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Table of Contents for PEBC pharmacist evaluating exam #14
PEBC pharmacist evaluating exam – Questions 1 to 10
Question 1: A pharmacy technician is preparing an emulsion and the pharmacist notice something unexpected with the emulsion. Which of the following is the most likely problem?
A. Sedimentation
B. Evaporation
C. Coalescence
D. Creaming
E. Flocculation
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Answer: D
Question 2: Patient taking Allopurinol for gout attack and not responding to medicine. Which of the following is the recommendation for this patient?
A. Indomethacin
B. Colchicine
C. Febuxostat
D. Denosumab
E. Prednisolone
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Answer: C
Febuxostat and Allopurinol, both are xanthine oxidase inhibitors. Even though they have the same mechanism of action, they both have different chemical structures. Hence, they can be used as an alternative to each other.
Question 3: What is the role of the Canadian Pharmacists Association (CPhA)?
A. Providing one-on-one medication advice and dispensing drugs to patients.
B. Lobbying for drug companies to get better deals from the government.
C. Advocating for the profession of pharmacy and ensuring pharmacists' voices are heard in healthcare decisions.
D. Controlling who can become a pharmacist and issuing licenses across Canada.
E. Running a network of pharmacies in Canada with lower medication prices.
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Answer: C
- The largest organization of pharmacists in Canada
- Advocates on behalf of pharmacists to governments, and the public (example: they have a campaign to increase the scope of practice of pharmacists)
- Leads a number of national projects, publications, and conferences
- Lobbies governments and publishes recommended government policies
- Publishes references like CPS, CTC, and CTMA, & Offers continuous education programs.
Question 4: What would you call a study where all pharmacists took a questionnaire to see their opinion about something?
A. Delphi analysis
B. Cross sectional
C. Case study
D. Longitudinal study
E. Meta analysis
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Answer: A
Delphi analysis = group survey + several rounds of questionnaire
Question 5: Which of the following is an example of extracellular anion?
A. Phosphate
B. Chloride
C. Potassium
D. Calcium
E. Magnesium
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Answer: B
Question 6: What is the mechanism of action of Rasagiline?
A. Reversible inhibition of MAO-B
B. Reversible inhibition of MAO-A
C. Irreversible inhibition of MAO-A
D. Irreversible inhibition of MAO-B
E. Reversible inhibition of MAO-A and MAO-B
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Answer: D
Selegiline and Rasagiline are irreversible inhibitors of MAO-B
Safinamide is reversible inhibitor of MAO-B
This question is important.
Question 7: Which cells line the blood-brain barrier?
A. Neurons
B. Oligodendrocytes
C. Astrocytes
D. Endothelial cells
E. Schwann cells
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Answer: D
Capillary endothelial cells line blood-brain barrier (BBB).
Astrocytes, Pericytes, and Microglia supports the function of BBB. The functions of all these cells are mentioned in the table below.
| Cell Type | Function |
| Neurons | Transmit nerve impulses |
| Oligodendrocytes | Form myelin sheath in the central nervous system |
| Astrocytes | Support BBB, maintain environment |
| Endothelial cells | Form the BBB, regulate substance passage |
| Pericytes | Regulate blood flow, maintain BBB integrity |
| Microglia | Immune response, influence BBB function |
| Schwann cells | Form myelin sheath in the peripheral nervous system |
Question 8: Which of the following in brain is responsible for emesis?
A. Hippocampus
B. Amygdala
C. Chemoreceptor trigger zone
D. Thalamus
E. Hypothalamus
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Answer: C
There are two medullary centers of vomiting in the brain known as the sensory Chemoreceptor trigger zone (CTZ) and vomiting center.
Question 9: Which of the following are the side effects of Phenytoin?
A. Gingival hyperplasia, ataxia, nystagmus
B. Steven-Johnson syndrome
C. Hirsutism and acne
D. All of the above
E. Coarse Facial features
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Answer: D
Hirsutism, acne, and coarse facial features are long-term side effects of taking Phenytoin.
Question 10: Which of the following decreases mortality in CHF?
A. Digoxin
B. Atorvastatin
C. Amlodipine
D. Captopril
E. Furosemide
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Answer: D
ACEIs & BBs are Recommended in all patients because they improve symptoms and reduce the risk of hospitalization, MI, and death in patients with HfrEF.
PEBC pharmacist evaluating exam – Questions 11 to 20
Question 11: What do we use for resistant schizophrenia?
A. Clozapine
B. Asenapine
C. Flupentixol
D. Olanzapine
E. Risperidone
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Answer: A
Clozapine ↓D2 ↓5HT2, ↓H1, ↓M, Alpha1-2 – Important question and important drug
Question 12: Bupropion works on which of the following neurotransmitters?
A. Serotonin
B. Norepinephrine
C. GABA
D. Acetylcholine
E. Histamine
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Answer: B
Bupropion is classified as NDRI = Norepinephrine DOpamine Reuptake Inhibitor. Serotonin (very little), dopamine & norepinephrine reuptake inhibitors.
Question 13: Long-term treatment with PPIs causes a deficiency of which of the following vitamins?
A. Vitamin C
B. Thiamine
C. Folic acid
D. Cyanocobalamin
E. Vitamin D
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Answer: D
This is a side effect of all PPI’s except Dexlansoprazole.
Important long-term side effects that can come as a case question are C. difficile diarrhea and osteoporosis. Also, memorize other side effects.
Question 14: What is the problem of tertiary references relative to other references?
A. Accuracy
B. Accessibility
C. Time to update
D. Cost
E. Completeness
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Answer: C
Question 15: Which of the following should a person with gluten sensitivity avoid eating?
A. Rye
B. Milk
C. Rice
D. Corn
E. Oats
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Answer: A
Question 16: A 70-year-old diabetic patient on insulin therapy with an HbA1c of 8 mmol and glucose levels of 10 mmol in both the morning and evening, also has dementia (taking Donepezil), GERD (taking Calcium Carbonate), and hypertension (taking Beta-Blockers). He presents with dizziness, low blood pressure (85/55 mmHg), and bradycardia. Answer the following questions based on the given information.
Question 16.1: When should this patient check his HbA1c?
A. Every month
B. Every 2 months
C. Every 3 months
D. Every 4 months
E. Every 6 months
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Answer: C
HbA1c measurements every 3 months for patients who have not achieved the target
values and every 6 months may be acceptable in stable patients who
consistently meet glycemic targets.
Question 16.2: What should this patient take to decrease his HbA1c?
A. Metformin
B. Glipizide
C. Insulin
D. Liraglutide
E. Acarbose
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Answer: D
Liraglutide is a GLP-1 analog. These drugs have the highest HbA1c-lowering effect.
Question 16.3: What is the cause of dizziness and bradycardia in this patient?
A. High blood pressure
B. Low blood sugar
C. BBs and donepezil
D. GERD medication
E. Insulin overdose
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Answer: C
Donepezil is a cholinergic agonist (reversible choline esterase inhibitor). Bradycardia is a side effect of Donepezil (Mnemonic = WET or DUMBELS). Bradycardia is also a side effect of beta blockers. Also, beta-blockers have a side effect by which they mask the symptoms of hypoglycemia. Additionally, none of the drugs in the case of this patient cause dizziness (So it is due to hypoglycemia).
Question 16.4: What is the drug – disease interaction in this case?
A. Insulin and dementia
B. Donepezil and GERD
C. Calcium Carbonate and hypertension
D. Beta-Blockers and dementia
E. Insulin and Beta-Blockers
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Answer: C
Donepezil increases the secretion of gastric HCl. This when combined with GERD increases the potential for esophageal ulcers, which in turn increases the risk of bleeding.
Question 16.5: Which medication is most appropriate to treat GERD in this patient, considering his current medical conditions and medications?
A. Esomeprazole
B. Famotidine
C. Ranitidine
D. Sucralfate
E. Metoclopramide
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Answer: A
Question 17: Which strategy is most effective for promoting medication adherence in patients with dementia?
A. Use of pill organizers
B. Verbal reminders from caregivers
C. Complex medication schedules
D. Written instructions
E. Increasing medication doses
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Answer: A
Question 18: What treatment is recommended after nonpharmacological measures for teething pain in infants?
A) Clove oil
B) Acetaminophen
C) Ibuprofen
D) Benzocaine gel
E) Lidocaine
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Answer: B
Question 19: Which of the following is recommended to be stored in the fridge?
A) Clarithromycin
B) Ketoconazole suspension
C) Azithromycin
D) Amoxicillin
E) Doxycycline
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Answer: B
Question 20: Which is used as a humectant, preservative, and solubilizing agent?
A) Glycerine
B) Ethyl alcohol
C) Petrolatum
D) Urea
E) Propylene glycol
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Answer: A
PEBC Knowledge Evaluation: Solved Examples (Q21-30)
Question 21: The filler used in hard gelatin capsules is:
A) Starch
B) Cellulose
C) Dibasic calcium phosphate
D) Magnesium stearate
E) Talc
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Answer: A
Question 22: A 52-year-old woman is experiencing menopausal hot flashes. She had a deep vein thrombosis (DVT) 5 months ago and is currently on warfarin therapy. Which of the following treatments for her hot flashes should be avoided due to her medical history?
A) Cognitive behavioral therapy
B) Estrogen hormone therapy
C) Using a fan
D) Avoiding triggers (caffeine, alcohol, stress)
E) Clonidine
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Answer: B
Question 23: A 35-year-old man with a history of asthma is brought to the emergency room with severe asthma exacerbation. Which of the following medications should NOT be used to control his asthma in this acute setting?
A) Terbutaline
B) Ipratropium
C) Formoterol
D) Oxygen
E) Salbutamol
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Answer: C
Question 24: Which enzyme class does protease belong to?
A) Lyase
B) Hydrolase
C) Esterase
D) Oxidoreductase
E) Transferase
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Answer: B
Question 25: What is the most abundant solute in plasma?
A) Albumin
B) Prothrombin
C) Chlorine
D) Potassium
E) Hemoglobin
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Answer: A
Plasma is about 92% water, with plasma proteins as the most abundant solutes. The
main plasma protein groups are albumins, globulins, and fibrinogens.
Question 26: When will the highest iron absorption in the body be obtained?
A) On an empty stomach
B) With food
C) With orange juice
D) With milk
E) At bedtime
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Answer: C
Iron salts have greater absorption when given on an empty stomach, but may cause
irritation. Also, Vitamin C enhances absorption.
Question 27: Achlorhydric condition can lead to a deficiency of which nutrient?
A) Iron
B) Vitamin B12
C) Folic acid
D) Niacin
E) Vitamin D
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Answer: B
The elderly are achlorhydric and commonly deficient in Vitamin B12.
Question 28: What is the drug of choice for absence seizures in a child under 2 years of age?
A) Phenytoin
B) Phenobarbital
C) Ethosuximide
D) Valproic acid
E) Primidone
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Answer: C
Question 29: Which organism is responsible for causing impetigo?
A) Streptococcus pyogenes
B) Staphylococcus aureus
C) Pseudomonas aeruginosa
D) Escherichia coli
E) Clostridium difficile
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Answer: B
| Condition | Description | Common Locations | Causative Organism(s) | Treatment |
| Impetigo | Superficial infection of skin primarily caused by Staphylococcus aureus and most often affecting young children. | |||
| Crusted or Nonbullous | Found on face, arms, or legs. | Face, arms, legs | Staphylococcus aureus and/or Streptococcus pyogenes | Topical antibacterial (fusidic acid, mupirocin, ozenoxacin) for 5 days. |
| Bullous | Caused by Staphylococcus aureus toxin, found in moist, intertriginous areas (e.g., axillae, neck folds, diaper area). | Moist, intertriginous areas (axillae, neck folds, diaper area) | Staphylococcus aureus | Oral antibacterial (cephalexin) for 7 days. |
Question 30: In a research study that costs $100,000 and causes an increase in patient life by 0.5 years, what is the correct expression of the cost-effectiveness analysis of that research?
A) $100,000 / QALY
B) $200,000 / LGY
C) $50,000 / QALY
D) $50,000 / LGY
E) $200,000 / QALY
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Answer: B
Sharpen Your Skills: Solved PEBC pharmacist evaluating exam – Questions 31 to 35
Question 31: Which of the following is used to treat chemotherapy-induced refractory diarrhea with colitis symptoms?
A) Loperamide
B) Bismuth salicylate
C) Lenreotide
D) Octreotide
E) Infliximab
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Answer: E
Question 32: A 32-year-old woman develops an itchy rash on her hands after wearing latex gloves. The rash appears 48 hours after exposure, indicative of contact dermatitis. What type of hypersensitivity reaction is?
A) Type I
B) Type II
C) Type III
D) Type IV
E) Type V
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Answer: D
Question 33: A 45-year-old patient is on lithium therapy for bipolar disorder. The physician is considering additional medications and wants to avoid any significant drug interactions with lithium. Which of the following medications has the least interaction with lithium?
A) Iron
B) Hydrochlorothiazide
C) Ibuprofen
D) Captopril
E) Furosemide
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Answer: A
Drug Interactions:
- Lithium levels can become toxic when taken with NSAIDs, ACE inhibitors, ARBs, and especially thiazide diuretics. For patients requiring long-term treatment with these medications, it’s essential to lower the lithium dose and frequently monitor serum lithium levels.
Handling Acute Illnesses:
- Suspend lithium use temporarily during acute illnesses that result in fluid and electrolyte loss.
Diet and Fluid Intake:
- Patients should keep their salt and caffeine consumption consistent.
- It is crucial to monitor fluid intake and output and adjust accordingly if there are unexpected losses due to vomiting or diarrhea.
Question 34: JT, a 72-year-old male is taking amlodipin, omeprazole, and clopidogrel for hypertension, occasional heartburn, and for storke prophylaxis. He recently got diagnosed with hyperlipidemia. His doctor recommends starting an antihyperlipidemic drug. Which of the following is the best recommendation for JT considering his medication profile?
A) Simvastatin
B) Atorvastatin
C) Pravastatin
D) Rosuvastatin
E) Lovastatin
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Answer: C
TIP: All statins except Pravastatin are metabolized by CYP 450 enzymes.
Conquered these PEBC Pharmacist Evaluating Exam questions? You’re on your way to Canadian pharmacy licensure! Utilize the PEBC syllabus, explore additional formats, manage exam time, and seek more resources. Good luck!
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