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Pharmacy PREP
Cardiovascular and Metabolic Syndrome MOCK Test
1) MJ is 82 year women has been customer at your pharmacy for many years. When her
son PK comes to pick her blister pack. She is currently using
hydrochlorothiazide/candesartan 12.5 mg/35 mg, metoprolol 50 mg bid, amlodipine 10
mg daily, metformin 500 mg tid, glyburide 2.5 mg bid, gliclazide MR 60 mg daily,
clonazepam 0.25 mg tid, metoclopramide PRN for nausea. Recently her metformin dose
is increased to 1000 mg bid to manage her high HbA1c > 9%. MJ caregiver says her
patient sometimes gets sweating, feels dizziness and confused specially after taking her
diabetic medications. Which of the following medication most likely associated with
high hypoglycemia?
A) Gliclazide B) Glyburide C) Metformin D) Glyburide + gliclazide E) Metformin +
glyburide
Ans. D

2) MJs caregiver wants to know which of her patient medications should be taken with
meals
Which of the following medications should be taken with meals?
A) metformin, glyburide, gliclazide, metoclopramide, metoprolol
B) metformin, glyburide, gliclazide and metoprolol
C) metformin, glyburide, gliclazide and hydrochlorothiazide/candesartan
D) metformin, glyburide, gliclazide and metoprolol, hydrochlorothiazide /candesartan
E) metformin, glyburide, gliclazide
Ans. E

3) Metformin should be taken with meals, because?

A) increase bioavailability
B) decrease hypoglycemia
C) mask taste disturbances
D) decrease gastrointestinal side effects
E) decrease lactic acidosis side effects
Ans. D

4) To minimize the highs and lows blood glucose levels in MJs pharmacotherapy. Which
of the following medication is the least suitable?
A) gliclazide B) glyburide C) Metformin D) regular insulin E) sitagliptine
Ans. B

5) As part of inter professional collaboration in diabetes care, a pharmacy may consider

referring to diabetic patient to all of the following professionals?
A) Physicians, nurse practitioners, dieticians, chiropodists, and optometrists.

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B) Physicians, nurse practitioners, physiotherapist, chiropodists, and podiatrist
C) Physicians, nurse practitioners, psychiatrist, physiotherapist and podiatrist
D) Physicians, nurse practitioners, dieticians, social worker, and personal support worker
E) Physicians, nurse practitioners, dieticians, social workers, and optometrists.
Ans. A
Ref: Pharmacy Practice 2013 and CDA guidelines.

6) KP is 53 year old patient who had hypertension came to pharmacy and had
prescription of rosuvastatin 10 mg daily as doctor diagnosed him to use hyperlipidemia.
Hel told to pharmacist do not want to start medication. Wants to try lifestyle changes.
Pharmacist start talking to him about his condition and explained to him benefit of using
of medication but also after patient wanted to go lifestyle modification first. What
should a good pharmacist do in this situation?
A) Respect patient autonomy and give him right to decide
B) Ask patient to see different doctor for second opinion
C) Ask patient to start after trying lifestyle modifications
D) Provide patient more evidence base document to show benefit of medication and
dangers of hyperlipidemia.
E) Ask patient what did your doctor tell you.
Ans: D

7) KM a 60 yo MI patient had bypass surgery past 4 months ago using ASA 325 mg daily,
clopidogrel 75 mg daily, rosuvastatin 10 mg daily, nodolol 80 mg daily and salbutamol
PRN, budesonide daily. Now hospitalized with severe asthma. What is the pharmacist
concern in KM?
A) drug and drug interactions
B) drug and disease interactions
C) drug and food interactions
D) Drug & drug interaction and drug & disease interaction
E) Drug & drug interaction and drug & food interaction
Ans: D

8) KT is a 80 yo patient came to emergency and doctor diagnosed STEMI. Her CK-MB,

Troponin and ECG were positive. KT arrived to emergence after 6 hours of myocardial
infarction symptoms. Currently patient blood pressure is 190/110. KT recently a month
had been discharged from emergency after treatment of intracranial hemorrhagic
stroke. Now KT surgeons are reluctant to treat with Alteplase. Which of the following
could be KTs absolute contraindication of Alteplase?
A) High blood pressure 190/110
B) Previous intracranial hemorrhagic stroke
C) KT age > 78 year old

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D) Arriving to emergence after 6 hours
E) KT is not suitable for Alteplase
Ans: B

9) Streptokinase has least selectivity to fibrin however also least intracranial bleeding
side effect compared to alteplase. All of the following are the clinical approved
indication of Streptokinase. except?
A) Deep vein thrombosis B) pulmonary embolism C) Myocardial infarctions D) Acute
stroke E) All of the above
Ans. D

10) A 64 yo man weighing 115 kg, and tall 60 inches, presents to his physician after long
international flight complaining of pain, swelling of his right lower leg. The patient had
knee surgery a month before he travelled. His medication profile includes, CHF (ejection
fraction < 15%), remission from lymphoma, MI. His father, mother, and sister are all
diseased from stroke, pulmonary embolism. Given his profile. Patient most likely
suffering from?
Which of the following is NOT risk factors of DVT?
A) Knee surgery B) over weight C) long flight D) family history E) Gender
Ans: E
Tips: RF for above patient, except gender. other RFs include age > 40 yr, cancer, CHF,
MI, and obesity and smoking, previous use of HRT and immobility.

11) What is the most important recommendation should provided to decrease risk of
deep vein thrombosis?
A) Avoid taking flights
B) Increase mobility of legs
C) Avoid physical activity
D) Avoid vitamin K intake
E) Avoid dark green vegetables
Ans: B

12) Patient is hospitalized. Drs initiated heparin infusion. What is incorrect about
heparin?
A) Heparin dose is based on body weight
B) Loading dose is 80 units/kg and maintenance dose is 15 to 25 units/kg/hr.
C) LMWH pharmacokinetics are predictable and easy for dose administration
D) LMWH has short half-life and the drug of choice in patient with renal clearance < 30
ml/min
E) LMWH have predictable response thus not monitored
Ans: C

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13) Which of the following low molecular weight heparin has higher selectivity to factor
Xa.
A) Enoxaparin B) Dalteparin C) Nadroparin D) Tinzaparin E) Heparin
Ans. A

Tips: LMWH act selectively binding with factor Xa, and factor IIa which is affects on
aPTT. However this has NO effect on prothrombin time, therefore INR is not beneficial.
Ref. Monograph LMWH in CPS.
Dabigatran can be monitored for aPTT. Ref: eCPS

14) MP is a 72 years old patient diagnosed for systolic congestive heart failure after his
LVEF is ≤ 40%. MPs blood pressure reading are 130/85 Doctor categorized MP
symptoms according to NYHA class 2. Doctor considering to prescribed Ramipril 5 mg as
initial therapy to CHF? What is therapeutic benefits of ACEi treatment for patient of
CHF?
A) Reduce mortality
B) Reduce readmission in hospital for heart failure
C) Improve symptoms and improve ejection fraction
D Decrease the rate of reinfarction in patients with coronary artery disease
E) all of the above
Ans. E
Tips: After initiating ACEi blood pressure changes occur in two weeks. Side effects can
occur in 3 days. If cough is bothersome contact doctor.

15) MP returns to pharmacy with a new prescription of metoprolol 50 mg bid, because

he says his heart failure symptoms were not improved his doctor said his LVEF <30%.
What is therapeutic benefit of beta blockers therapy in CHF?
A) Reduce mortality
B) Reduce readmission in hospital for heart failure
C) Improve symptoms and improve ejection fraction
D Decrease the rate of reinfarction in patients with coronary artery disease
E) all of the above
Ans. E

16) Patients using beta blockers (metoprolol, carvedilol and bisoprolol) in congestive
heart failure, have the risk of treatment such as fluid retention, worsening of heart
failure, fatigue, bradycardia, heart blockade, and hypotension. Thus which of the
following are monitored in congestive heart failure patient using beta blockers?
A) changes in fatigue and dyspnea symptoms
B) Fluid accumulation by taking weight
C) heart rate
D) blood pressure

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E) All of the above
Ans. E
Tips: Beta blockers can worsen heart failure thus monitor fluid retention. If beta
blockers are NOT tolerated than add ACEi and ARB or Amlodipine.

17) After initiating metoprolol therapy, MP visits his physician with increased pedal
edema and shortness of breath. Doctor considering treating fluid retention and
dyspnea. What the best treatment options?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Verapamil
E) Hydralazine and isosorbide dinintrate
ans.
Ans. A

18) What is the therapeutic benefit of adding diuretics to congestive heart failure
patient?
A) Improve CHF symptoms such as pedal edema and dyspnea
B) Decrease mortality
C) Decrease rehospitalization
D) Decrease CHF progression
E) All of the above
Ans. A

19) MPs congestive heart failure continued to deteriorate on optimal doses of ramipril
and metoprolol. Doctor prescribed candesartan 32 mg daily. What is pharmacist
concern?
A) Side effect of hypotension, ↑ SrCr and hyperkalemia (K >5)
B) Combination of ACEi plus ARBs
C) Increased risk of fluid retention
D) Increased aldosterone concentration
E) Risk of renal failure
Ans. A

20) MPs doctor prescribed digoxin 0.125 mg daily to improve quality of life and
symptoms and exercise tolerance. What is the reason low dose of digoxin was
prescribed?
A) age
B) low ejection fraction

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C) hyperkalemia
D) to avoid drug interactions
E) to avoid digitalis toxicity
Ans. A

21) MPs doctor prescribed spironolactone 12.5 mg daily to treat severe symptoms of
congestive heart failure and reduced ejection fraction. What are the greatest risk of
hyperkalemia?
A) patients with renal dysfunction CrCl < 30 ml/min and elevated serum potassium K+ >
5
B) patients with renal dysfunction CrCl < 30 ml/min and age
C) patients with renal dysfunction CrCl < 30 ml/min and using NSAIDs
D) patients with renal dysfunction CrCl < 30 ml/min and using ACEi
E) patients with renal dysfunction CrCl < 30 ml/min and using ARBs
ans: A
Tips: Spironolactone is added in sever CHF or NYHA class 4 patient.

22) MK is a 62-year-old man. He is on warfarin 2.5 mg daily for the for the prevention of
atrial fibrillation. Past 3 days ago MK developed sore throat and his doctor considering
prescribing ampicillin 500 mg QID
A-Effects of warfarin may be increased resulting in increased risk of bleeding.
B-Effects of warfarin may be decrease resulting in increased risk of bleeding.
C- Effects of warfarin may be increased resulting in decreased risk of bleeding.
D) Effects of warfarin may be decrease resulting in decreased risk of bleeding.
E) Effects of warfarin may be decrease resulting do not effects on bleeding
Ans: A
Tips: INR should be monitored upon addition of ampicillin and withdrawal of ampicillin.
INR should be periodically reassessed for at least 3 weeks after ampicillin discontinue,
since adjustment in the warfarin dose may be necessary to maintain an effective level of
anticoagulation.
Cotrimoxazole increase INR. Macrolide (erythromycin, clarithromycin) increase INR.
Fluroquinolones increase INR.

23) MK is currently stabilized on warfarin 2.5 mg QD treatment. Which of the following

drugs may decrease warfarin levels.
A) Carbamazepine
B) Clarithromycin
C-Cotrimoxazole
D-Ciprofloxacin
E-Digoxin
Ans: A
Tips: Carbamazepine is enzyme CYP 2D6 inducers. It will decrease warfarin blood levels.
Clarithromycin (and, to a lesser extent, azithromycin) and cotrimoxazole may increase

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warfarin blood levels. Clarithromycin may also increase levels of carbamazepine,
digoxin, statins and theophylline. Other antibiotics that may increase warfarin and
digoxin levels include fluroquinolones.

24) A patient comes to physician with CVD. he is suffering from stress due to loss of job.
his mother died due to stroke at age 62 y and father died at 59 due to heart attack. He is
obese and smokes and drinks 4 daily and what is not a risk factor?
A) family history B) smoking C) alcohol D) stress E) obesity

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.

25) What could be pulmonologist concern?

A) Felodipine 5 mg daily
B)Tamsulosin 0.4 mg daily
C) Amiodarone 400 mg daily
D)Blood pressure
E) Heart rate
Ans-C
Tips: Amiodarone can cause pulmonary fibrosis (cough and SOB).

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26) All of the following are side effects of amiodarone EXCEPT:
A) Conjunctivitis (optic neuritis, vision changes)
B) Pulmonary fibrosis
C) Aplastic anemia
D) Liver dysfunction
E) Photophobia
Ans: C
Tips: The pulmonologist concerns that ST's medications are causing his symptoms are
valid. ST is exhibiting signs and symptoms of Amiodarone- induced pulmonary fibrosis.
These patients typically present with an elevated ESR and dyspnea during the first year
of therapy. Treatment involves dosage reduction or discontinuation of amiodarone or
initiation of corticosteroid therapy. Symptoms resolve quickly once therapy is altered.

27) Which of the following is NOT required to monitor for amiodarone?

A) eye exam
B) occult blood in stools
C) Persistent coughs
D) Chest x-ray
E) Peripheral skin pigmentation
Ans: B
Tips: Occult blood in stool is a traces blood which is NOT detectable.

A 55 year-old male, new patient to your pharmacy, overweight suffered a non-ST

elevation myocardial infarction 6 days ago had PCI in hospital, bare metal stent to
proximal LAD. Currently his medical conditions 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. Patient using currently
vitamin E 800 IU uses for the last one year, hoping that prevent any cardiovascular
problems.

28) What is 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
Ans: B
Tips: TC page 460, 6th ed. shows 140/90

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29) After percutaneous intervention (PCI), and 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
Ans: C
Tips: Comparison of ASA, clopidogrel and ticlopidine.

30) 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?
A) The neurosurgeon should be notified before surgical procedure
B) Institute of Safe Medication Practices Canada
C) Pharmacy and Therapeutic Committee
D) The Canadian Institute of Health Information
E) All of the above
ANS: E

31) 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 system in computers.
E) Academic detailing to enhance prescription practices
ANS: A

32) 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 look-alike vials of 10,000 units/1 mL heparin vials. Both
concentrations... are in the same size vials with similar orange-brown labels and vial

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caps... causing the nurse to overlook the stocking error. The patient received heparin
20,000 units, but the nurse quickly noticed the mistake!
Which of the following is the management of heparin overdose? except
A) Stop using heparin and test aPTT
B) Protamine sulphate antidote administration
C) Treatment included administration of intravenous fluids, plasma volume expander,
fresh frozen plasma, packed red blood cells, and platelets.
D) Stop heparin infusion and check INR
ANS:D

33) Multiple issues often underlie the inadvertent administration of high-concentration

heparin. What are the examples of contributing factors to such incidents include:
A) The storage of high-concentration heparin vials close to low-concentration heparin
flush products.
B) Confirmation bias that can cause a health care professional to read a label or select a
drug product and “see” what they expect to see, rather than what is actually selected.
C) Often, more concentrations than necessary are present in both the pharmacy and
patient care area stock.
D) Incomplete communication between physicians and nurses at the time of gathering
drugs and supplies for central vascular line (CVL) insertion and during procedure
E) All of the above
ANS:E

34) GS is a 49 year women. Her physician had prescribed morphine ‘.5 mg’ IV for the
management of post-operative pain. However, a unit secretary did not see the decimal
point and transcribed the order by hand onto a medication administration record (MAR)
as ‘5 mg.’ An experienced nurse followed the directions on the MAR without question
and gave the 5 mg of IV. Morphine initially and another 5 mg dose two hours later.
Which of the following serious symptoms could be associated with fatal error?
A) Mydriasis
B) Severe constipation
C) Respiratory depression
D) Bleeding
E)All of the above
Ans: C

35) BN is a 91kg, 52-year old female who was recently diagnosed with type 2 diabetes.
On physical exam her BP was 190/94, serum creatinine was 150umol/L, K is 4.5mmol/L.
11) The recommended BP target for BN is?
A) <130/80
B)>130/80
C) 140/90
D)<140/90

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E)>140/90
Ans: A

36) What is the target waist line circumference?

A)<99 cm B)<102 C)<88 cm d)>88 cm e)>102 cm
Ans:C

37) What is the initial therapy?

A) Ramipril 5 mg
B) Verapamil/Losartan
C) Atenolol
D) metoprolol
E) Hydrochlorothiazide 50 mg
Ans: B
Tips: if it SBP is 20 units higher than 160 and DBP > 10, may require combo. TC page 456.

38) After 6 months, she has still high blood pressure 155/90, what to do?
A) Increase dose to Ramipril 10 mg
B) Check the compliance of medication
C) Change Ramipril 2.5 mg to Losartan
D) Change Ramipril 2.5 mg to Hydrochlorothiazide 25 mg
E) Change Ramipril 2.5 mg to Metoprolol 50 mg
ANS: B

39) BB is a 55year old obese man who has been a patient at your pharmacy for many
years. He is receiving atenolol 50 mg OD for hypertension, atorvastatin 20 mg OD and
glyburide 5 mg BID for blood glucose control. He smoked a pack of cigarettes a day for
the last 38 years. His lipid profile is under controlled. By some reason he started to take
herbal product containing niacin and find problem of muscular pain. This pain was not
continuous. What should patient do?
A. Take Tylenol on prn base
B. Refer to his physician
C. Ask for creatinin kinase test
D. Patient need not to worry as this pain subsides after discontinuation of herbal
products.
E. Use antidote of niacin
Ans-D

40) A 65-year-old man with a history of hypertension, atrial fibrillation,

hypercholesterolemia, and a right middle cerebral artery stroke 6 months previous
reports 3 separate episodes of head deviation to the left with rhythmic jerking of the

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left arm and left side of his face lasting approximately 1 minute. He is taking warfarin,
atenolol, and atorvastatin. What is drug of choice for epilepsy.
A) Lamotrigine (monotherapy)
B-Gabapentin,
C-Valproic acid
D-Phenytoin
E-Carbamazepine
Ans: A

41) A pharmacist is working as a relief in another pharmacy. A patient came with a

prescription of Ativan 1 mg. The pharmacist remembered that the same patient came
with another prescription of same drug two days ago in the other pharmacy where he
worked. What should the pharmacy do?
A. Call the police
B. Refuse to fill the new prescription
C. Discuss the matter with the patient
D. Call the doctor and tell him that the patient is addictive
Ans: C
Tips: tell patient that, want to discuss with your new doctor.

42) A 58-year-old female Janna is patient with weight of 52 kg. Her creatinine clearance
40mL/min has MI., Angina, atrial fibrillation, CHF and hypercholesterolemia.
KCl = 4 meq/L (normal value 3.5 to 5 meq/L). Current her CrCl is <30
Current medication:
Digoxin 0.125 mg po QD, Furosemide 40 mg po QD, Warfarin 5 mg po QD, Lovastatin
20mg po initiated 1 month ago, Captopril 12.5 mg po tid, Kcl, 20 meq po BID,
Nitroglycerin 0.4mg SL prn, Nitroglycerin patch 0.4mg/hr q 24h. Hydrochlorothiazide 25
mg daily,
Which of the following medication is most likely concern in patient profile due to low
CrCl, Except?
A) ACEi
B) Hydrochlorothiazide
C) Digoxin
D) Captopril
E) Lovastatin
Ans: E
Tips: Digoxin dose is suitable for this creatinin clearance because it is a low level.
Furosemide should be increased due to renal creatinine clearance is low. TC 4th ed. page
1202. Avoid furosemide if CrCl is < 30 ml/min. Hydrochlorothiazide is <50 ml/min. Statin
are hepatically eliminated.

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43) A patient was on lovastatin since last six months. His lipid profile is under controlled.
By some reason he started to take herbal product containing niacin and find problem of
muscular pain. This pain was not continuous. What should patient do?
A) Take Tylenol on PRN base
B) Contact to doctor
C) Contact to doctor and ask for CK-MM tests
D) Patient need not to worry
ANS: C
Tips: TC 6th ed. page 440. Statin induced myopathy management.

44) What laboratory test monitored regularly, patient using statins?

A) LFT (AST +ALT) B) CK-MB C) BP D) RFT E) CK-MM
ANS: A

45)What statin should take with food?

A) Atorvastatin
B) Lovastatin
C-Fluvastatin
D-Simvastatin
E-Rosuvastatin
ANS: B
Tips: FL are taken with food. Lovastatin have very high effect on bioavailable.
RSAL avoid with antacids because decrease 30% efficacy.
For fluvastatin do not crush or chew

46) What is the target of total cholesterol in the patient have coronary artery disease
(MI, post MI, STEMI, NSTEMI, Unstable angina)
A) < 2.2 mmol/L
B) <4.0 mmol/L
C) <1.8 mmol/L
D) 4.5 mmol/L
ANS: B
TC page 436, 6th ed.

47) What is the target of LDL in the patient have diabetes mellitus
A) < 2.2 mmol/L
B) <2.0 mmol/L
C) <1.8 mmol/L
D) 2.5 mmol/L
ANS: B

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48) Which of the following patient have high risk of Acute Coronary syndrome.
A) + ve cardiac enzyme like Troponin I
B) ST segment changes (ECG)
C) TIMI risk score > 3
D) Heart failure
E) All of the above
ANS: E

A 80 yo male with NYHA II CHF (EF 33%), purchasing Gravol for nausea, dizziness,
↓appetite x 2wks. He thinks it is related to recent ramipril dose increased. Patient
medical history include MI (past 3 yr ago), HTN(past 20 yrs), ↑lipids(x 2yrs), CHF(x 1yr),
atrial fibrillation ( for 10 wks). His current meds include: Pravastatin 40mg QD (x2yrs),
amiodarone 200mg QD (x6wks), digoxin 0.25mg QD (x1yr), warfarin 5mg QD
(for a 6wks), carvedilol 25mg BID (x 1yr), HCTZ 25mg QD (x 25yrs), Ramipril 10mg QD
(↑from 5mg 2wks ago).

49) A patient has symptoms of heart failure at less than ordinary activity, which is
defined as?
A) symptoms may appear at climbing one flight upstairs. Or walking 200 yards
b) symptoms may appear 30 minutes jogging
C-symptoms may appear after 3 to 5 times of exercise for 30 min in a week
D-None of the above
Ans-A

50) What is initial therapy for patient has heart failure symptoms from NYHA
classification 1 to IV.
A) ACE I and beta blockers
B-ARBs and beta blockers
C-Digoxin and beta blockers
D-Diuretics and beta blockers
E-Spironolactone and beta blockers
Ans: A

51) If hypothetically doctor choose to use metoprolol and enalapril to assess the
tolerability. Which of the following need to be watched?
A) Shortness of breath
B) Ankle edema
C) Weakness
D) Dry or productive cough
E) Fatigue
Ans: D

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52) Ted is a 55 year-old male, and a new patient to your pharmacy. 163 cm, 86 kg
He suffered a non-ST elevation myocardial infarction 1 week ago. He tells you that he
had PCI in hospital, with a bare metal stent to his proximal LAD. What are the clinical
features used to calculate TIMI risk score?
A)Age >65 y
B)hypertension
C)high cholesterol
D)any ASA use within 7 d
E) all of the above
Ans: E

53) AB is 72 kg. 50 y/o woman who was recently diagnosed with type 2 diabetes. On
physical exam her BP is 120/80. Her family doctor told her the results of her 24hour
urine collection showed a normal amount of protein in the urine. Which of the following
interventions should be implemented to decrease Ms AB’s chance of developing renal
disease?
A)Initiation of an ACE inhibitor
B)Initiation of an ARB
C)Optimal blood glucose control
D)Reduction of protein intake to 0.6 g/kg/day
ANS: C

54) A patient was taking Dimicron 180 mg (glicalizide) dose recently decreased to 80 mg
BID. also the patient. The patient suppose to be given 1 box of Diovan (valsartan) 80 mg
and boxes of Dimicron the label of Diovan was wrongly placed on Dimicron and the vice
versa. The patient is advised to take 1 pill of Diovan and 2 pill of Dimicron. Because of
wrong labeling, which symptoms patient experience initially?
A) Increased pulse rate
B) decrease pulse rate
C) Decrease systolic pressure
D) decrease diastolic pressure
E) Hypoglycemia
ANS: C

55) MP is a 50 year old man. His medical history started hydrochlorothiazide (HCTZ) 25
mg po qd 2 months ago. After 4 months HCTZ increased 25 mg po because his BP was
uncontrolled. He is diabetic, has hypercholesterolemia. MP had anaphylactic reaction
with amoxicillin in childhood. He smokes half pack a day. Which section of SOAP we
have to write this allergy?
A) Subjective
B) Objective
C) Assessment

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D) Plan
E) Follow up
Ans: A

56) Which of the following is the next most appropriate step in treating MP?
a. Discontinue HCTZ and re-evaluate blood pressure.
b. Adding lisinopril 10 mg po qd to HCTZ 25 mg po qd
c. Adding Atenolol 100 mg po qd to HCTZ 25 mg po qd
d. Increase HCTZ to 50 mg po qd
e. Lifestyle changes require and discontinue HCTZ
Ans: B
Tips: Atenolol masks hypoglycemia and hydrochlorothiazide is diabetogenic.

57) Counseling on hydrochlorothiazide 25 mg po qd includes:

A. Do not wear contact lenses
B. Take it in the morning
C. Take with a glass of orange juice or banana (K+ supplement)
D. All of the above
E. B and C
Ans: B

58) A 75 year old female patient on lansoprazole tablet, and ASA 81mg, admitted to the
ICU experiencing DVT. She was given streptokinase, and her condition was stable and
discharged then from the hospital. Best prophylactic therapy for her is:
(A) Continuous infusion of heparin + warfarin
(B) Warfarin
(C) Subcutaneous dalteparin + warfarin
(D) Subcutaneous dalteparin
(E) Continuous heparin infusion
Ans: (C)
Reference: Therapeutic Choices 5th edition Page 596

59) In the above question, if the patient developed GIT hemorrhage, What laboratory
test is monitored in patient taking heparin and warfarin?
A) aPTT
B) INR
C) no test is required
D) aPTT and INR
E) blood pressure

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Ans: D

60) Which medication show decreased mortality in cardiovascular disease (CVD):

(A) Nifedipine
(B) Verapamil
(C) Ramipril
(D) Propranolol
(E) Carvedilol
Ans: (C)
Tips: ACEi lower mortality in CAD and Cardio selective beta blockers also reduce
mortality.

61) A 58 year-old woman presents you with a prescription for simvastatin (10 mg daily ).
She is also taking atenolol (50 mg daily) having suffered a heart attack last year. Are you
happy to dispense the simvastatin? Justify your decision.
A. There is no interaction with atenolol.
B. There is drug interactions with atenolol
C. Atenolol decrease effect of simvastatin
D. None of the above
Ans: a

62) Which of the following factors cause statin induce myopathy?

A) men
B) using cholestyramine
C) use of fluroquinolone
D) Chronic renal insufficiencies
E) using long duration
Ans. D
Tips: Tell your doctor immediately if any of muscle pain symptoms like
Muscle pain/tenderness/weakness.

Factors increase myopathy with statins: Patient factors: Advanced age (>80 y), Alcohol
abuse, Chronic renal insufficiency, Excessive grapefruit juice intake, Frailty, small body
frame, Hepatic dysfunction, Hypothyroidism (untreated), Inherited myopathies, and
Intercurrent infections.
Perioperative periods, Polypharmacy, Vigorous exercise, Women are more affected than
men.
Concomitant medications: Amiodarone, Azole antifungals (itraconazole,
ketoconazole),Calcium channel blockers (nondihydropyridine type), Cyclosporine,
Fibrates (particularly gemfibrozil),HIV protease inhibitors, Macrolide antibiotics
(clarithromycin, erythromycin), Nicotinic acid (rarely)

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Statin properties: High statin dose, High bioavailability, Limited protein binding,
Lipophilicity, Membrane transporter affinity
Potential for drug–drug interactions metabolized by cytochrome P450 pathways,
especially 3A4 and 2C9

MP is a 62 year-old male, presents with the following prescriptions after being

discharged from hospital: nitroglycerin patch (Nitro-Dur®) 0.4mg daily, ASA (Aspirin) 81
mg daily and metoprolol (Lopressor®) 25mg twice daily.
Past Medical History indicates Stable angina x 2 years, no known allergies, current
medication Nitroglycerin (Nitrostat) sublingual tablets 0.6 mg prn.

63) What is the recommended length of time that AA should go without wearing the
nitroglycerin patch daily to avoid tolerance?
A) 2-4 hours B) 10-12 hours C) 6-8 hours D) 14-16 hours
Ans-B
Tips: Drug free period (nitrate free) is 10 to 12 hours require minimizing nitrate
tolerance.

64) What is an important point to discuss with MP regarding nitroglycerin patch use?
I) Rotate application site regularly and remove patch for 10-12 hr daily.
II) Redness at application site requires drug discontinuation
III-Remove patch while bathing or showering and occlusive dressings may increase
absorption.
A) I only B-III only C-I and II only D-II and III only E-I, II, III
Ans-A
Tips: Keep patch on while bathing or showering.

65) Which side effects MP has the most at risk of experiencing?

A) Hyperkalemia B-Hypotension C-Cough D-Dry mouth E-Irritation
Ans-B

66) Which of the following counselling tips regarding nitroglycerin sublingual tablet use
is NOT appropriate to provide MP
A-Tablets should be stored tightly capped glass bottle
B-Discard cotton plug from bottle.
C- Persistent chest pain after using 3 doses in a 15-minute interval should prompt to
seek immediate medical attention
D) A tingling or burning sensation when dissolved under the tongue is a reliable test for
potency.
E)Tablets should not be chewed or crushed.
Ans-D

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67) MJ is 62 year women has been customer at your pharmacy for many years. MJ
comes to pick her new prescription glargine (lantus). She is currently using regular
insulin at bedtime. Her doctor advised her to continue regular insulin and new
prescription of glargine. When she asked about mixing glargine and regular insulin the
same syringe. The pharmacist should that the product.
A) Stable if administered immediately and may be premixed and stored in refrigerator
for upto 7 days
B)Have not been studied when administered together
C)Should never be mixed in the same syringe
D) Mixing regular and glargine insulin increase risk of cancer side effect
E) If you are using regular and glargine always choose insulin pen devices.
Ans. C

68) MK is 80 year old patient recently diagnosed with recurrent paroxysmal atrial
fibrillation (two or more episodes are termed as recurrent). His doctor informed him
that even recurrences of atrial fibrillation can lead to thromboembolism and have
enormous amount of stroke risk. MKs current medical conditions include hypertension,
high LDL, hypothyroidism and asthma. Currently he is on
Canadesartan/hydrochlorothiazide 16 mg/12.5 mg, atorvastatin 40 mg, levothyroxine
0.25 mcg, salbutamol 1 puff prn, fluticasone inhaler bid. What is appropriate for the all
patient to prevent stroke associated with atrial fibrillations?
A) anticoagulants therapy
B) antiplatelet therapy
C) ratre control drug such as digoxin, beta-blockers, verapamil, and/or diltiazem.
D) rythm control drugs such as amiodarone or dronedarone
E) dual antiplatelet therapy
ans: a
Tips: Whether rate or rhythm control is employed, all patients must take an
anticoagulant indefinitely because even asymptomatic recurrences of AF can lead to
thromboembolism.

69) MKs doctor considering to initiate dronedarone therapy to maintain sinus rythm.
Like amiodarone, dronedarone blocks sodium, calcium, and potassium myocardial
currents, providing both rhythm and rate control. Which of the following is NOT the side
effect of dronedarone?
A) pulmonary fibrosis
B) hypothyroidism
C) vision changes
D) skin discolouration
E) all of the above
Ans; E

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Tips: dronedarone does not contain iodine, it does not appear to cause hypothyroidism,
pulmonary fibrosis, vision changes, and skin discolouration, which are significant
problems with amiodarone.

70)Which of the following drugs would cause drug induced atrial fibrillation?
A) amiodarone
B) dronedarone
C) salbutamol
D) hydrochlorothiazide/candesartan
E) Metoprolol
Ans:C
Tips: salbutamol is beta agonist can induce atrial fibrillation.

71) A52-year-old female patient on omeprazole, iron supplements, ASA 81 mg, she got
deep vein thrombosis, is admitted to the hospital and was given thrombolytic agent.
Doctor considering adding antiplatelets dose. What antiplatelet is suitable?
A) clopidogrel
B) increase ASA dose to 325 mg
C) ASA+Dipyradamole
D) GP IIb/IIIa inhibitors
Ans: B
Tips: clopidogrel inhibits CYP2C19 and this is substrate of omeprazole and not
preferable to combine with PPIs.

72) Which of the following proton pump inhibitor is suitable in patient receiving
clopidogrel?
A) omeprazole B) lansoprazole C) Pantoprazole D) esomeprazole
Ans: C
Tips: From all PPIs, pantoprazole has least drug interaction with clopidogrel.

73) A 16-year-old high school student currently on insulin treatment for his type I
diabetes. Current reading for insulin for a patient is:
At 7 am 12 units NPH (70/30), 6 units regular insulin
At 5 pm 12 units NPH (70/30), 6 units regular insulin
Reading at 7 am (2-3 mmol/L)
Reading at 5 pm (2-3 mmol/L)
Target blood sugar levels (5.8 mmol/L) should be between 5 am to 7 pm. What would
you do?
A-Decrease both time NPH (basal) and maintain regular (prandial) insulin
B) Decrease regular insulin, increase NPH

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C) Increase NPH morning and evening, decrease regular
D) No changes necessary
Ans. A

74) Concomitant use of diuretics and ACEI, especially in whom diuretic therapy was
recently instituted, may experience hypotension effects after the first dose of ACEI. This
can be minimized by:
a) Discontinue ACEI
b) loop diuretics
c) Discontinue diuretics
d) Discontinue diuretic for few days
e) All of the above
Ans: d (CPS 2007 Pg 10)

75) You are a new pharmacist practicing in a community pharmacy setting. A patient
John Mikhel, comes into the pharmacy to get a new prescription filled for Dimicron MR
30 mg (glicalizide), In checking her patient profile, you learn that she is long-time patron
of the pharmacy., is 60 yo, is 6'.1 tall and weighs 200 lbs. His father was passed away at
young age by juvenile diabetes (type I DM) He has a refill history for Rosuvastatin that
indicates a pattern of late refills, in fact, the last refill should have run out of two weeks
ago. She got new prescription for ramipril filled three weeks ago and one for
clarithromycin two weeks ago. The rosuvastatin, ramipril and Dimicron MR (gliclizide)
are prescribed by Dr AM and the clarithromycin by Dr. PM.
What additional information should be obtained from John in future interactions?
except?
A) Obtain information of current prescription and non prescription medication to ensure
profile is complete.
B) Obtain information of chronic use of medications
C) Assess understanding about acute care medications
D) Possible presence of other medical problems that are not being treated or his
physician is unaware of
E) None of the above
Ans: E

76) What barrier do you think might keep you from getting a complete picture of her
medication therapy?
A) Lack of self confidence and anxiety of her father death with type I DM
B) Environmental barrier because he is tall
C) Administrative barrier at pharmacy
D) Poor communication skills of patient
E) Pharmacist barrier

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Ans: A

77) KM is A 41 year old male using antihypertensive captopril bid and indomethacin for
treatment of acute gout attacks and ASA 81 mg for primary prevention of
cerebrovascular risk. What is the interactions between captopril and indomethacin?
A) Increase in prostaglandin and Na/water retention
B) Decrease in prostaglandin and Na/Water retention
C) Increase risk of anti inflammatory effect of indomethacin
D) Increase risk of gastrointestinal bleeding
E) Decrease risk of gastrointestinal bleeding
Ans: B

78)JP is a 47 year old male diabetes patient taking metformin 850 mg BID. Blood sugar
is not controlled. Patient complaining he is not taking medicine regularly due to GI side
effect. What to do?
A) Reduce dose of metformin and add gliclazide
B) Reduce dose of metformin and add pioglitazone
C) Reduce dose of metformin and add acarbose
D) Reduce dose of metformin and sitagliptine
E) Reduce dose of metformin and saxigliptine
Ans: A
Tips: choose from difference class and preferably sulfonylureas and more evidence.

79) If consider adding pioglitazone. Which of the following is true about using
pioglitazone for type 2 diabetes?
a) It lowers risk of fractures
B) It is associated small risk of bladder cancer
C) It has high risk of hypoglycemia
D) It is likely to cause weight loss
E) It lowers risk of heart failure
Ans: B
Tips: Pioglitazone associated with high risk fractures in seniors, small bladder cancer
(monitor blood urine), cause weight gain and high risk of heart failure.

80) Complications of diabetes typically include all of the following except:

a) retinopathy
b) nephropathy
c) pulmonary disease
d) cardiovascular disease
e) high triglycerides

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ans: C
TIPS: Diabetic complications such as macrovascular or microvascular changes,
neuropathy, kidney disease, erectile dysfunction. REF (TC,4th edition, 804).

81) SD is a 91kg, 52-year old female who was recently diagnosed mild hypertension On
physical exam her BP was 150/94, serum creatinine was 150 umol/L, K is 4.5 mmol/L.
She is taking metformin and glicalizide for the past 4 yrs for type 2 DM.
Recommended hypertension therapy for SD if her blood pressure is?
A. >130/80 B) <140/90 C) <125/75 d) <100/80
Ans: A
Tips: TC chapter Hypertension page 216. Mild hypertension without commodities target
BP 160/90.
For hemorrhagic stroke more severe headache. However ischemic is less severe.
Pharmacotherapy 8th ed.

82) Complications of hypertension include damage to all of the end organs except:
a) heart b) eyes c) liver d) large vessels
Ans. C

83) KJ is 57 year old patient on glyburide 2.5 mg bid, metformin 500 mg tid, and still
blood sugar is not controlled because her new lab test HbA1C 7.5%. What to do?
A) switch to insulin
B) add another medication
C) Increase glyburide dose
D) increase metformin
E) Use insulin NPH morning
Ans: C

84) MM a 45 yo male patient with prosthetic valve replacement. His doctor wants to
maintain the Patient on INR 2.5 to 3.5 to avoid any clot formation. Patient was
prescribed Heparin 10,000Iu and Warfarin 4mg PO qd. Currently patient is stabilized on
warfarin 2.5 mg daily for the past 5 yrs. However, patient is not satisfied due to difficulty
to keeping up with warfarin side effects, of nausea and maintaining dietary controls and
frequent monitoring.
MM have heard about new anticoagulant Dabigatran and have some questions, what is
incorrect about Dabigatran?
A) Dabigatran 150 mg twice daily is more effective than warfarin
B)Dabigatran 110 mg twice daily has a better safety profile (less bleeding) than warfarin
C) Dabigatran is in the same class as Exanta (ximelagatran) are factor Xa
inhibitor.

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D)Dabigatran does not require regular monitoring like warfarin
E)Factor Xa inhibitor ximelegatran is safe to use in liver failure patient
Ans: E
Tips: But Exanta had too much liver toxicity. So far, liver toxicity doesn't seem to
be a serious problem with Pradax. For now, don't recommend it for patients who
already have liver disease.

85) MM is developed sore throat and his doctor wants to prescribe ampicillin 500 mg
QID
A-Effects of warfarin may be increased resulting in increased risk of bleeding
B) Effects of warfarin may be decrease resulting in increased risk of bleeding
C) Effects of warfarin may be increased resulting in decreased risk of bleeding
D) Effects of warfarin may be decrease resulting in decreased risk of bleeding
E) Effects of warfarin may be decrease resulting do not effects on bleeding
Ans-A
Tips: INR should be monitored upon addition of ampicillin and withdrawal of ampicillin.
INR should be periodically reassessed for at least 3 weeks after ampicillin D/C, since
adjustment in the warfarin dose may be necessary to maintain an effective level of
anticoagulation.

86) MM is currently stabilized on Warfarin 2.5 mg QD treatment. Which of the following

drugs may decrease warfarin levels
A) Carbamazepine B) Clarithromycin C) Cotrimoxazole D) Ciprofloxacin
E) Digoxin
Ans-A
Tips: Carbamazepine is enzyme CYP 2D6 inducers. It will decrease warfarin blood
levels. Clarithromycin (and, to a lesser extent, azithromycin) and cotrimoxazole may
increase warfarin blood levels. Clarithromycin may also increase levels of
carbamazepine, digoxin, statins and theophyllines. Other antibiotics that may increase
warfarin and digoxin levels include fluoroquinolones.

87) A 50 years old man, presented to the emergency ward with swollen right leg and
may have been diagnosed with deep vein thrombosis. The best initial treatment for this
patient is:
A. Give ASA 325 mg po, to act as antiplatelets
B. Give enoxaparin 4000 IU sc q24 hour
C. Give warfarin 3 mg to maintain INR 2 to 3
D. Give enoxaparin + warfarin
E. Give streptokinase 1.5 million IU i.v. is over 1hour
Ans: D
Tips: Since warfarin take 36 hrs for exerting its effect. Hence we use enoxaprin and to
initiate the action promptly and start together with warfarin.

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BM, a 60 year old –old male, diagnosed hypertension for the past 30 years and 10 year
history of Ischemic heart disease (IHD), poorly controlled due to poor compliance. He
has no family history of heart disease and social history includes smoked for past 40
years; currently smoke 1-2 packs per week and on average drinks a six pack of beer per
week. Current medications include: Hydrochlorothiazide 25 mg PO daily, nitroglycerin
0.4 mg PRN for chest pain, Ketoprofen, 75 mg PO TID
No known medical allergies, physical examination includes anxious male, BP 125/90, HR
105, wt 68 kg, 1+ ankle edema, bluish-gray skin discoloration on sun – exposed areas.
Lab values Na 134, K 3.9, Cl 102, HCO 3 28, BUN 6.1, Cr 106, Hct 0.38, Hgb 140, MCV 88,
AST 0.70, ALT 0.64, LDH 3.18, Alk Phos 0.8, Alb 38 & ESR 43 mm/hr.

88) Which of the following monitoring parameters is NOT important in the early
assessment of ACE inhibitor therapy in BM?
A) Serum K+
B) Serum creatinine
C) Renal function test
D)Liver function test
E) Serum Na+
Ans-E

89) Which of the following ACE inhibitor works best if you take it on an empty stomach?
A. Lisinopril
B)Captopril
C)Enalapril
D)Ramipril
E)All of the above
Ans: B
Tips: Captopril and parindaropil is taken empty stomach.

90) which of the following antihypertensive should NOT be used in a patient with
systolic dysfunction?
A. Ramipril
B)Felodipine
C)Amlodipine
D)Verapamil
E)Atenolol
Ans-D
Tips: drug of choice for systolic dysfunction. ACEI alternate ARBs. Drug of choice for
isolated systolic hypertension ACE I alternate ARBs. Congestive heart failure avoid using
verapamil and diltiazem because it cause -ve inotropic effect. Among ACEi fosinopril do
NOT require dose adjustment in renal patient because eliminates renal and hepatic
(50:50).

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91) Which of the following in BM profile is objective according to SOAP note?
A) ACE i Side effects
B) Cardiovascular laboratory values
C) Patient symptoms
D) all of the above
Ans: B

92) KP is a 47-year-old patient has just started raw diet only few days, taken citrus juice
daily. Maintain healthy life style such diet and exercise. Patient using atorvastatin 20 mg
to treat high cholesterol and recent visit doctor, he increases atorvastatin dose to 40
mg. Patient complains severe dyspepsia and diarrhea. It’ may be due to:
a. Because he is on raw food diet
b. Changed atorvastatin 20 mg to 40 mg
c. Takes citrus juice
d. Exercise
e. Multivitamins
Ans. B
Tips: What does statins have GI SEs. However statins common GI SEs. Raw food is high
fibre content (insoluble fibre).

93) KP is diagnosed high LDL and TG, what is the best therapy to initiate?
A) Rosuvastatin
B) Cholestyramine
C) Niacin
D) Fenofibrate
E)Ezetamibe
Ans: A
TC page 438, 6th ed. Rosuvastatin and atorvastatin have high lowering effect on LDL and
TG.

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