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質問 1：
A 49-year-old man presents to his physician with a 3-day acute attack of gout in four joints of the right foot. The patient has a history of at least three previous gout attacks; in one, a joint aspirate was positive for urate crystals. His history also includes type 2 diabetes mellitus and two calcium oxalate kidney stones.
Laboratory values include creatinine 3.1 mg/dL, uric acid 11.7 mg/dL, and A1C 6.8%. The patient is allergic to aspirin. Vital signs are BP135/82mm Hg and HR 90 bpm and regular.
Current medications are glipizide 10 mg daily and enalapril 20 mg daily.
Which short-term regimen is most appropriate for treating this patient's gout?
A. Indomethacin 50 mg three times daily
B. Prednisone 40 mg daily
C. Celecoxib 200 mg daily
D. Colchicine 0.6 mg hourly
正解：B
質問 2：
A 59-year-old patient with a diagnosis of deep vein thrombosis is anticoagulated with enoxaparin 1 mg/kg every 12 hours and warfarin 5 mg daily. On the third day of therapy, his INR
= 2.2. The patient is symptomatically improved. Which of the following is the most appropriate management of this patient?
A. Continue enoxaparin and warfarin.
B. Discontinue enoxaparin and continue warfarin.
C. Discontinue enoxaparin and increase warfarin.
D. Continue enoxaparin and hold Warfarin.
正解：D
質問 3：
The Joint Commission requires accredited organizations to encourage which groups to report concerns about safety?
A. Medical students rotating through organizations
B. Patients and families
C. Local specific disease support groups
D. National special interest groups
正解：D
質問 4：
A pharmacotherapy specialist has been asked to provide information on the incidence of a particular side effect for a drug that has now been on the U.S. market for 5 years. The only information available comes from the FDA's MedWatch program. The apparent incidence of a given adverse effect, as determined from the MedWatch database, is likely to be which of the following?
A. Reliable because healthcare institutions such as hospitals are mandated to report all adverse drug events to the FDA
B. Unreliable because reporting healthcare providers usually fail to establish a temporal relationship
C. Reliable because the data are accumulated in cooperation with the pharmaceutical industry
D. Unreliable because the voluntary nature of reporting makes numerator data questionable
正解：A
質問 5：
A 45-year-old patient develops neutropenia, fever, headache, meningismus, and lethargy after induction chemotherapy for acute lymphocytic leukemia. A lumbar puncture reveals 1,000 total nucleated cells with elevated CSF protein with gram stain showing Gram-positive rods. Which of the following is the best initial empiric therapy for this patient?
A. Ceftazidime and gentamicin
B. Ampicillin
C. Ceftriaxone
D. Ampicillin and cefotaxime
正解：C
質問 6：
A patient is receiving oxcarbazepine. Which is the most relevant toxicity monitoring parameter?
A. Serum potassium
B. Serum Creatinine
C. TSH
D. Serum Sodium
正解：D
質問 7：
A 40-year-old transplant recipient who is receiving cyclosporine develops seizures requiring anticonvulsant therapy. Because a drug interaction is likely to occur between cyclosporine and phenytoin, the pharmacotherapy specialist suggests that the resident do which of the following?
A. Increase the phenytoin dose.
B. Increase the cyclosporine dose.
C. Decrease the phenytoin dose.
D. Decrease the cyclosporine dose.
正解：B
質問 8：
A 28 year old patient presents to a physician and reports persistent nasal discharge and facial tenderness for the past 15 days. The patient has no known drug allergies. Which recommendation would be best for treating this acute sinusitis?
A. Azithromycin
B. Amoxicillin/clavulanate acid
C. No antimicrobial indicated at this time
D. Sulfamethoxazole/trimethoprim
正解：B
A 49-year-old man presents to his physician with a 3-day acute attack of gout in four joints of the right foot. The patient has a history of at least three previous gout attacks; in one, a joint aspirate was positive for urate crystals. His history also includes type 2 diabetes mellitus and two calcium oxalate kidney stones.
Laboratory values include creatinine 3.1 mg/dL, uric acid 11.7 mg/dL, and A1C 6.8%. The patient is allergic to aspirin. Vital signs are BP135/82mm Hg and HR 90 bpm and regular.
Current medications are glipizide 10 mg daily and enalapril 20 mg daily.
Which short-term regimen is most appropriate for treating this patient's gout?
A. Indomethacin 50 mg three times daily
B. Prednisone 40 mg daily
C. Celecoxib 200 mg daily
D. Colchicine 0.6 mg hourly
正解：B
質問 2：
A 59-year-old patient with a diagnosis of deep vein thrombosis is anticoagulated with enoxaparin 1 mg/kg every 12 hours and warfarin 5 mg daily. On the third day of therapy, his INR
= 2.2. The patient is symptomatically improved. Which of the following is the most appropriate management of this patient?
A. Continue enoxaparin and warfarin.
B. Discontinue enoxaparin and continue warfarin.
C. Discontinue enoxaparin and increase warfarin.
D. Continue enoxaparin and hold Warfarin.
正解：D
質問 3：
The Joint Commission requires accredited organizations to encourage which groups to report concerns about safety?
A. Medical students rotating through organizations
B. Patients and families
C. Local specific disease support groups
D. National special interest groups
正解：D
質問 4：
A pharmacotherapy specialist has been asked to provide information on the incidence of a particular side effect for a drug that has now been on the U.S. market for 5 years. The only information available comes from the FDA's MedWatch program. The apparent incidence of a given adverse effect, as determined from the MedWatch database, is likely to be which of the following?
A. Reliable because healthcare institutions such as hospitals are mandated to report all adverse drug events to the FDA
B. Unreliable because reporting healthcare providers usually fail to establish a temporal relationship
C. Reliable because the data are accumulated in cooperation with the pharmaceutical industry
D. Unreliable because the voluntary nature of reporting makes numerator data questionable
正解：A
質問 5：
A 45-year-old patient develops neutropenia, fever, headache, meningismus, and lethargy after induction chemotherapy for acute lymphocytic leukemia. A lumbar puncture reveals 1,000 total nucleated cells with elevated CSF protein with gram stain showing Gram-positive rods. Which of the following is the best initial empiric therapy for this patient?
A. Ceftazidime and gentamicin
B. Ampicillin
C. Ceftriaxone
D. Ampicillin and cefotaxime
正解：C
質問 6：
A patient is receiving oxcarbazepine. Which is the most relevant toxicity monitoring parameter?
A. Serum potassium
B. Serum Creatinine
C. TSH
D. Serum Sodium
正解：D
質問 7：
A 40-year-old transplant recipient who is receiving cyclosporine develops seizures requiring anticonvulsant therapy. Because a drug interaction is likely to occur between cyclosporine and phenytoin, the pharmacotherapy specialist suggests that the resident do which of the following?
A. Increase the phenytoin dose.
B. Increase the cyclosporine dose.
C. Decrease the phenytoin dose.
D. Decrease the cyclosporine dose.
正解：B
質問 8：
A 28 year old patient presents to a physician and reports persistent nasal discharge and facial tenderness for the past 15 days. The patient has no known drug allergies. Which recommendation would be best for treating this acute sinusitis?
A. Azithromycin
B. Amoxicillin/clavulanate acid
C. No antimicrobial indicated at this time
D. Sulfamethoxazole/trimethoprim
正解：B
Koshiba -
BPS-Pharmacotherapy試験を合格しました。よかったんです。
引き続き問題集を購入していきたいと思います。
今後ともよろしくお願いします。