Systematic approach to MI queries MCQs With Answer

Introduction: This collection of multiple-choice questions focuses on a systematic approach to handling medication information (MI) queries, tailored for M. Pharm students in Clinical Pharmacy Practice. It emphasizes structured steps—receiving and prioritizing queries, defining clinical questions using frameworks like PICO, selecting and searching appropriate tertiary, secondary and primary resources, critical appraisal of evidence, synthesizing recommendations, documenting, and patient-centered communication. Questions probe both conceptual understanding and practical application: search strategies (MeSH, filters), levels of evidence, causality assessment, special populations (pregnancy, pediatrics, renal impairment), and urgent query workflows. Use these MCQs to sharpen decision-making, literature evaluation, and evidence-based responses in professional MI services.

Q1. Which initial step is most important when a medication information (MI) query is received in a drug information center?

• Begin literature search immediately
• Ask the requester to provide a diagnosis
• Clarify and prioritize the question, including patient-specific details
• Provide a rapid anecdotal recommendation

Correct Answer: Clarify and prioritize the question, including patient-specific details

Q2. When framing a clinical question for an MI query, which framework best structures therapy-related inquiries for literature searching?

• SOAR (Situation, Options, Actions, Results)
• PICO (Patient/Problem, Intervention, Comparison, Outcome)
• ABCDE (Assessment, Benefits, Contraindications, Dosage, Evaluation)
• SOAP (Subjective, Objective, Assessment, Plan)

Correct Answer: PICO (Patient/Problem, Intervention, Comparison, Outcome)

Q3. Which resource is considered a tertiary source typically used for quick background information in MI practice?

• Randomized controlled trial in a peer-reviewed journal
• Systematic review with meta-analysis
• Textbook or clinical handbook
• Clinical trial registry entry

Correct Answer: Textbook or clinical handbook

Q4. For an in-depth, up-to-date answer on efficacy and safety, which evidence source is most appropriate to prioritize?

• Manufacturer promotional brochure
• Primary randomized controlled trials and systematic reviews
• Tertiary drug monograph published 10 years ago
• Individual case reports only

Correct Answer: Primary randomized controlled trials and systematic reviews

Q5. Which search strategy element improves retrieval of relevant articles in databases like PubMed?

• Using MeSH terms combined with appropriate Boolean operators
• Searching only with full sentences to mimic the clinical question
• Applying no filters to maximize quantity regardless of relevance
• Relying solely on Google searches without academic databases

Correct Answer: Using MeSH terms combined with appropriate Boolean operators

Q6. When responding to an urgent MI query about a suspected overdose, what is the priority action for the MI pharmacist?

• Recall similar past cases from memory
• Provide a comprehensive literature review within 48 hours
• Give immediate, evidence-based acute management recommendations and advise clinical escalation
• Wait for lab values before advising any interventions

Correct Answer: Give immediate, evidence-based acute management recommendations and advise clinical escalation

Q7. Which statement best describes the GRADE approach commonly referenced in MI evidence appraisal?

• GRADE ranks drugs by cost-effectiveness only
• GRADE downgrades all non-randomized studies to low quality automatically
• GRADE assesses certainty of evidence across studies considering risk of bias, inconsistency, indirectness, imprecision and publication bias
• GRADE is a checklist for pharmacokinetic interactions

Correct Answer: GRADE assesses certainty of evidence across studies considering risk of bias, inconsistency, indirectness, imprecision and publication bias

Q8. Which of the following is the best resource to check for up-to-date drug interactions and mechanism explanations?

• Local newspaper health column
• Reputable interaction database (e.g., Micromedex or Lexicomp)
• Package insert alone without cross-reference
• Drug advertisements

Correct Answer: Reputable interaction database (e.g., Micromedex or Lexicomp)

Q9. When answering a query about drug use in pregnancy, which factor is most critical to include in the reply?

• Manufacturer’s recommended retail price
• Evidence on teratogenicity, timing during pregnancy, and available human data
• Only animal reproductive toxicity data without context
• Information only from older pregnancy category labels without narrative interpretation

Correct Answer: Evidence on teratogenicity, timing during pregnancy, and available human data

Q10. Which appraisal criterion addresses whether study results apply directly to the patient in the MI query?

• Bias assessment
• Precision
• Indirectness
• Statistical significance

Correct Answer: Indirectness

Q11. For dose adjustment recommendations in renal impairment, which piece of information is essential before making a specific dosing suggestion?

• Patient’s renal function estimate (e.g., eGFR or CrCl) and current medication regimen
• Only the patient’s age
• Generic name of drug without pharmacokinetic data
• Manufacturer’s marketing materials

Correct Answer: Patient’s renal function estimate (e.g., eGFR or CrCl) and current medication regimen

Q12. Which type of evidence provides the highest internal validity for assessing drug efficacy in a single trial?

• Randomized controlled trial with adequate randomization and blinding
• Observational cohort study
• Case series
• Expert opinion

Correct Answer: Randomized controlled trial with adequate randomization and blinding

Q13. When documenting an MI query response, which element is crucial for medico-legal completeness?

• Date and time of the query, requester identity, search strategies, evidence cited, and final recommendation
• Only the final recommendation without supporting references
• Personal opinions without search documentation
• Vague summary with no timestamps

Correct Answer: Date and time of the query, requester identity, search strategies, evidence cited, and final recommendation

Q14. Which approach is most appropriate when the literature provides inconsistent or low-quality evidence for a medication question?

• Make a definitive recommendation without qualifiers
• Explain uncertainty, present available evidence and alternatives, and recommend monitoring or specialist referral
• Decline to answer the query entirely
• Refer only to a single tertiary source

Correct Answer: Explain uncertainty, present available evidence and alternatives, and recommend monitoring or specialist referral

Q15. What is the role of ‘grey literature’ in answering MI queries?

• It should never be used because it is always unreliable
• It can provide additional context such as recent guidelines, conference abstracts, or regulatory reports when peer-reviewed data are limited
• It replaces peer-reviewed studies as primary evidence
• It is limited to pharmaceutical sales brochures

Correct Answer: It can provide additional context such as recent guidelines, conference abstracts, or regulatory reports when peer-reviewed data are limited

Q16. Which critical appraisal question assesses the magnitude and clinical importance of benefit in a study?

• Was the allocation concealment adequate?
• What is the absolute risk reduction and number needed to treat (NNT)?
• Is the study open-label?
• Were the authors’ conflicts of interest declared?

Correct Answer: What is the absolute risk reduction and number needed to treat (NNT)?

Q17. In evaluating adverse drug reaction causality for an MI response, which structured tool is commonly used?

• WHO-UMC causality assessment system
• PRISMA flow diagram
• CONSORT checklist
• STROBE statement

Correct Answer: WHO-UMC causality assessment system

Q18. When communicating an MI response to a clinician, which style maximizes clinical utility?

• Long narrative with raw data only and no actionable summary
• Structured reply: concise answer, rationale with key evidence, suggested actions, and references for follow-up
• Vague recommendations to allow clinician freedom
• Only cite primary literature without interpretation

Correct Answer: Structured reply: concise answer, rationale with key evidence, suggested actions, and references for follow-up

Q19. Which search filter or limit is appropriate when looking for high-quality randomized trials in PubMed?

• Apply filters for ‘Case Reports’ and ‘Letters’
• Select ‘Clinical Trial’ and use randomized trial filters or PubMed Clinical Queries
• Restrict to articles older than 20 years only
• Use only author names as search terms

Correct Answer: Select ‘Clinical Trial’ and use randomized trial filters or PubMed Clinical Queries

Q20. Which ethical consideration must be declared when preparing an MI response based on evidence potentially influenced by industry funding?

• Ignore funding sources because scientific data speak for themselves
• Disclose conflicts of interest and the funding sources of cited studies when relevant
• Assume all industry-funded studies are invalid and exclude them without comment
• Only cite industry-sponsored results to ensure completeness

Correct Answer: Disclose conflicts of interest and the funding sources of cited studies when relevant

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