Scar-crossed Liver
On a Renal Roll
Beta Blockerbusters
No Rx Needed
Bugs and Drugs
100

This classification system assesses the severity of liver disease and serves as a predictor of patient survival. It is often used for drug dose adjustments in liver disease.

What is Child-Pugh? 

100

Two common lab markers to estimate kidney function. 

Serum creatinine and blood urea nitrogen

100

In patients with systolic heart failure, only these three beta blockers have proven mortality benefit in clinical trials.

What is metoprolol succinate, carvedilol, bisoprolol.

100

These OTC products should be avoided in patients taking anticoagulants. 

What is NSAIDs?

100

This resource is used to aid in selection of selecting empiric treatment and monitor resistance trends over time.

What is an antibiogram?

200

What lab value that measures blood clotting time can be elevated in liver disease? 

What is INR? 

200

In addition to diabetes and proteinuria, this is a risk factor for the progression of CKD.

Uncontrolled hypertension

200

Name a beta blocker that would be preferred in patients with asthma or COPD.

What is a selective beta-1 blocker. Metoprolol, bisoprolol, nebivolol, atenolol.

200

These 5 natural products starting with the letter “G” are known to increase bleeding risk.

What is Ginko, garlic, ginger, glucosamine, and ginseng

200

This class of antibiotics is not active against enterococcus or atypicals.  

What is Cephalosporins?

300

This vitamin is used to treat and prevent Wernicke-Korsakoff syndrome.

What is thiamine? 

300

In hypertensive patients with CKD, which class of blood pressure lowering medications is preferred and why? 

What are ACEi or ARBs due to their proven benefits for the prevention of CKD progression, especially in those with significant albuminuria.

300

This is the main therapeutic goal when beta blockers are used in atrial fibrillation management.

What is the ventricular response (or heart rate)?

300

A 55-year-old female with a history of controlled hypertension presents with nasal congestion and a cough. Which ingredient in an OTC cold product would be inappropriate for her?

  • A. Guaifenesin
  • B. Dextromethorphan
  • C. Pseudoephedrine
  • D. Diphenhydramine

What is C? Pseudoephedrine is a decongestant that acts as a vasoconstrictor, which can increase blood pressure and is therefore contraindicated or used with caution in patients with hypertension. 

300

List the SPACE organisms. 

What is Serratia, Providencia, actinobacter, Citrobacter, Enterobacter?

400

This type of hepatitis is acute, self-limiting in most cases and is usually transmitted by contaminated food/water.

What is hepatitis A?

400

It is recommended to discontinue metformin therapy when estimated glomerular filtration rate (eGFR) falls below this value.

What is 30 mL/min/1.73m2?


400

A patient is taking metoprolol tartrate 50 mg twice daily. You’re switching them to an equivalent daily dose of metoprolol succinate. What dose should they receive?

 What is metoprolol succinate 100 mg once daily?

400

An 80-year-old male with benign prostatic hyperplasia (BPH) asks for an OTC medication to help with occasional insomnia. Which of the products listed should the pharmacist counsel him to avoid?

  • A. Melatonin
  • B. Diphenhydramine
  • C. Doxylamine

What is A,C? Both diphenhydramine and doxylamine are first-generation antihistamines with anticholinergic effects. This can worsen urinary retention, a common symptom of BPH.

400

Name 3 oral antibiotics with MRSA coverage. 

What is trimethoprim-sulfamethoxazole, doxycycline, minocycline, clindamycin, linezolid, tedizolid delafloxacin and tigecycline. 

500

A syndrome of neuropsychiatric abnormalities caused by acute or chronic hepatic insufficiency. 

What is hepatic encephalopathy? 

500

What would be the primary risk associated with the combination of spironolactone, lisinopril, and Bactrim in a CKD patient? 

What is elevated potassium? 

500

In patients abusing cocaine, which type of beta blockers are considered safer?

What are mixed α- and β-blockers (e.g., labetalol or carvedilol)? They avoid unopposed α-adrenergic stimulation that can worsen vasospasm.

500

What is the interaction between some statin medications and grapefruit juice? 

Grapefruit juice inhibits CYP3A4 which is responsible for statin metabolism. This inhibition leads to more of the statin being absorbed into the bloodstream, increasing its concentration and the risk of side effects like muscle pain and rhabdomyolysis 

500

This type of organism has a thin cell wall and will take up safranin counterstain. 

What is gram negative?

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