pebc evaluating exam questions

PEBC evaluating exam questions #7

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By Dhruv Mangukia

Welcome back to yet another blog post to practice a few more PEBC evaluating exam questions.

As with all the previously published question sets for PEBC evaluating exam questions, this one contains additional notes, revision tips, and some mnemonics. And yes, this one is also worth 10 to 15 minutes of reading time. Please read, memorize, and revise these questions until you are confident.

BOOKMARK this page so that you can visit later. All the best.

Table of Contents for PEBC evaluating exam questions #7

Question 1: Which of the following is true for the Canadian Health Act?

A. Universality, Priority, Accessibility, Comprehensiveness, Public administration
B. Equality, Provinciality, Accessibility, Portability, Comprehensiveness
C. Universility, Public administration, Portability, Accessibility, Comprehensiveness
D. Provinciality, Universality, Equality, Priority, Immobility
E. Priority, Groupability, Universailty, Comprehensiveness, Public administration
Click here to see the answer

Answer: C

Mnemonic: UPPAC

Question 2: What happens when the ethinyl group is added to estrogen?

A. Higher bioavailability and increased resistance to metabolism
B. Lower bioavailability due to increased metabolism
C. Makes it suitable for iv administration
D. Makes it suitable for use in patients with history of deep vein thrombosis
E. Reduces the side effects of estorgen
Click here to see the answer

Answer: A

Mnemonic: UPPAC

Question 3: A patient needs to achieve a target plasma concentration of 4 mg/L of a drug. The volume of distribution (Vd) is 60 L, and the bioavailability (F) is 80%. What is the loading dose?

A. 600 mg
B. 480 mg
C. 300 mg
D. 520 mg
E. 450 mg
Click here to see the answer

Answer: C

Loading dose = Cp x Vd/F

Just put the values in the above formula

Question 4: A study was conducted to evaluate the effectiveness of a new vaccine in preventing influenza infection. The study included 200 people who took the vaccine and 200 people who were administered distilled water for injection to induce a placebo effect. In the vaccine group, 10 people developed the disease. In the unvaccinated group, 40 people developed the disease. Based on the given information, answer the following questions

Question 4.1: What is the relative risk (RR) of developing the disease in those individuals who are vaccinated in comparison to ones who are not vaccinated?

A. 0.25
B. 0.30
C. 0.20
D. 1.10
E. 0.90
Click here to see the answer

Answer: A

RR (Relative Risk) = Incidence in the experiment group/Incidence in the control group

Question 4.2: What is the number needed to treat (NNT) to prevent one additional case of the disease?

A. 35
B. 10
C. 20
D. 30
E. 5
Click here to see the answer

Answer: B

NNT = 1/ARR

ARR = Absolute Risk Reduction

Question 5: JT comes to pharmacy with the following prescription

Rx

Tramadol 100 mg q6h 1 tab PRN F10d, Mitte 40 tab, R 3

Choose the correct answer from the following options

A. Tramadol is prescribed every 8 hours
B. Tramadol should not be taken for more than 7 days
C. Refills are not allowed
D. Refills are allowed only if interval is mentioned
E. No problem with prescription
Click here to see the answer

Answer: B

Tramadol is a straight narcotic. The prescription of a narcotic cannot be refilled.

Question 6: JT comes to the pharmacy complaining that he is experiencing difficulty in swallowing phenytoin capsules. He inquired if a liquid dosage form is available for his medicine. Currently, JT is taking 100 mg of phenytoin per dose. Which of the following statements is true?

A. 23 ml of 4 mg/ml of phenytoin suspension per dose
B. 25 ml of 4 mg/ml of phenytoin suspension per dose
C. 30 ml of 4 mg/ml of phenytoin suspension per dose
D. Refer to a doctor as Pharmacist cannot change phenytoin capsules
E. Explain the patient that nausea will eventually go away
Click here to see the answer

Answer: A

Phenytoin capsules, iv, and im have 92% bioavailability while other dosage forms has 100% bioavailability.

100 mg capsules at 92% bioavailability give 92% phenytoin. Option A is 23 * 4 = 92 mg.

Question 7: Calculate the dosage form of subcutaneous morphine 5 mg qid to oral morphine. The bioavailability of subcutaneous morphine is twice that of the oral form.

A. 5 mg oral morphine q6h
B. 10 mg oral morphine q4h
C. 2.5 mg oral morphine every 6 hours
D. 40 mg oral morphine per day in 6 divided doses
E. 40 mg oral morphine per day in 4 divided doses
Click here to see the answer

Answer: E

5 mg oral morphine qid = 5 * 4 = 20 mg/day

Subcutaneous has twice the bioavailability of oral dosage form. So, if sc is 20 mg/day, then oral is 40 mg/day. Now, the subcutaneous dose was 4 times in a day. So, oral dose of 40 mg is in 4 divided doses.

Question 8: What is the mechanism of action of Omalizumab?

A. inhibits the binding of IgE antibodies to IgE receptors
B. B-cell depletor
C. TNF alpha inhibitor
D. IL - 1 inhibitor
E. IL - 5 inhibitor
Click here to see the answer

Answer: A

Question 9: Individuals can be protected by vaccination against which of the following microorganism-caused diseases?

A. Treponema palladium
B. Plasmodium vivax
C. Bordetella pertussis
D. Leishmania species
E. Human immunodeficiency virus
Click here to see the answer

Answer: C

Pertussis is caused by Bordetella pertussis. Pertussis is also known as whooping cough.

Question 10: A drug has two structures which are mirror images of each other. Which type of isomerism is this?

A. Diastereomers
B. Geometric isomers
C. Conformational isomers
D. Constitutional isomers
E. Enantiomers
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Answer: E

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Question 11: JT is a pregnant woman with asymptomatic bacteriuria. She has a history of experiencing hives and severe rash upon taking penicillin. The bacterial culture was sensitive to nitrofurantoin, cloxacillin, cephalosporin, and amoxicillin. Answer the following questions based on the information provided.

Question 11.1: Which of the following is the most appropriate treatment for JT?

A. No need for medicines as JT does not have any symptoms
B. Nitrofurantoin for 7 days
C. Cephalosporin for 14 days
D. Amoxicillin for 10 days
E. Pain killer for her burning sensation after urination
Click here to see the answer

Answer: B

Question 11.2: She came later to the pharmacy complaining about the symptoms indicative of vaginal candidiasis. What is the pharmacist’s recommendation?

A. No need for any medicine as JT is taking Nitrofurantoin
B. Discontinue Nitrofurantoin as vaginal candidiasis is a side effect
C. Single dose of Fluconazole
D. Cotrimazole 1%
E. Miconazole 2%
Click here to see the answer

Answer: D

Question 12: Betacarotene is a precursor of vitamin A. The chemical reaction involved in the formation of vitamin A is known as:

A. Oxidative deamination
B. Hydrolysis
C. Oxidative cleavage
D. Reduction
E. Azo reduction
Click here to see the answer

Answer: C

Question 13: Sumatriptan is structurally related to which of the following?

A. Tryptamine
B. Histidine
C. Methionine
D. Leucine
E. Isoleucine
Click here to see the answer

Answer: A

Tryptamine is an indolamine metabolite of tryptophan. Tryptophan is an essential amino acid.

Question 14: JT is a young mom who comes to the pharmacy with her 18-month-old child. JT told the pharmacist that the baby is frequently experiencing symptoms that are indicative of recurrent otitis media for 3 weeks. Based on the given information, answer the following questions.

Question 14.1: Which of the following is the causative agent?

A. H. influenza
B. N. meningitis
C. S. pneumonia
D. S. aureus
E. P. aeruginosa
Click here to see the answer

Answer: C

Causative agents for Otitis media are S. pneumonia, H. influenza, and M. catarrhalis

Question 14.2: Which of the following would be the pharmacist’s recommendation?

A. Amoxicillin for 10 days
B. Amoxicillin + clavulanate for 10 days
C. Hydroxychloroquine for 7 days
D. Rifampicin for 5 days
E. Clindamycin for 14 days
Click here to see the answer

Answer: B

Question 15: What is the mechanism by which monoclonal antibodies are absorbed?

A. Hepatic and Portal circulation
B. Lymphatic circulation and blood
C. Pulmonary circulation
D. Active transport via hepatic circulation
E. Endocytosis via pulmonary circulation
Click here to see the answer

Answer: B

Question 16: What is the mechanism of action of Tacrolimus?

A. IL - 2 inhibitor
B. B-cell depletor
C. TNF alpha inhibitor
D. IL - 1 inhibitor
E. IL - 5 inhibitor
Click here to see the answer

Answer: A

Tacrolimus mechanism of action – Tacrloimus is a calcineurin inhibitor that further inhibits T – T-lymphocyte signal transduction and IL – 2 transcription.

Question 17: Which of the following vitamins are vegan people usually found to be deficient of?

A. Vitamin B12
B. Vitamin C
C. Vitamin D
D. Vitamin E
E. Vitamin B6
Click here to see the answer

Answer: A

Question 18: Which of the following is the most abundant in adaptive immunity?

A. Natural Killer Cells
B. Antibodies
C. Eosinophils
D. Basophils
E. Neutrophils
Click here to see the answer

Answer: B

Question 19: PEGFilgrastim is produced by conjugating Filgrastim with PEG. Why is Filgrastim conjugated with PEG?

A. Increases the half life of Filgrastim
B. Decreases the half life of Filgrastim
C. Reduces the side effects of Filgrastim
D. Increases the dosing interval
E. Reduces the dosing frequency
Click here to see the answer

Answer: A

Question 20: Why is PEG added to a suppository base?

A. PEG reduces the melting point of the drug
B. PEG improves the stability of the drug
C. PEG increases the wettability
D. PEG gives a smooth texture to suppository
E. PEG is not added to suppository base
Click here to see the answer

Answer: C

PEG can be used as a base in suppository formulation. It can also be added to suppositories to increase the wettability.

Question 21: JT is taking Dabigatran as a prophylaxis for Atrial fibrillation. Now she is experiencing symptoms like bloody or tarry stools, dark or pink-coloured urine, and prolonged bleeding. These symptoms are conclusive of a Dabigatran overdose. What is the pharmacist’s recommendation?

A. Andexanet
B. Deferoxamine
C. Protamine sulfate
D. Vitamin K
E. Idarucizumab
Click here to see the answer

Answer: E

Quick revision on Dabigatran:

Dabigatran is a prodrug with a mechanism of action that involves direct Thrombin (factor IIa) inhibition. Dabigatran is a substrate of P-gp and CYP3A4 and should be avoided in patients with CrCl < 30 ml/min.

Drug OverdoseAntidote
Apixaban and RivaroxabanAndexanet
DabigatranIdarucizumab
DeferoxamineIron
HeparinProtamine Sulfate
WarfarinVitamin K
Table: Drug overdose and antidotes

Question 22: Which of the following antidepressants has the highest QT prolongation?

A. Citalopram
B. Sertraline
C. Venlafaxine
D. Mirtazapine
E. Moclobemide
Click here to see the answer

Answer: A

Citalopram and Escitalopram cause QT prolongation

Question 23: Which of the following drugs cause Tardive dyskinesia?

A. Citalopram
B. Duloxetine
C. Haloperidol
D. Mirtazapine
E. Donepezil
Click here to see the answer

Answer: C

Typical (1st generation) antipsychotics have high EPS.

Tardive dyskinesia is one of the symptoms of EPS (Extrapyramidal Symptoms). Tardive dyskinesia is irregular jerky movements often involving the lower face + distal extremities. This may be chronic. This can become irreversible if continued for a long time.

Additional resource on Tardive dyskinesia

The video attached here is only for understanding the symptoms of Tardive dyskinesia. As such, it is not important from PEBC evaluating exam perspective.

Additional reference: What is Tardive dyskinesia?

Question 24: Which of the following statements is correct about volume of distribution?

A) The total volume of blood in the body.
B) Ratio of dose and plasma concentration
C) The volume of urine produced by the kidneys per hour.
D) The volume of the liver where drug metabolism occurs.
E) The volume of the gastrointestinal tract where drug absorption occurs.
Click here to see the answer

Answer: B

The volume in which a drug would need to be uniformly distributed to produce the observed blood concentration.

Question 25: JT is a 16-year-old teen who was prescribed Salbutamol 2 puffs 2 times a day 1 month ago. Initially, the drug was working fine but all of a sudden, she felt that the medicine was not working. What is this called?

A. Anaphylaxis
B. Tolerance
C. Tachyphylaxis
D. Metastasis
E. Genetic polymorphism
Click here to see the answer

Answer: C

Tachyphylaxis is acute desensitization or a sudden decrease in a drug’s response. Tolerance is chronic desensitization or a gradual reduction in a drug’s response.

Nitrates for chest pain, Hydralazine for high blood pressure, and Oxymetazoline for nasal congestion are some drugs known to cause tachyphylaxis.

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