Prometric Questions - Yellow File - MOH | SPLE | HAAD | DHA - 35

Which one of the following designs could be deemed an study? 
A) Cohort  B) Clinical trials C) Case-control  D) Cross-sectional 

The correct answer is B) Clinical trials.

Reason:

Experimental Study: Clinical trials are experimental (interventional) studies. The researcher actively controls and manipulates the intervention or treatment given to participants (such as testing a new medication or vaccine) to determine its safety and efficacy.
Observational Studies: Cohort, Case-control, and Cross-sectional designs are purely observational study designs. In these designs, researchers observe outcomes without intervening or applying any treatment.

Which of the following situation demonstrates a direct association pharmacoepidemiological study?
A) The study reveals that it is not a false association 
B) The regression provides misleading statistical evidence
C) The association between two variables is a result of another
D) The association between the two attributes is not through attributes 

The correct answer is D) The association between the two attributes is not through attributes.

A direct association in pharmacoepidemiology means that the relationship between two variables/exposures is not explained or mediated by a third variable. 

In epidemiology, a direct association occurs when an exposure directly leads to an outcome without operating through an intermediate variable or third attribute.
A) Not a false association → relates more to validity/causality.
B) Misleading statistical evidence → suggests statistical error/bias.
C) Association results from another variable → indirect/spurious association.
D) Association is not through other attributes → direct association ✅

Exam tip:
Direct association = X → Y without a third variable in between.

A patient came to the pharmacy returning phenytoin 30mg suspension bottles. He explained that when he opened the second bottle after consuming the first one, he noticed that the solution was different. The pharmacist dispensed another bottle to the patient and documented the event in the patient profile.
Which one of the following forms should the pharmacist use to report the product quality issue?
A) Opportunity Report Form
B) Quality Defects Reporting Form
C) Adverse Drug Event Reporting Form
D) Medication Returned by Patient Form

The correct answer is B) Quality Defects Reporting Form.

Explanation:

Quality Defects Reporting Form: Used when a medication shows a physical or chemical abnormality—such as differences in color, appearance, consistency, taste, or packaging—that suggests a manufacturing error, contamination, or product degradation.
A) Opportunity Report Form ❌ — for identifying opportunities to improve medication-use processes.
C) Adverse Drug Event Reporting Form ❌ — used when the medication causes or is suspected of causing harm/adverse effects.
D) Medication Returned by Patient Form ❌ — documents returned medications, but the key issue here is the suspected quality defect.

🧠 Exam tip

Different appearance/packaging/physical characteristics of a medicine → Quality Defect Report.
Patient experiences harm/side effect → Adverse Drug Event Report.

During prescription verification, a pharmacist identified a drug interaction in a 23-year-old woman diagnosed with urinary tract and prescribed an antibiotic. Pharmacist contacted the change to a drug that will not harm the patient.  Which of the following antibiotics is the best option for the patient? 
A) Cephalexin  B) Ciprofloxacin  C) Nitrofurantoin  D) Trimethoprim-sulfamethoxazole 

The correct answer is C) Nitrofurantoin.

Explanation:

First-line Therapy with Minimal Interactions: Nitrofurantoin is a primary first-line agent recommended for uncomplicated lower urinary tract infections (cystitis) in young women. It acts locally in the urine/bladder and has a very narrow systemic therapeutic footprint, giving it a much lower risk profile for drug-drug interactions compared to other systemic antibiotics.
A) Cephalexin — can be used for UTI, but generally not the preferred first-line choice when nitrofurantoin is appropriate.
B) Ciprofloxacin — effective but generally avoided for uncomplicated UTI when safer alternatives are available because of its adverse-effect profile and antimicrobial stewardship concerns.
D) Trimethoprim-sulfamethoxazole — another option when local resistance is appropriate and there are no contraindications.

Exam tip:
👉 Uncomplicated cystitis → Nitrofurantoin is a key first-line choice.

A 7-year-old girl presents with moderate dehydration due to vomiting. 
Test Result: Sodium 134 (134-146 mmol/L) Potassium 2.9 (3.5-5.1 mmol/L) Chloride 98 (97-108 mmol/L) Bicarbonate 30 (21-28 mmol/L).
What is the most suitable replacement fluid? 
A) 0.9% Sodium chloride   
B) 5% Dextrose with sodium bicarbonate 
C) 0.9% sodium chloride with potassium chloride 
D) 5% Dextrose/0.225 % sodium chloride with potassium

Correct answer: C) 0.9% sodium chloride with potassium chloride

Why?

The child has:
Moderate dehydration → needs isotonic fluid replacement.
K⁺ = 2.9 mmol/L → significant hypokalemia, so potassium replacement is needed.
HCO₃⁻ = 30 mmol/L → elevated, consistent with metabolic alkalosis from vomiting (loss of gastric H⁺/Cl⁻).

Therefore, among the choices, 0.9% NaCl + KCl addresses both the volume depletion and potassium deficit.

Option	Reason
A) 0.9% NaCl	Provides volume but doesn't correct hypokalemia ❌
B) 5% dextrose + sodium bicarbonate	Bicarbonate is inappropriate because she already has alkalosis ❌
C) 0.9% NaCl + KCl	Replaces fluid + corrects potassium deficit ✅
D) 5% dextrose/0.225% NaCl + potassium	Too hypotonic for initial treatment of moderate dehydration ❌

Exam tip:
Vomiting → volume depletion + hypokalemic metabolic alkalosis → normal saline + KCl.
In practice, potassium is generally added only after adequate urine output/renal function is confirmed.

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