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PHARMACIST QBANK & MOCK EXAM 2

Question 1:
Melina is a 70-year-old female, 68 kg diagnosed with chronic kidney disease (CKD) with poorly controlled type 2 diabetes. Medications: Insulin glargine: 20 units/day, Insulin aspart: 12 units TID with meals, Atorvastatin: 80 mg daily, Lisinopril: 15 mg daily. Her lab work follows:

Lab	Current levels	Normal levels
Serum creatinine	186 µmol/L	44 to 88 µmol/L
Serum phosphate	2.3 mmol/L	0.85 to 1.45 mmol/L
Serum calcium	2.4 mmol/L	2.1 to 2.6 mmol
Serum albumin	40 g/L	35 g/L to 50 g/L
Serum potassium	6 mmmol/L	3.5 to 5.2 mmol/L

What is Melina’s current creatinine clearance?
A. 32 mL/min
B. 26 mL/min
C. 20 mL/min
D. 15 mL/min
ANSWER

Answer:B. 26 mL/minL

Estimate creatinine clearance (ClCr) for drug dosing using the Cockcroft-Gault equation
𝐶𝑟𝐶𝑙 (𝑚𝑙/𝑚𝑖𝑛)=(1.2 ×(140−𝑎𝑔𝑒)×(𝑤𝑒𝑖𝑔ℎ𝑡 𝑖𝑛 𝐾𝑔))/(𝑆𝐶𝑟 (𝑚𝑖𝑐𝑟𝑜 𝑚𝑜𝑙/𝐿))

Multiply by 0.85 for female

Estimate creatinine clearance (ClCr) for drug dosing using the Cockcroft-Gault equation
𝐶𝑟𝐶𝑙 (𝑚𝑙/𝑚𝑖𝑛)=(1.2 ×(140−70)×(68 𝐾𝑔))/(186 𝑚𝑖𝑐𝑟𝑜 𝑚𝑜𝑙/𝐿) = 30.7 mL/min
Multiply by 0.85 for female = 30.7 ml/min x 0.85 = 26.1 mL/min

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