BIOL 241 · Final Exam (graded) — 100 questions
Microbiology & immunology · 88/100 · time: 1h 48m
1. A 72‑year‑old with Type 2 diabetes, eGFR 38 mL/min, and pts
hypertension. Which oral antidiabetic is MOST appropriate
considering renal impairment?
a) Metformin ✔
b) Glipizide
c) Pioglitazone
d) SGLT‑2 inhibitor
✓ Correct: Metformin is renally cleared; dose adjust if eGFR < 30.
,2. A 78‑year‑old with acute confusion, fluctuating attention, and pts
hallucinations. Which finding BEST differentiates delirium from
dementia?
a) Progressive memory loss over years
b) Insidious onset with personality changes ✘
c) Acute onset and fluctuating course ✔
d) Cortical atrophy on imaging
✘ Incorrect: correct answer is c (acute onset & fluctuating).
3. A 70‑year‑old with hypothyroidism and known CAD. Which pts
levothyroxine initiation strategy is recommended?
a) Full replacement (1.6 µg/kg/day)
, b) Low dose (12.5–25 µg/day) and titrate slowly ✔
c) T3/T4 combination
d) Loading dose 200 µg
✓ Correct: low dose avoids cardiac stress.
4. A 67‑year‑old with BPH and significant nocturia. Which pts
alpha‑blocker is MOST appropriate in controlled hypertension?
a) Tamsulosin ✔
b) Doxazosin
c) Terazosin
d) Alfuzosin
, ✓ Correct: tamsulosin is uroselective, less hypotension.
5. An 82‑year‑old with falls, on multiple meds. According to Beers pts
criteria, which drug is MOST associated with fall risk?
a) Lisinopril
b) Metoprolol
c) Zolpidem ✔
d) Atorvastatin
✓ Correct: zolpidem is Beers criteria fall‑risk.
6. A 68‑year‑old with COPD exacerbation and severe penicillin pts
allergy. Which antibiotic for CAP?
Microbiology & immunology · 88/100 · time: 1h 48m
1. A 72‑year‑old with Type 2 diabetes, eGFR 38 mL/min, and pts
hypertension. Which oral antidiabetic is MOST appropriate
considering renal impairment?
a) Metformin ✔
b) Glipizide
c) Pioglitazone
d) SGLT‑2 inhibitor
✓ Correct: Metformin is renally cleared; dose adjust if eGFR < 30.
,2. A 78‑year‑old with acute confusion, fluctuating attention, and pts
hallucinations. Which finding BEST differentiates delirium from
dementia?
a) Progressive memory loss over years
b) Insidious onset with personality changes ✘
c) Acute onset and fluctuating course ✔
d) Cortical atrophy on imaging
✘ Incorrect: correct answer is c (acute onset & fluctuating).
3. A 70‑year‑old with hypothyroidism and known CAD. Which pts
levothyroxine initiation strategy is recommended?
a) Full replacement (1.6 µg/kg/day)
, b) Low dose (12.5–25 µg/day) and titrate slowly ✔
c) T3/T4 combination
d) Loading dose 200 µg
✓ Correct: low dose avoids cardiac stress.
4. A 67‑year‑old with BPH and significant nocturia. Which pts
alpha‑blocker is MOST appropriate in controlled hypertension?
a) Tamsulosin ✔
b) Doxazosin
c) Terazosin
d) Alfuzosin
, ✓ Correct: tamsulosin is uroselective, less hypotension.
5. An 82‑year‑old with falls, on multiple meds. According to Beers pts
criteria, which drug is MOST associated with fall risk?
a) Lisinopril
b) Metoprolol
c) Zolpidem ✔
d) Atorvastatin
✓ Correct: zolpidem is Beers criteria fall‑risk.
6. A 68‑year‑old with COPD exacerbation and severe penicillin pts
allergy. Which antibiotic for CAP?
