Ambulatory Care Ambulatory Care Pharmacology Questions and Answers

Question 1

A 65-year-old male, recently started on high-intensity atorvastatin for secondary prevention of ASCVD, calls the clinic complaining of new-onset, bilateral thigh pain that began a week ago.
He denies injury, and his creatine kinase (CK) level is within the normal range.
What is the most appropriate next step in managing this patient's symptoms?

Accepted Answer

Hold the atorvastatin for 2-4 weeks and, if symptoms resolve, re-challenge with the same or a lower dose.

Answer

Reassure the patient that this is a benign side effect and advise him to continue the medication.

Answer

Immediately switch to a different high-intensity statin, such as rosuvastatin.

Answer

Refer the patient to a rheumatologist for a full workup of myopathy.

Question 2

Which of the following is a key advantage of using a direct oral anticoagulant (DOAC) such as apixaban over warfarin for the treatment of non-valvular atrial fibrillation?

Accepted Answer

Fewer significant drug-drug and drug-food interactions.

Answer

The availability of a widely used, inexpensive point-of-care test for monitoring.

Answer

A significantly lower risk of major gastrointestinal bleeding.

Answer

The requirement for frequent dose adjustments based on INR monitoring.

Question 3

In addition to its glucose-lowering effects, which of the following is a well-established benefit of initiating an SGLT2 inhibitor, such as empagliflozin, in a patient with type 2 diabetes and established cardiovascular disease?

Accepted Answer

Reduction in the risk of hospitalizations for heart failure.

Answer

Significant weight gain.

Answer

Increased risk of hypoglycemia when used as monotherapy.

Answer

Improvement in diabetic gastroparesis symptoms.

Question 4

A 55-year-old African American male without other comorbidities is newly diagnosed with Stage 1 hypertension. According to the 2017 ACC/AHA hypertension guidelines, which of the following would be the most appropriate initial monotherapy?

Accepted Answer

Amlodipine

Answer

Lisinopril

Answer

Metoprolol succinate

Answer

Losartan

Question 5

When prescribing opioids for chronic non-cancer pain, which practice is a key component of the CDC Clinical Practice Guideline for Prescribing Opioids for Pain?

Accepted Answer

Routinely utilizing state Prescription Drug Monitoring Program (PDMP) data before and during therapy.

Answer

Prioritizing extended-release/long-acting opioid formulations as initial therapy.

Answer

Co-prescribing a benzodiazepine to manage anxiety often associated with chronic pain.

Answer

Avoiding the use of non-pharmacologic therapies once an opioid has been initiated.

Question 6

Based on the most recent Global Initiative for Asthma (GINA) strategy report, which statement best describes the recommended approach for adult patients with mild asthma?

Accepted Answer

As-needed low-dose inhaled corticosteroid (ICS)-formoterol is the preferred reliever therapy.

Answer

Short-acting beta-agonist (SABA) monotherapy as needed is the recommended first-line treatment.

Answer

Daily medium-dose inhaled corticosteroid (ICS) is recommended for all patients.

Answer

Scheduled, around-the-clock SABA therapy is preferred to prevent inflammation.