Pharm
Bot Med
Homeopathy
Conditions
Wild Card
100
A 75-year-old patient with nonvalvular atrial fibrillation is started on rivaroxaban. What is a critical counseling point for this medication?
A. Take with vitamin K supplements
B. Discontinue if mild bleeding occurs
C. Do not stop abruptly without medical advice
D. Monitor INR weekly
C. Do not stop abruptly without medical advice
Rivaroxaban has a black box warning. Abrupt discontinuation can lead to increased risk of stroke.
100
A 52-year-old woman with osteoarthritis and a history of peptic ulcer disease presents with mild psoriasis. You plan to use an alterative herb with liver-supportive effects. Which herb would be contraindicated due to her gastrointestinal history?
A. Berberis aquifolium
B. Arctium lappa
C. Smilax spp.
D. Galium aparine
B. Arctium lappa
Arctium lappa is helpful for psoriasis and eczema, but is contraindicated in active or acute GI disease, including peptic ulcers. Berberis aquifolium is safe in this context and also commonly used in psoriasis.
100
Which remedy is commonly used for warts and feelings of mental fragmentation?
a) Platina
b) Tuberculinum
c) Thuja occidentalis
d) Psorinum
c) Thuja occidentalis
“Thuja tree with low self esteem”
Warts, bumps, lumps, skin tags
Never well since vaccination
Religious affections
Feelings of fragility and isolation, hides true self
Feeling of being rotten on the inside
Lots of sweat
Vertigo
Craves raw onion
100
Testing for anti-intrinsic factor (IF) autoantibodies is used to identify this condition
Pernicious anemia - AI disease causing severe malabsorption of vit B12
100
A 35-year-old patient complains of brief episodes of vertigo when turning their head in bed. Dix-Hallpike test reproduces the symptoms and causes horizontal nystagmus. What is the best next step in treatment?
Epley Maneuver
This is first-line treatment for benign paroxysmal positional vertigo (BPPV). It repositions canaliths in the inner ear.
200
A long-term user of proton pump inhibitors is at increased risk for which of the following?
A. Hypercalcemia
B. Vitamin B12 malabsorption
C. Hyperkalemia
D. Hypoglycemia
B. Vitamin B12 malabsorption
PPIs reduce gastric acid which is necessary for B12 absorption. Long-term use can cause B12 deficiency.
200
Which of the following herbs would be absolutely contraindicated in bloody diarrhea?
a. Glycyrrhiza glabra
b. Geranium maculatum
c. Althaea officinalis
d. Frangula purshiana
d. Frangula purshiana
It is a cathartic laxative
200
Which remedy suits a shy, forgetful child with swollen glands?
a) Phosphorus
b) Calcarea carbonica
c) Silicea
d) Baryta carbonica
d) Baryta carbonica
200
Which of the following conditions is commonly associated with restrictive cardiomyopathy?
a. Alcohol use, myocarditis, and peripartum complications
b. Sarcoidosis, amyloidosis, myocardial fibrosis after open-heart surgery, and radiation
c. Missense mutation in sarcomere proteins
d. Chronic cocaine use and doxorubicin toxicity
b. Sarcoidosis, amyloidosis, myocardial fibrosis after open-heart surgery, and radiation
200
Honeymoon cystitis is one of the keynotes of which remedy?
Staphysagria
“Abused with a STAPH in the pelvis and teeth”
Pelvic and abdominal conditions
Honeymoon cystitis
Styes, sharp cuts
Sweet but suppressed, passive, timid, easily irritated
Black crumbling teeth
Throws things when angry
300
Which ophthalmic medication works by increasing the outflow of aqueous humor and is known to cause eye pigmentation changes as a side effect?
A. Timolol
B. Atropine
C. Latanoprost
D. Gentamicin
C. Latanoprost
Latanoprost is a prostaglandin analog that increases aqueous humor outflow. Known AE includes increased iris pigmentation (especially in light-colored eyes).
300
A patient seeks a nootropic herb to support cognitive function and memory, preferably one with vasodilating and antioxidant properties. Which herb fits this description?
A. Piper methysticum
B. Valeriana officinalis
C. Centella asiatica
D. Artemisia absinthium
C. Centella asiatica
300
Which remedy fits a patient with paralysis, stiffness, and urinary incontinence?
a) Lachesis
b) Hypericum
c) Rhus toxicodendron
d) Causticum
d) Causticum
“Burning for the CAUSE…Feeling the BURN 2020” The Portland Remedy
Burns
Neurological problems
Sympathetic, activist types
Tendency to rheumatic, skin & mucous membrane ailments
Craves salt and smoked meat
Urinary incontinence
300
A 50-year-old patient presents with episodes of confusion, weakness, and sweating that occur during fasting. Labs show increased serum insulin and C-peptide levels. What is the most likely diagnosis?
B. Insulinoma
Insulinoma is a pancreatic beta-cell tumor causing fasting hypoglycemia with elevated insulin and C-peptide.
300
A 65-year-old woman with COPD is prescribed a bronchodilator that blocks muscarinic receptors and is taken once daily. What is the most likely medication?
A. Ipratropium
B. Montelukast
C. Tiotropium
D. Guaifenesin
C. Tiotropium - Long-acting muscarinic antagonist (LAMA) for COPD maintenance.
A. Ipratropium – Also anticholinergic, but short-acting.
B. Montelukast – Leukotriene receptor antagonist, used for asthma/allergies.
D. Guaifenesin – Expectorant, no bronchodilation.
400
A patient with a pituitary stalk tumor presents with polyuria, polydipsia, and highly dilute urine (specific gravity <1.006). A water deprivation test shows continued production of large volumes of dilute urine. Which treatment is most appropriate?
A. Desmopressin (exogenous ADH)
B. Thiazide diuretics (HCTZ)
C. Fluid restriction
D. Furosemide
A. Desmopressin (exogenous ADH)
Central Diabetes Insipidus is due to insufficient ADH production, so replacement with desmopressin corrects water loss.
400
A patient with seasonal allergic rhinitis wants a natural anti-allergic herb with immune-modulating and mild mucolytic effects. Which herb would be most appropriate?
A. Sambucus canadensis
B. Euphrasia officinalis
C. Scutellaria baicalensis
D. Ephedra sinica
B. Euphrasia officinalis
400
Violent behavior and intense fear with nightmares points to:
a) Syphilinum
b) Stramonium
c) Staphysagria
d) Tabacum
b) Stramonium
400
A 6-year-old boy returns from a family trip to a petting zoo. Two days later, he develops abdominal cramping and bloody diarrhea, but no fever. His parents report he ate a hamburger that was pink in the middle. On exam, he is pale and lethargic.What is the most likely diagnosis and associated complication?
A. Shigella – Seizures
B. Campylobacter – Guillain-Barré syndrome
C. EHEC (E. coli O157:H7) – Hemolytic uremic syndrome
D. Yersinia – Reactive arthritis
C. EHEC (E. coli O157:H7) – Hemolytic uremic syndrome
Bloody diarrhea without fever after eating undercooked beef = EHEC.
Risk of HUS (triad: hemolytic anemia, thrombocytopenia, AKI).
400
A 62-year-old woman with Alzheimer’s disease is started on a new medication that improves her memory by increasing acetylcholine levels. She later develops nausea, diarrhea, and insomnia. Which drug is she most likely taking?
A. Rivastigmine
B. Memantine
C. Bromocriptine
D. Levodopa
A. Rivastigmine - Acetylcholinesterase inhibitor used in Alzheimer's. It increases acetylcholine levels and often causes GI upset and insomnia.
B. Memantine – NMDA antagonist, fewer GI side effects.
C. Bromocriptine – Dopamine agonist for Parkinson’s.
D. Levodopa – Used in Parkinson’s, not Alzheimer’s.
500
Which of the following is a major adverse effect associated with fluoroquinolones (e.g., ciprofloxacin)?
A) Hepatotoxicity
B) Tendinopathy and Achilles tendon rupture
C) Ototoxicity
D) Nephrolithiasis
B) Tendinopathy and Achilles tendon rupture
Mnemonic: “Flox makes you flop” – fluoroquinolones can weaken tendons and lead to rupture, especially the Achilles.
500
Which tincture formula would be most effective for a case of uncomplicated cystitis?
A. Arctostaphylos uva ursi, althea officinalis, verbascum flavescens
B. Althea officinalis, allium cepa, solidago spp.
C. Zea mays, althea officinalis, arctostaphylos uva ursi
D. Eupatorium perfoliatum, matricaria chamomilla, arctostaphylos uva ursi
C. Zea mays, althea officinalis, arctostaphylos uva ursi
500
A patient complains of profuse acrid nasal discharge that irritates the upper lip and eyes that water from allergies, symptoms worsening outdoors. The best remedy is:
a) Euphrasia
b) Allium cepa
c) Arsenicum album
d) Pulsatilla
b) Allium cepa
"Acrid discharge cepa-ing from the nose"
Acrid nasal discharge, nose running like a faucet
Bland tears
Cough from tickle in throat
Burning pains alternating symptoms side to side
500
A 63-year-old male smoker presents with fatigue, hyponatremia, and new confusion. CT chest reveals a central mass. Labs show elevated ADH levels. Biopsy reveals small round blue cells. What is the most likely diagnosis and associated paraneoplastic syndrome?
A. Large Cell Carcinoma – Aggressive peripheral mass
B. Squamous Cell Carcinoma – Hypercalcemia via PTHrP
C. Small Cell Lung Carcinoma – SIADH causing hyponatremia
D. Mesothelioma – Hemorrhagic pleural effusion
C. Small Cell Lung Carcinoma – SIADH causing hyponatremia
500
A 29-year-old woman presents with fatigue, double vision, and difficulty swallowing. She feels worse after prolonged activity. Pupils are spared. Reflexes and sensation are normal. What condition does she have?
Myasthenia Gravis
Fluctuating muscle weakness worsened with exertion; classic in young women. Ptosis and diplopia are early signs. Preserved reflexes and sensation. Pupils spared.