week. She believes she must have picked up a “stomach bug” and would like something for symptom relief. The most appropriate pharmacist recommendation for FR is to:a. take loperamide and dimenhydrinate for symptom relief.b. take increased fluids and bed rest until the symptoms resolve.c. contact FR’s physician to discontinue the ASA until these symptoms resolve.d. contact FR’s physician to discontinue amiodarone until these symptoms resolve.e. contact FR’s physician to suggest that a digoxin level be taken.18. DS is a 27 year old male who comes to the pharmacy seeking advice because, for the past 24 hours, he has experienced abdominal cramping, mild fever and frequent, loose stools with some blood loss. DS thinks it may be related to the antibiotic he has been taking for a dental abscess. Current medications include: clindamycin 150 mg QID x10 days, started 8 days ago, and losartan 25 mg daily for hypertension, started 3 months ago. The most appropriate pharmacist response is that these symptoms: a. are expected, transient side-effects of clindamycin; treat symptoms and continue medications.b. may indicate an interaction between clindamycin and losartan; pharmacist call to dentist is warranted.c. may indicate clindamycin-related pseudomembranous colitis; seek immediate medical attention.d. may indicate losartan-related pseudomembranous colitis; seek immediate medical attention.e. are probably unrelated to DS’s medications; treat for flu symptoms and follow- up if no improvement.19. FD, a 58 year old male with hypertension, asks the pharmacist if cranberry juice would be useful for his current symptoms, which include frequency and a large volume of urine, but no urgency, or painful urination. Further questioning reveals that for the past 2 months he has also experienced polydipsia and polyphagia. The pharmacist should refer FD to his physician because these symptoms are consistent with:a. cholelithiasis.b. a urinary tract infection.c. prostate hyperplasia.d. diabetes mellitus.e. renal complications of hypertension. 20. A local physician approaches the community pharmacist to collaborate on a health promotion pamphlet addressing medication adherence. Which of the following is NOT an appropriate topic for the pamphlet?a. The team relationship of the patient with both his physician and pharmacistb. The service of the pharmacy providing reminder calls for medication refillsc. Advice to bring upcoming refill requests to scheduled physician appointmentsd. The various kinds of reminder packaging available to assist patientse. Referral to industry-sponsored consumer websites for information regarding medications21. Academic detailing by pharmacists provides a service to physicians by:a. educating on improved prescribing legibility.b. advising on optimal patient interviewing techniques.c. recommending strategies to avoid medication wastage.d. providing current information on best prescribing practices.e. promoting the use of physician samples given to patients.COMPETENCY 3: Ethical, Legal and Professional Responsibilities22. According to the Narcotic Control Regulations of the Controlled Drugs and Substances Act, which of the following practitioners may prescribe narcotic drugs?a. Veterinariansb. Nurse practitionersc. Podiatristsd. Midwivese. Physiotherapists23. The ethical principle of veracity requires that pharmacists:a. respect the rights of others to make choices.b. do good to patients, placing the benefit of the patient over other factors such as cost.c. avoid, remove or prevent harm.d. act with fairness, to allow people to receive that to which they are entitled.e. act with honesty, without deception.24. JN, a 17 year old male with a highly resistant form of testicular cancer, is in 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 JN 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. Confidentialityb. Non-maleficencec. Justiced. Veracitye. Autonomy25. Which of the following medications does NOT require witnessed destruction?a. Ketamineb. Nabilone c. Diazepamd. Testosterone e. Gabapentin26. The Canada Health Act (1984) embodies all of the following principles, EXCEPT:a. affordability.b. accessibility.c. comprehensiveness.d. portability.e. universality.27. ST is no longer satisfied with the service she has been getting at Pharmacy X across town, so she comes to your pharmacy requesting a refill of 3 months’ supply on a prescription for an oral contraceptive that she originally had filled at Pharmacy X. What is the correct procedure for obtaining the remaining refills?a. The pharmacist must contact Pharmacy X to get the prescription refills transferred, and document the transfer appropriately.b. The pharmacist cannot refill this prescription without phoning the prescribing physician.c. The pharmacist may refill the prescription as long as the patient provides you with the label from the original prescription.d. The pharmacist may refill the prescription and notify Pharmacy X within 24 hours that this has been done.e. Inform ST that the prescription resides at Pharmacy X and she must return there for refills.28. According to federal legislation, which of the following examples shows a legally correct refill designation on a written prescription for dexamphetamine?a. Repeat twice.b. Repeat monthly.c. Repeat as needed.d. Repeat twice as required.e. Repeat twice at 14 day intervals.29. According to the Benzodiazepine and Other Targeted Substances Regulations, what is the expiry date for refilling a prescription for lorazepam?a. Six months from the date writtenb. Six months from the date originally filledc. One year from the date writtend. One year from the date originally fillede. No specific expiry date; at the pharmacist’s discretion30. The standard of publicly funded health care in Canada is mandated by:a. the Canada Health Act.b. individual provinces and territories.c. Health Canada’s Health Environment and Consumer Safety directorate.d. Canadian Agency for Drugs and Technologies in Health.e. National Association of Pharmacy Regulatory Authorities.31. The pharmacist receives a phone call from a physician who wishes to leave a verbal prescription for 30 alprazolam 0.25 mg tid, with 2 repeats. It is a new prescription for the patient. Which of the following statements is true?a. Prescriptions for benzodiazepines should be filed with the narcotic and controlled prescriptions.b. The prescription should not be dispensed because verbal prescriptions are not allowed for benzodiazepines.c. The prescription may be dispensed for the original quantity only, because refills are not permitted.d. Transfer of this prescription is permitted as long as the prescription is only transferred once.e. Keeping reports of sales in a manner that permits an audit is required for all benzodiazepines.32. For a drug going through research and development processes in Canada, which of the following statements is true?a. Application for patent protection is granted for a maximum period of three years.b. A New Drug Submission must be filed in order to start clinical trials.c. Clinical trials involve three phases assessing animal safety and efficacy.d. Each package size of a drug product must have a unique Drug Identification Number (DIN).e. Health Canada under the Food & Drugs Act & Regulations provides Notice of Compliance.33. Which of the following is the national voluntary organization for advocacy of pharmacists and patient care?a. Canadian Foundation for Pharmacyb. Canadian Pharmacists Associationc. Canadian Patient Safety Instituted. Institute for Safe Medication Practicese. National Association of Pharmacy Regulatory Authorities COMPETENCY 4: Drug, Therapeutic and Practice Information 34. Which of the following would be the most useful reference to learn what combination of antiretroviral agents is currently recommended as a first line therapy to treat HIV infection?a. Meta-analysesb. Randomized, controlled trialc. Pharmacology textbookd. Clinical practice guidelinese. Compendium of Pharmaceuticals and Specialties35. Which information source would be most appropriate to consult first, to determine if labetalol is a cardioselective beta-blocker?a. Compendium of Pharmaceuticals and Specialtiesb. Randomized, controlled trial datac. Meta analysis of beta blocker therapyd. Cochrane Library databasee. Case reports36. Type II statistical error in a study comparing 2 drug treatment regimens occurs when:a. the control drug is not a "gold standard" treatment. b. a statistically significant difference exists but the difference is not clinically important. c. the population under investigation does not represent the population with the disease. d. the data shows no difference between 2 treatment regimens and a difference actually does exist.e. the data shows a difference between 2 treatment regimens but a difference does not actually exist.37. An adequately powered, randomized controlled trial conducted over 2 years demonstrated that the primary outcome (a serious cardiovascular event) occurred in 15% of the patients who received the new drug, whereas the primary outcome occurred in 25% of the patients who received a placebo. The relative risk reduction achieved with the new drug is:a. 10%.b. 15%.c. 25%.d. 40%.e. 50%.38. In an adequately powered, randomized controlled trial conducted over 3 years, a specific serious side effect (i.e. reduction in leukocytes) with conventional therapy is seen in 0.5% of the study sample. In patients who receive a newly discovered drug, only 0.45% experience the same side effect. Based on these results, the minimum number of patients that would need to receive the new drug for 3 years to statistically demonstrate the prevention of one episode of this side effect in at least one patient (i.e., NNT) is:a. 15.b. 20.c. 150.d. 200.e. 2000.
مبروك للجميع النجاح وربنا يوفقكم فى الحصول على وظيفه
بس معلش كنت عايزه اسالكم يا دكاتره هو BNF ذاكرتوه ازاى اصله كبير جدا وبيلخبط بين S/E و CAUTIONوC/I وهو بياخد وقت اد ايه فى المذاكره
وهل الامتحانات السابقه بتغطى جزء كبير من الاسئله اللى بتجيى فى الامتحان وكمان كتاب Appleton
السلام عليكم يا دكاترة مبرووووووووووووووووووووووك لكل اللي نجحوا انا فرحتلكم كتير لانكم تستحقوا النجاح مبروك دنابلس ود بوشي علي النجاح وعقبال القانون ان شاء الله ومبروك د جوجو ود هيكري ود نبيل انا فرحتلكم والله وعقبال باقي الدكترة ان شاء الله.وادعولي وادعوا لباقي الدكاترة بالنجاح .