PLE Category: Pharmacology

PLE-6276

A 25-year-old woman with AIDS comes to the physician because of a 10-day history of fever, shortness of breath, night sweats, fatigue, and a non-productive cough. She had been treated with antiretroviral agents for 2 years but stopped taking her medications 6 weeks ago. She has no known allergies. Her temperature is 38.6 C, pulse is 110/min, respiration are 20/min, and blood pressure is 110/60 mm Hg. Examination shows no cyanosis. Diffuse fine crackles are heard bilaterally. An x-ray of the chest shows bilateral interstitial infiltrates. A silver stain of sputum is positive for cysts and organisms. Which of the following is the most appropriate pharmacotherapy?

PLE-6270

A 17-year-old boy is brought to the emergency department by his parents because of bizarre behavior for 6 hours. Last night, he was out with friends, and since returning, he has been confused and has trashed his room. His blood pressure is 165/95 mm Hg. He is hypervigilant, has little spontaneous speech, and is disoriented to place and time. He appears catatonic but abruptly becomes assaultive two times and needs to be restrained. Which of the following is the most likely substance taken?

PLE-6271

A 32-year-old woman comes to the physician because of a 3-month history of increasing pain and stiffness in her wrists, hands, and ankles. During this period, she also has had progressive fatigue and morning stiffness lasting 2 hours. She has a 1-year history of rheumatoid arthritis treated with naproxen. Examination shows redness, swelling, and warmth over the wrist, hand, and ankle joints bilaterally. There are non tender subcutaneous nodules over the extensor surfaces of both elbows. X-ray films of the hands show diffuse osteopenia and erosions over several of the distal metacarpal bones. Which of the following is the most appropriate pharmacotherapy?

PLE-6272

An otherwise healthy 19-year-old woman comes to the physician because of a 3-year history of intermittent facial blemishes. She drinks wine occasionally on weekends. She takes no medications. Examination shows multiple 1- to 2-mm red and white papules on the forehead and cheeks. Which of the following is the most appropriate initial pharmacotherapy?

PLE-6273

A 67-year-old man is hospitalized for treatment of renal insufficiency. Three days after admission, his pulse is 40/min. An ECG shows tall, tented T waves. Serum studies show a sodium level of 134 mEq/L, potassium level of 6.9 mEq/L, and glucose level of 85 mg/dL. What is the most appropriate next step in management? Is it intravenous administration of which of the following?

PLE-6268

A 37-year-old man comes to the physician because of a 1-week history of pain with swallowing. He received the diagnosis of AIDS 4 years ago but has not been able to tolerate highly active antiretroviral therapy. He currently takes TMP-SMX. Vital signs are within normal limits. Examination shows a few white plaques over the pharynx. CD4+ count is 50/mm3, and plasma HIV viral load is 50,000 copies/mL. Which of the following is the most appropriate pharmacotherapy?

PLE-6269

A 47-year-old woman comes to the physician for a routine health maintenance examination. She has a 2-year history of venous insufficiency and noted daily swelling of her ankles that worsens in the evening. She takes no medications. Her pulse is 80 bpm, and blood pressure is 160/100 mmHg. Cardiopulmonary examination shows no abnormalities. Examination of the lower extremities shows 2+ edema and increased pigmentation. Which of the following antihypertensive medications would most likely exacerbate this patient’s swelling?

PLE-6265

Is this drug a derivative of rifamycin? If so, is it indicated as a replacement for rifampin in the treatment of tuberculosis in HIV-infected patients who are also taking protease inhibitors concurrently?

PLE-6266

What is not true about sulfonamides?

PLE-6267

A 45-year-old soldier has been maintaining on fluoxetine for his major depressive disorder. Which of the following drugs can precipitate a potentially fatal syndrome of hypertension, hyperreflexia, tremor, clonus, hyperthermia, diarrhea, mydriasis, and agitation within hours when taken concurrently with fluoxetine?