Medications is 35% of the scored PTCE (the PTCB exam). Answer 10 exam style questions on OTC drugs, vitamins and biologics and see exactly which concepts would cost you points on test day.
Start the 10 questions →A patient with rheumatoid arthritis fills a prescription for Humira pens. Adalimumab belongs to which drug class?
These questions cover biologics: TNF blockers, biologics: name stems, biologics: TNF blocker warnings, immunology: methotrexate dosing and immunology: antimalarial for autoimmune disease. Each one shows the correct answer and why every other option is wrong, so a miss tells you exactly what to review before the PTCE.
Prefer to read first? Every question from the practice set above, with the correct answer and why each wrong option is wrong.
Answer: C. Adalimumab (Humira) is a monoclonal antibody that blocks tumor necrosis factor (TNF). It is used for rheumatoid arthritis, psoriatic arthritis, Crohn's disease, plaque psoriasis and other immune conditions. Pens are stored refrigerated.
Why not A: Bisphosphonates, such as alendronate, treat osteoporosis.
Why not B: Xanthine oxidase inhibitors, such as allopurinol, lower uric acid in gout.
Why not D: Low molecular weight heparins, such as enoxaparin, are injectable anticoagulants.
Exam tactic: TNF blockers: adalimumab (Humira), etanercept (Enbrel), infliximab, certolizumab, golimumab.
Answer: A. The -mab stem identifies a monoclonal antibody, a large protein biologic given by injection or infusion. Most require refrigeration.
Why not B: Kinase inhibitors usually end in -tinib (imatinib) or -nib.
Why not C: Many antivirals end in -vir (acyclovir, oseltamivir).
Why not D: Anabolic steroids do not use a -mab stem; examples include oxandrolone.
Exam tactic: -mab = monoclonal antibody; -tinib = tyrosine kinase inhibitor.
Answer: B. TNF blockers suppress part of the immune system. Their boxed warning covers serious infections (including tuberculosis, fungal and bacterial infections) and malignancy. Patients are screened for TB before starting.
Why not A: Severe hypoglycemia is a risk of insulin and sulfonylureas, not TNF blockers.
Why not C: Tendon rupture is a fluoroquinolone boxed warning.
Why not D: A rise in blood pressure is not the TNF blocker boxed warning.
Exam tactic: Immune suppressing biologics = infection risk, TB screening first.
Answer: D. For rheumatoid arthritis and psoriasis, oral methotrexate is dosed once weekly. Entering or taking it daily has caused fatal toxicity, so methotrexate is a high-alert medication and the weekly day should appear on the label.
Why not A: Methotrexate is not a controlled substance.
Why not B: Grapefruit juice is not part of methotrexate administration.
Why not C: Methotrexate tablets are stored at room temperature.
Exam tactic: Oral methotrexate for RA = ONCE WEEKLY. Daily entry is a fatal error.
Answer: A. Hydroxychloroquine is an antimalarial also used as a disease-modifying drug for lupus and rheumatoid arthritis. Long-term use requires periodic eye exams because of retinal toxicity.
Why not B: Hydroxychloroquine is not an opioid.
Why not C: Hydroxychloroquine is an oral tablet, not a refrigerated biologic.
Why not D: Statins end in -statin (atorvastatin); hydroxychloroquine does not lower cholesterol.
Exam tactic: Hydroxychloroquine: lupus/RA/malaria, eye exams long term.
Answer: C. Dupixent is dupilumab, a monoclonal antibody used for moderate to severe atopic dermatitis, asthma and other type 2 inflammatory conditions.
Why not A: Etanercept is Enbrel, a TNF blocker.
Why not B: Adalimumab is Humira, a TNF blocker.
Why not D: Omalizumab is Xolair, an anti-IgE antibody.
Exam tactic: Match the brand's first letters: DUPIxent = DUPIlumab.
Answer: B. Anastrozole is an aromatase inhibitor. It lowers estrogen production and is used for hormone receptor-positive breast cancer in postmenopausal women, as are letrozole and exemestane.
Why not A: Tyrosine kinase inhibitors usually end in -tinib, such as imatinib.
Why not C: Alkylating agents include cyclophosphamide; anastrozole is hormonal therapy.
Why not D: Monoclonal antibodies end in -mab and are injected; anastrozole is an oral tablet.
Exam tactic: -trozole/-strozole = aromatase inhibitor (anastrozole, letrozole).
Answer: D. The -tinib stem identifies a tyrosine kinase inhibitor, an oral targeted cancer therapy. Imatinib is used for CML and GI stromal tumors. Many are hazardous drugs requiring safe handling.
Why not A: Histamine-2 receptor antagonists end in -tidine (famotidine).
Why not B: Aromatase inhibitors include anastrozole and letrozole.
Why not C: Monoclonal antibodies end in -mab.
Exam tactic: -tinib = tyrosine kinase inhibitor (oral targeted therapy).
Answer: B. Adequate folic acid before conception and in early pregnancy lowers the risk of neural tube defects such as spina bifida.
Why not A: Iron, not folic acid, is the main supplement for iron deficiency anemia.
Why not C: Folic acid is not taken to reduce morning sickness.
Why not D: Calcium and vitamin D, not folic acid, are linked to bone and tooth formation.
Exam tactic: Folic acid = neural tube defect prevention.
Answer: C. Oral iron commonly causes dark or black stools, constipation, nausea and stomach upset. Iron is also a frequent cause of accidental poisoning in young children, so child-resistant packaging matters.
Why not A: Dry cough is a classic ACE inhibitor effect.
Why not B: Orange urine and tears are caused by rifampin.
Why not D: Ringing in the ears is a sign of salicylate (aspirin) toxicity.
Exam tactic: Iron: black stools, constipation; keep away from children.
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