CSP NASP Question Bank + CSP Handbook Questions
RB is a 20 year old female recently ap-
proved for CF treatment with Trikafta®
(elexacaftor/tezacaftor/ivacaftor). She is
homozygous for the F508 del mutation
in the CFTR gene and meets criteria
for treatment with this medication. Her
current medications include inhaled al-
buterol, normal saline, tobramycin, Ad-
vair® and Pulmozyme®. She is also tak-
ing buspirone, cetirizine, vitamin D3, in-
sulin (regular and long acting), mon-
telukast, omeprazole, and Creon®. What
Trikafta® should be taken with a high fat
is an important counseling point to cover
containing meal and she should avoid
with RB?
food or drink containing grapefruit.
Trikafta® should be taken with a high fat
containing meal and she should avoid
food or drink containing grapefruit.
Trikafta® is taken once a day with a high
fat containing meal.
Patient can discontinue inhaled medica-
tions once she starts Trikafta®
None of the above
AJ is a 32 year old female who pre-
sents to clinic 5 years post transplant.
She and her husband are considering
starting a family and would like to know
if it is safe for her to become pregnant.
Her post transplant immunosuppression
Discontinue mycophenolate mofetil and
regimen consists of tacrolimus 2mg BID,
start Azathioprine
mycophenolate mofetil 1000mg BID, and
prednisone 5mg daily. Assuming she has
no other comorbidities, what recommen-
dations would you make concerning her
medication therapy if she is wanting to
conceive?
, CSP NASP Question Bank + CSP Handbook Questions
Patients cannot get pregnant post trans-
plant
Discontinue tacrolimus and start cy-
closporine modified
Discontinue mycophenolate mofetil and
start Azathioprine
No changes to medication therapy
MS is 45 yo African American Female
with HCV thought to be acquired from
a blood transfusion during ASD repair
in 1976. She has never been treated
for HCV. She recently had an abdominal
ultrasound with shear wave elastogra-
phy indicating a Metavir Score of F0-F1.
PMH includes migraines and hyperten-
sion. Recent pertinent labs include: GT
1A, HCV RNA 8,782,824 IU/ML, base-
line resistance testing not completed,
AST 64, ALT 79, Plt 180, Hgb 13.2, CrCl
83ml/min. Current medications include: Harvoni® (LDV/SOF) x12 weeks
multivitamin, lisinopril 10mg daily, suma-
triptan 50mg prn migraines. Which of the
following regimens would you be most
appropriate to treat MS's HCV?
Harvoni® (LDV/SOF) x8 weeks
Harvoni® (LDV/SOF) x12 weeks
Mavyret® (G/P) x12 weeks
Zepatier® (EBR/GZR) + RBV x12 weeks
Assuming she was treated with Har-
voni® (LDV/SOF), when counseling MS,
, CSP NASP Question Bank + CSP Handbook Questions
what is an important topic to discuss with
her regarding possible drug/drug interac-
tions?
She must stop her sumatriptan when
starting Harvoni® (LDV/SOF) due to sig-
nificant drug/drug interaction reducing
efficacy of ledipasvir (LDV).
She must monitor her BP while on Har-
Ask MS if she takes any over the counter
voni® (LDV/SOF). Lisinopril concentra-
acid-reducing products not listed on her
tions can be increased due to drug/drug
medication list as these medications can
interaction with ledipasvir (LDV) and she
decrease the absorption of ledipasvir
must monitor for hypotension.
(LDV), resulting in possible effects on
HCV treatment efficacy.
Ask MS if she takes any over the counter
acid-reducing products not listed on her
medication list as these medications can
decrease the absorption of ledipasvir
(LDV), resulting in possible effects on
HCV treatment efficacy.
Tell her to stop all of her other medica-
tions now; Harvoni® (LDV/SOF) is the
only medication that matters anymore.
AH is a 69 yo white M with HCV thought
to be acquired via IVDU in the 1960s
as well as multiple prison tattoos. He
is GT1a with a viral load of 17,586,502
IU/mL. He has never been treated for his
HCV. PMH includes CKD stage 5 on HD
MWF, ischemic cardiomyopathy, MI x2,
diabetes, and HLD. His recent abdominal
US with elastography reveals a Metavir
score of F2. He recently completed base-
line resistance testing for NS5a resis-
tance and this was unremarkable. Oth-
er pertinent labs include: AST 60, ALT
55, Plt 274, Hgb 9.2, CrCl~13ml/min.
RB is a 20 year old female recently ap-
proved for CF treatment with Trikafta®
(elexacaftor/tezacaftor/ivacaftor). She is
homozygous for the F508 del mutation
in the CFTR gene and meets criteria
for treatment with this medication. Her
current medications include inhaled al-
buterol, normal saline, tobramycin, Ad-
vair® and Pulmozyme®. She is also tak-
ing buspirone, cetirizine, vitamin D3, in-
sulin (regular and long acting), mon-
telukast, omeprazole, and Creon®. What
Trikafta® should be taken with a high fat
is an important counseling point to cover
containing meal and she should avoid
with RB?
food or drink containing grapefruit.
Trikafta® should be taken with a high fat
containing meal and she should avoid
food or drink containing grapefruit.
Trikafta® is taken once a day with a high
fat containing meal.
Patient can discontinue inhaled medica-
tions once she starts Trikafta®
None of the above
AJ is a 32 year old female who pre-
sents to clinic 5 years post transplant.
She and her husband are considering
starting a family and would like to know
if it is safe for her to become pregnant.
Her post transplant immunosuppression
Discontinue mycophenolate mofetil and
regimen consists of tacrolimus 2mg BID,
start Azathioprine
mycophenolate mofetil 1000mg BID, and
prednisone 5mg daily. Assuming she has
no other comorbidities, what recommen-
dations would you make concerning her
medication therapy if she is wanting to
conceive?
, CSP NASP Question Bank + CSP Handbook Questions
Patients cannot get pregnant post trans-
plant
Discontinue tacrolimus and start cy-
closporine modified
Discontinue mycophenolate mofetil and
start Azathioprine
No changes to medication therapy
MS is 45 yo African American Female
with HCV thought to be acquired from
a blood transfusion during ASD repair
in 1976. She has never been treated
for HCV. She recently had an abdominal
ultrasound with shear wave elastogra-
phy indicating a Metavir Score of F0-F1.
PMH includes migraines and hyperten-
sion. Recent pertinent labs include: GT
1A, HCV RNA 8,782,824 IU/ML, base-
line resistance testing not completed,
AST 64, ALT 79, Plt 180, Hgb 13.2, CrCl
83ml/min. Current medications include: Harvoni® (LDV/SOF) x12 weeks
multivitamin, lisinopril 10mg daily, suma-
triptan 50mg prn migraines. Which of the
following regimens would you be most
appropriate to treat MS's HCV?
Harvoni® (LDV/SOF) x8 weeks
Harvoni® (LDV/SOF) x12 weeks
Mavyret® (G/P) x12 weeks
Zepatier® (EBR/GZR) + RBV x12 weeks
Assuming she was treated with Har-
voni® (LDV/SOF), when counseling MS,
, CSP NASP Question Bank + CSP Handbook Questions
what is an important topic to discuss with
her regarding possible drug/drug interac-
tions?
She must stop her sumatriptan when
starting Harvoni® (LDV/SOF) due to sig-
nificant drug/drug interaction reducing
efficacy of ledipasvir (LDV).
She must monitor her BP while on Har-
Ask MS if she takes any over the counter
voni® (LDV/SOF). Lisinopril concentra-
acid-reducing products not listed on her
tions can be increased due to drug/drug
medication list as these medications can
interaction with ledipasvir (LDV) and she
decrease the absorption of ledipasvir
must monitor for hypotension.
(LDV), resulting in possible effects on
HCV treatment efficacy.
Ask MS if she takes any over the counter
acid-reducing products not listed on her
medication list as these medications can
decrease the absorption of ledipasvir
(LDV), resulting in possible effects on
HCV treatment efficacy.
Tell her to stop all of her other medica-
tions now; Harvoni® (LDV/SOF) is the
only medication that matters anymore.
AH is a 69 yo white M with HCV thought
to be acquired via IVDU in the 1960s
as well as multiple prison tattoos. He
is GT1a with a viral load of 17,586,502
IU/mL. He has never been treated for his
HCV. PMH includes CKD stage 5 on HD
MWF, ischemic cardiomyopathy, MI x2,
diabetes, and HLD. His recent abdominal
US with elastography reveals a Metavir
score of F2. He recently completed base-
line resistance testing for NS5a resis-
tance and this was unremarkable. Oth-
er pertinent labs include: AST 60, ALT
55, Plt 274, Hgb 9.2, CrCl~13ml/min.
