PEBC (Cardiovascular and CNS) Sample Questions
Categories: PEBC Canada
In these questions inclusive refer to the following:
A 55 year-old male, new patient to your pharmacy, overweight suffered a non-ST elevation myocardial infarction 6 days ago and had PCI in hospital, bare metal stent to proximal LAD. Currently his medical conditions are hypertension, LDL 2.5mmol/L, Tchol/HDL 5. Social history: has smoked 1 ppd x 30 years, family history: brother died of MI 6 years ago. Currently have new prescriptions: EC ASA 325 mg once daily, clopidogrel 75 mg once daily, metoprolol 50 mg bid and ramipril 2.5 mg once daily. Patients are currently using vitamin E 800 IU for the last one year, hoping to prevent any cardiovascular problems.
Ques. What are the recommended blood pressure goals for secondary prevention of Acute coronary syndrome patients.
A) 135/85
B) 140/90
C) 145/95
D) 160/85
E) 150/90
Answer: (b)
Ques. After percutaneous intervention (PCI), a stent doctor has prescribed EC ASA 325 mg once daily, clopidogrel 75 mg once daily. Which of the following is NOT the common side effect of clopidogrel?
A) Joint pain (arthralgia)
B) Headache
C) Constipation
D) Rash
E) Diarrhea
Answer: (c)
Ques. A patient was scheduled for an endovascular coiling procedure to treat a brain aneurysm. Several days before the procedure, the neurosurgeon wrote a prescription for Plavix 150 mg po daily with acetylsalicylic acid (ASA) 325 mg po daily. The patient was to take these medications to prevent platelet aggregation and clot formation during, and as a result of, insertion of a foreign substance (the coils) into the vascular system. The day before the scheduled procedure, the patient was admitted to the hospital as planned. Fortunately, the patient had remembered to bring all current medications to the hospital. During medication reconciliation, the pharmacist noticed that the patient was taking Pradax 150 mg daily instead of the intended Plavix 150 mg daily. The hospital pharmacist called the community pharmacy to discuss the situation. It was determined that the order for Plavix had been misinterpreted and that Pradax had been dispensed in error. The hospital pharmacist should inform this incident to?
I) The neurosurgeon should be notified before surgical procedure
II) Institute of Safe Medication Practices Canada
III) Pharmacy and Therapeutic Committee
A) I only
B) III only
C) I and II only
D) II and III only
E) I, II, III
Answer: (c)
Ques. Which of the following measures can prevent these type mix ups errors!
A) Include the generic name throughout the prescription process like clopidogrel for Plavix and dabigatran etexilate for Pradaxa
B) Read label with patient at counselling point
C) Read label at the time taking drug from shelf and read label at the time of counting and placing bottle back into shelf
D) Consider automated alert systems in computers.
E) Academic detailing to enhance prescription practices
Answer: (a)
Ques. A physician asked for heparin 2,000 units during a procedure. The nurse retrieved two vials of heparin from an automated dispensing cabinet that was supposed to be stocked with 1,000 units/1 mL vials. But a pharmacy technician had accidentally stocked the cabinet with lookalike vials of 10,000 units/1 mL heparin vials. Both concentrations... are in the same size vials with similar orange-brown labels and vial caps... causing the nurse to overlook the stocking error. The patient received 20,000 units, but the nurse quickly noticed the mistake!
Which of the following is the management of heparin overdose?
I) Stop using heparin and test aPTT and INR
II) Protamine sulphate antidote administration
III) Treatment included administration of intravenous fluids, plasma volume expander, fresh frozen plasma, packed red blood cells, and platelets.
A) I only
B) III only
C) I and II only
D) II and III
E) I, II, III
Answer: (e)