PEBC (Collaboration and Team Work) Sample Questions Set-4
Categories: PEBC Canada
Question. A 60 year-old female. Presents with a three-month history of difficult ambulating secondary-to-left knee pain. Pain worsens with activity, improves with rest. Had been using extra-strength acetaminophen (500 mg tablets) with minimal relief. You had seen her in the clinic two months ago, where you performed the following investigations: CBC, chemistry panel, renal function, ESR: all normal, X-ray left knee: asymmetrical joint-space narrowing, subchondral osteosclerosis consistent with osteoarthritis. At that time, you had recommended using acetaminophen 1 g four times daily, and scheduled a follow-up for today. Today, she reports only minimal improvement in pain and mobility. Aside from her knee symptoms, she has no other complaints. No history of reflux or ulcers. Nonsmoker; no alcohol.
What is the appropriate action to relieve her arthritic pain?
A) increase dose of acetaminophen
B) Switch to NSAIDS
C) Switch to NSAIDS and PPI
D) Switch to topical NSAIDS and PPI
E) None of the above
Answer: (b)
Question. What type of patient requires gastro protection along with NSAIDs? Except
A) high dose NSAIDS
B) history of previous ulcers
C) concomitant therapy with corticosteroids
D) concomitant therapy with anticoagulants
E) Patient did not respond with acetaminophen
Answer: (e)
Question. Two years later, the above patient has been admitted to hospital with an acute, upper gastrointestinal bleed, and you are her admitting physician. She had been using Naproxen 500 mg twice daily, chronically over the past two years, with adequate control of her symptoms of osteoarthritis. What is the appropriate action?
A) Discontinue Naproxen 500 mg bid and switch to ibuprofen
B) Discontinue Naproxen 500 mg bid to switch to acetaminophen 1 g qid
C) Discontinue Naproxen 500 mg bid
D) Reduce the dose of Naproxen 500 mg qd
E) Add PPIs
Answer: (c)
Question. A pharmacist in academic detail discussing with a doctor about NSAIDs, what is an incorrect statement?
A) If patient is on NSAIDS have heartburn or ulcer symptoms refer to doctor
B) Discontinue NSAIDs if patient is > 65 yo and renal disease
C) If continuing NSAID add one PPI if patient have heartburn or ulcer symptoms
D) Recommend to reduce the dose of NSAID for ulcer symptoms
E) Discontinue NSAIDS if there is GI bleeding symptoms
Answer: (d)
Question. Who provides recommendation for formulary listing to the to publicly drug plans in Canada and cost effectiveness of new drugs.
A) Common Drug Review (CDR)
B) Therapeutic directorate, Health Canada
C) Drug utilization review (DURs)
D) Pharmacy and Therapeutic Committee
E) Medication Advisory Committee
Answer: (a)
Question. Who provides recommendations for formulary listing to hospital drugs?
A) Pharmacy and Therapeutic committee
B) Therapeutic directorate, Health Canada
C) Drug utilization review (DURs)
D) Purchase committee
E) Medication Advisory Committee
Answer: (a)
Question. Osteoarthritis patients using diclofenax gel (Voltaren gel) what risk factors do you consider? Except
A) age >65 yo
B) GI bleeding
C) Renal disease
D) already using NSAIDs
E) anticoagulants therapy
Answer: (a)
Question. A 60 yo have chronic osteoarthritis pain should be referred to all except?
A) physician
B) chiropractor
C) podiatrist
D) occupational therapist
E) neurologist or psychiatrist
Answer: (e)