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The FPGEE exam has 200 questions and runs 4 hours 30 minutes.
These 10 free FPGEE questions are organized by exam domain, so you can see how each part of the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) blueprint is tested. Reveal the answer and explanation under each question.
Recurrent meningococcal disease is documented in a 19-year-old whose quantitative IgG, IgA, and IgM concentrations, neutrophil count, and oxidative-burst test are all normal. Which immune defect is most likely?
Correct answer: C - Terminal complement deficiency involving C5 through C9
Profuse diarrhea is followed by an arterial pH of 7.29, PaCO2 of 29 mm Hg, and HCO3- of 14 mEq/L. For metabolic acidosis, expected PaCO2 = 1.5(HCO3-) + 8 +/- 2. This pattern is best classified as:
Correct answer: A - Metabolic acidosis with appropriate respiratory compensation
In a compliant cleanroom suite, a Category 2 compounded sterile preparation is made aseptically from only sterile starting components. No sterility test is performed, and validated chemical stability is 21 days under refrigeration. The latest permissible USP <797> beyond-use date at 2-8 degrees C is:
Correct answer: D - 10 days
Renal dosing is being assessed for a 68-year-old woman who is 64 inches tall, weighs 90 kg, and has a stable serum creatinine of 1.6 mg/dL. The label directs Cockcroft-Gault with adjusted body weight when total weight is at least 120% of ideal body weight. Use female IBW = 45.5 + 2.3 kg per inch over 5 feet, AdjBW = IBW + 0.4(TBW - IBW), and female CrCl = [(140 - age) x weight]/(72 x SCr) x 0.85. Full dose applies at CrCl at least 50 mL/min, reduced dose at 30-49 mL/min, and avoidance below 30 mL/min. Select the correct estimate and dosing category.
Correct answer: B - Use the reduced dose; CrCl is about 37 mL/min
Minutes after handling an organophosphate pesticide, a farm worker develops miosis, profuse sweating, bronchorrhea, bradycardia, diarrhea, and muscle fasciculations. Airway support and decontamination are underway. Which antidotes should be given now?
Correct answer: A - Atropine plus pralidoxime
Four days into a smoke-free hospital stay, a patient previously stable on clozapine develops excessive sedation, confusion, and sialorrhea despite no medication changes. What pharmacokinetic change explains the deterioration?
Correct answer: D - Loss of smoke-induced CYP1A2 activity raises clozapine exposure
Urine pH is 7.0 in a patient eliminating a weak acid with a pKa of 4.0. Assume that only the unionized form is readily reabsorbed across the renal tubule. What happens to the drug in this urine?
Correct answer: C - Mostly ionized, with less tubular reabsorption
Following percutaneous coronary intervention for acute coronary syndrome, a 58-year-old is identified as a CYP2C19 poor metabolizer and has no contraindication to ticagrelor. Choose the most appropriate P2Y12 strategy.
Correct answer: B - Replace clopidogrel with ticagrelor because clopidogrel activation is reduced
During an overnight shift, a pharmacist verifies a genuine emergency and receives an oral Schedule II prescription for an emergency quantity of morphine. What follow-up does US federal law require?
Correct answer: D - Follow-up is due within 7 days; if absent, the pharmacist notifies DEA
Economic evaluation of two treatments for the same condition yields the following: Treatment A costs $4,800 per patient and produces 0.82 QALY; Treatment B costs $5,600 and produces 0.75 QALY. How should Treatment A be characterized?
Correct answer: C - Treatment A dominates because it is less costly and more effective
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