Department of Pharmacy
Licensing Examination
Name___________________________________ I.D ___________________
Part I
1. A 62-year-old woman with a history of hypertension and hyperlipidemia presents to the hospital
with diffuse muscle pain, weakness, and dark urine. She has no history of autoimmune or renal
disease. Over the past month, she has had symptoms of cold intolerance, weight gain, and
constipation. Her medications include hydrochlorothiazide, simvastatin, and gemfibrozil. Urine
dipstick reveals 3+ blood; however, there are no red blood cells on microscopic analysis. Some of
the other laboratory values are shown below.
Creatinine 2.3 mg/dL Creatine kinase 34,000 U/L TSH 8.0 μU/mL
Which of the following is the most likely cause of her presentation?
Hashimoto thyroiditis
(B) Pyelonephritis
(C) Polymyositis
(D) Medication effect
Note: Hashimotos Thyroiditis symptoms are constipation, hair loss, excessive sleep.
2. A 28-year-old woman frantically presents to the Emergency Department in the middle of the
night with chest discomfort that awoke her from sleep . She has experienced similar episodes a
few times before, always at night, but never as bad as this. She reports a history of migraines but
denies any other medical history, including heart disease. Her medications include NSAIDs as
needed and OCPs. She smokes a half pack of cigarettes a day but denies any alcohol or drug use.
She admits that she gets “stressed out” a lot but believes that overall she lives a healthy lifestyle.
Laboratory values show normal CK and troponin. An ECG shows ST elevations and she is taken
for coronary angiography that does not show any significant coronary occlusions.
What is the most appropriate treatment for this patient?
(A) Alprazolam
(B) Diltiazem
(C) Alteplase
(D) NSAIDs
(E) Reassurance
3. A 53-year-old man is hospitalized with pneumonia and is placed on a cardiac monitor. While in the
room, you notice that he is in normal sinus rhythm but has occasional wide complexes without any
