Clinical pharmacy Book for Exit Exam and Coc exam

A patient presents with red eye, mucopurulent discharge, and morning crusting. Which topical antibiotic is most commonly used in Ethiopian primary care? A) Chloramphenicol 0.5% eye drops B) Gentamicin eye drops C) Ciprofloxacin eye drops D) Tetracycline eye ointment

A 17‑year‑old has comedonal acne (blackheads and whiteheads) on the forehead and nose, no inflammation. What is first‑line topical treatment? A) Benzoyl peroxide 2.5% gel B) Clindamycin 1% lotion C) Tretinoin 0.025% cream (topical retinoid) D) Oral doxycycline

A 4‑year‑old child has honey‑crusted lesions around the nose and mouth. What is the topical treatment of choice for localized impetigo in Ethiopia? A) Mupirocin 2% ointment B) Gentamicin cream C) Clotrimazole cream D) Hydrocortisone cream

A 7‑year‑old boy has scaling, patchy hair loss, and broken hairs on the scalp. KOH prep shows hyphae. What is the appropriate treatment? A) Topical ketoconazole shampoo alone B) Oral griseofulvin or terbinafine for 6‑8 weeks C) Topical clotrimazole cream twice daily D) Selenium sulfide shampoo only

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A 12‑year‑old with sickle cell disease presents with severe bone pain. What is the appropriate initial analgesic? A) Oral paracetamol B) Oral ibuprofen C) IV morphine (titrated) D) IM pethidine

A patient on phenytoin for seizures develops nystagmus, ataxia, and drowsiness. Serum phenytoin level is 28 mcg/mL (therapeutic range 10–20). What is the cause? A) Drug interaction with rifampin B) Saturation of hepatic metabolism at therapeutic doses C) Renal failure D) Non‑adherence

A patient on digoxin for heart failure develops nausea, vomiting, and yellow vision. ECG shows frequent premature ventricular contractions. What is the most appropriate next step? A) Check serum digoxin level and hold digoxin B) Administer IV calcium C) Give digoxin immune Fab (antidote) immediately…

A patient with end‑stage lung cancer has severe breathlessness at rest, oxygen saturation 92% on room air. Opioids are indicated. Which opioid and route is preferred? A) Oral morphine immediate release (2.5–5 mg every 4 hours) B) IV fentanyl bolus C) Nebulized morphine D) Intramuscular pethidine

A diabetic patient has burning, shooting pain in both feet. Which drug is considered first‑line for diabetic peripheral neuropathy? A) Paracetamol B) Amitriptyline or gabapentin C) Tramadol D) Diclofenac

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A 25-year-old patient returning from a malarious area in Ethiopia presents with fever, chills, and a blood smear showing Plasmodium vivax. Which two drugs are needed for radical cure? A) Artemether-lumefantrine + primaquine B) Quinine + doxycycline C) Chloroquine + primaquine D) Artesunate + sulfado…

A patient with pulmonary TB who has been on rifampicin, isoniazid, pyrazinamide, and ethambutol (RHZE) for 6 weeks develops jaundice and dark urine. Liver enzymes are markedly elevated. What is the most appropriate next step? A) Add N-acetylcysteine and continue RHZE B) Stop all four drugs immediate…

A 30-year-old patient newly diagnosed with HIV has a CD4 count of 280 cells/mm³ and no co-infections. According to Ethiopian national guidelines, which first-line antiretroviral regimen is recommended? A) Tenofovir + Lamivudine + Dolutegravir (TLD) B) Zidovudine + Nevirapine + Efavirenz C) Abacavir …

A 58-year-old patient with hypertension and chronic kidney disease (eGFR 40 mL/min) has a blood pressure of 155/95 mmHg despite taking losartan 50 mg daily. Which medication should be added NEXT? A) Hydrochlorothiazide B) Amlodipine C) Spironolactone D) Propranolol

A 45-year-old Ethiopian patient with type 2 diabetes mellitus (T2DM) presents with a HbA1c of 8.5% despite taking metformin 1000 mg twice daily. He has no history of hypoglycemia, and his eGFR is 55 mL/min/1.73m². Which of the following is the MOST appropriate next therapy to add? A) Glibenclamide …