PEBC (Therapeutic) Sample Questions
Categories: PEBC Canada
In these questions inclusive refer to the following:
FG is a 65-year-old war veteran with a 40-year history of paranoid schizophrenia. His symptoms include poor personal hygiene, blunted affect, and delusions, accompanied by auditory and visual hallucinations. His delusional symptoms relate to his wartime experiences. His visual hallucinations involve enemy soldiers from the war who he believes are stalking him. FG's auditory hallucinations include the sounds of war, accompanied by enemy soldiers threatening to end his life if he does not keep his guard up. FG has been unable to maintain a job or adequate housing for many years. He currently lives under a bridge "in case he needs to make a getaway down the river."
When workers from the free clinic are able to locate him, they attempt to provide medical care and evaluate his schizophrenia. If sample medications are available, they provide him with them. According to their records, FG was given haloperidol 15 mg 3 times daily and benztropine 1 mg 3 times daily when they last evaluated him. He was given enough medication for a few weeks so that they could evaluate the effectiveness and any adverse effects. During previous trials with other neuroleptic agents, extrapyramidal side effects have limited the dose FG could tolerate. The physician on the team would like to discontinue the haloperidol and initiate an agent with fewer extrapyramidal side effects. He searches the medication supply and finds that he has samples of fluphenazine, chlorpromazine, thiothixene, and risperidone.
Ques. Which agent is least likely to cause extrapyramidal side effects?
A) Fluphenazine
B) Chlorpromazine
C) Thiothixine
D) Risperidone
E) Clozapine
Answer. (d)
Ques. MJ is a 29 year old who has been diagnosed with Crohn's disease. If MJs doctor is considering CDs for remission. What is the treatment?
A) 5-ASA 4 to 5 wk
B) Sulfasalazine 4 to 5 wk
C) Prednisone PO 40-60 mg, 12 to16 wks
D) Methotrexate
E) Infliximab
Answer: (c)
In these questions inclusive refer to the following:
ST, is a 57-year-old male nurse who works for the local pulmonologist, arrives at work one day complaining of weakness and fatigue. He explains that these symptoms have worsened over several days. He reports feeling out of breath when walking around the office but denies having had these difficulties in the past. ST's medical history is significant for hypertension and benign prostatic hypertrophy. Three months ago he was hospitalized with a ventricular arrhythmia. His current medication regimen includes:
Felodipine 5 mg daily
Tamsulosin 0.4 mg daily
Amiodarone 400 mg daily
ST denies the use of herbal products or OTC medications. He denies tobacco use but admits to social drinking. His family history is significant for hypertension. The pulmonologist for whom ST works is concerned about ST's symptoms and performs a physical examination, along with laboratory work. ST's vital signs are reported as follows: blood pressure, 150/95 mm Hg; heart rate, 90 beats/min, temp 98.6°F, and respiratory rate, 20 breaths/min. The exam is unremarkable, with no signs of pulmonary congestion, lower extremity edema, or signs of infection. The basic metabolic panel and complete blood count are within normal limits. The only lab result found to be outside of normal limits is an elevated erythrocyte sedimentation rate (ESR). The pulmonologist is concerned that ST's medications may be causing pulmonary problems. He performs a bronchoscope to obtain a lung biopsy, which demonstrates diffuse alveolar damage and fibrosis.
Ques. What could be a pulmonologist concern?
A) Felodipine 5 mg daily
B) Tamsulosin 0.4 mg daily
C) Amiodarone 400 mg daily
D) Blood pressure
E) Heart rate
Answer. (c)
Ques. All of the following are side effects of amiodarone EXCEPT:
A) Conjunctivitis
B) Pulmonary fibrosis
C) Aplastic anemia
D) Liver dysfunction
E) Photophobia
Answer: (c)
Ques. Which of the following is NOT required to monitor for amiodarone?
A) eye exam
B) occult blood in stools
C) Persistent cough
D) Chest x-ray
E) Peripheral skin pigmentation
Answer: (b)