Clinical Pharmacotheraputics Past Paper-Pharm D University of Lahore

THE UNIVERSITY OF LAHORE-ISLAMABAD CAMPUS

SCHOOL OF PHARMACY

Subject: Clinical Pharmacotheraputics	Session:                 Pharm-D
Total Marks:  10	Date: 10/1/13
Time Allowed:  30 min	Paper:
Name:	Roll No.

A 81-year-old man presents with pallor, glossitis,cheilitis, and vitiligo. Which of the following

is the most likely diagnosis?

(A) sickle cell anemia

(B) cold agglutinin syndrome

(C) methemoglobinemia

(D) pernicious anemia

(E) polycythemia

A7-year-old boy has severe microcytic anemiadue to beta-thalassemia major (homozygous).

He requires frequent blood transfusions (onceevery 6 weeks) to prevent the skeletal and

developmental complications of thalassemia.Which of the following medications is also

indicated in the treatment of patients requiringfrequent blood transfusions?

(A) oral calcium supplements

(B) fresh frozen plasma

(C) desferrioxamine

(D) penicillamine

(E) cryoprecipitate

A23-year-old woman has symptoms of fatigueand not feeling well. She appears well and thephysical examination is normal, but her hemoglobinis low at 9.8 g/dL with a mean corpuscularvolume (MVC) of 76 fL. Her familyhistory is positive for thalassemia. She alsomentions a history of heavy menses in the pastyear. Which of the following would be mosthelpful in distinguishing thalassemia from oneof pure iron deficiency anemia?

(A) peripheral blood smear

(B) osmotic fragility test

(C) Ham’s test

(D) Hb electrophoresis on paper

(E) serum ferritin determination

A 50-year-old White woman presents with a3-week history of tiredness and pallor. Afamilymember has noted some yellowness of hereyes, but she denies darkening of the urine.Physical examination reveals only slight jaundice.Laboratory data include hemoglobin of9 g/dL, reticulocyte count of 8%, a bilirubin inthe serum of 2 mg/dL and decreased hepatoglobin Which of the following is the most likelycause for her anemia?

(A) blood loss externally

(B) decreased red cell production

(C) ineffective erythropoiesis

(D) intravascular hemolysis

(E) extravascular hemolysis

A 24-year-old man develops acute onset ofanorexia, nausea, and vomiting. This is followedby clinical jaundice and right upperquadrant discomfort 1 week later. Four weeksago, he was traveling infaislabad, wherehe ate food from street vendors. On examination, he is Jaundiced with rightupper quadrant tenderness but the rest of theexamination is normal. His hepatitis serology ispositive for an agent that could have been preventedwith vaccination.

(A) hepatitis A virus

(B) hepatitis B virus

(C) hepatitis C virus

(D) hepatitis D virus

(E) hepatitis E virus

A 32-year-old man presents with jaundice and malaise.He is found to have acute hepatitis B with positivehepatitis B virus (HBV) DNA and E antigen. Which ofthe following antiviral agents are approved as part of atherapeutic regimen for mono-infection with hepatitis B?

A. Efavirenz

B. Ganciclovir

C. Lamivudine

D. Rimantadine

E. Tenofovir

A previously unvaccinated health care worker incursa needle stick from a patient with known active hepatitisB infection. What is the appropriate managementfor the health care worker?

A. Hepatitis B immunoglobulins

B. Hepatitis B vaccine

C. Hepatitis B vaccine plus hepatitis B immunoglobulins

D. Hepatitis B vaccine plus lamivudine

E. Lamivudine plus tenofovir

A 29-year-old woman who recently immigratedto the United States from South America presents to alocal emergency room with severe abdominal pain,jaundice, and fever. No one else at home is ill. She is unsurehow long her symptoms have been going on, butdescribes a sudden worsening over the past 3 days. Shehas been unable to get out of bed and has not been eatingwell over that period of time. She has had nauseaand vomiting. She denies alcohol or illicit drug use. Sheis rapidly triaged and on initial laboratory studies isfound to have an ALT and AST in the thousands. She isto be admitted for inpatient management, and viralhepatitis serologies are sent. In a patient with acute hepatitisB, which of the following would be the first indicationof infection?

A. Anti-HBc (antibody to hepatitis B core antigen)

B. Clinical symptoms such as fever, jaundice, and abdominalpain

C. HBeAg (hepatitis B e antigen)

D. HBsAg (hepatitis B surface antigen)

E. Increased transaminases

In chronic hepatitis B virus (HBV) infection, presenceof hepatitis B e antigen (HBeAg) signifies which ofthe following?

A. Development of liver fibrosis leading to cirrhosis

B. Dominant viral population is less virulent and lesstransmissible

C. Increased likelihood of an acute flare in the next 1–2weeks

D. Ongoing viral replication

E. Resolving infection

Q.No 2) Write down the treatment of chronic Hepatitis B with doses and frequency? (1)

Prepared by:

Dr. Haseeb Sattar