CSP EXAM TEST (SPECIALTY PHARMACY) WITH CORRECT ANSWERS!!

CSP EXAM TEST (SPECIALTY PHARMACY) WITH CORRECT ANSWERS!!

Question 1
What is the correct formula for calculating the Proportion of Days Covered (PDC)?
A) PDC = (Total days of supply dispensed / Days in a period) x 100
B) PDC = (Number of refills dispensed / Number of expected refills) x 100
C) PDC = (# of unique days with supply / number of days in a period) x 100
D) PDC = (Total tablets taken / Total tablets prescribed) x 100
E) PDC = (Days of possession / Observation period start date) x 100
Correct Answer: C) PDC = (# of unique days with supply / number of days in a period) x 100
Rationale: PDC is calculated as the number of unique days a patient has medication on
hand divided by the number of days in the measurement period, multiplied by 100.

Question 2
Which medication is a Janus Kinase (JAK) inhibitor?
A) Humira (adalimumab)
B) Orencia (abatacept)
C) Actemra (toclizumab)
D) Xeljanz (tofacitinib)
E) Rituxan (rituximab)
Correct Answer: D) Xeljanz (tofacitinib)
Rationale: Xeljanz (tofacitinib) is an oral medication that works by inhibiting the Janus
Kinase (JAK) family of enzymes, unlike the others which are biologics with different
mechanisms.

Question 3
Which of the following biologic medications is known to potentially elevate cholesterol levels
and requires monitoring of lipid panels?
A) Actemra (toclizumab)
B) Enbrel (etanercept)
C) Simponi (golimumab)
D) Kineret (anakinra)
E) Humira (adalimumab)
Correct Answer: A) Actemra (toclizumab)

,Rationale: Actemra (toclizumab), an IL-6 receptor antagonist, is known to cause elevations
in lipid parameters (total cholesterol, LDL, triglycerides), requiring baseline and routine
monitoring.

Question 4
Which shingles vaccine is safe to administer to an immunocompromised patient, such as one
taking a TNF inhibitor for rheumatoid arthritis?
A) Adacel (Tdap)
B) Zostavax (zoster vaccine live)
C) Shingrix (zoster vaccine recombinant)
D) Varivax (varicella vaccine live)
E) Pneumovax 23
Correct Answer: C) Shingrix (zoster vaccine recombinant)
Rationale: Shingrix is a non-live, recombinant vaccine, making it safe for administration to
immunocompromised patients taking TNF inhibitors or other biologics. Zostavax (B) is a
live vaccine and is contraindicated in these patients.

Question 5
Most biologics increase the risk of infections. Which of the following biologic agents also
significantly increases the risk of neutropenia?
A) Rituxan (rituximab)
B) Taltz (ixekizumab)
C) Remicade (infliximab)
D) Cimzia (certolizumab pegol)
E) Humira (adalimumab)
Correct Answer: B) Taltz (ixekizumab)
Rationale: Taltz (ixekizumab), an IL-17A inhibitor, has been associated with a risk of
neutropenia (low neutrophil count), requiring monitoring of complete blood counts (CBC).

Question 6
Which psoriasis medication does NOT require screening for tuberculosis (TB) prior to initiation
of therapy?
A) Stelara (ustekinumab)

,B) Otezla (apremilast)
C) Cosentyx (seculinumab)
D) Humira (adalimumab)
E) Taltz (ixekizumab)
Correct Answer: B) Otezla (apremilast)
Rationale: Otezla (apremilast) is an oral phosphodiesterase 4 (PDE4) inhibitor and is not
associated with the same risk of opportunistic infection, such as TB reactivation, as biologic
agents (A, C, D) and does not require TB screening.

Question 7
What is the standard starting dose for Taltz (ixekizumab) when used to treat psoriatic arthritis
(PsA)?
A) 160mg subcutaneously once, followed by 80mg subcutaneously at weeks 2, 4, 6, 8, 10 and
12; then 80mg subcutaneously every 4 weeks
B) 160mg subcutaneously once, followed by 80mg subcutaneously every 4 weeks
C) 160mg subcutaneously once, followed by 80mg subcutaneously every week for 4 weeks, then
80mg every 4 weeks
D) 160mg subcutaneously once, followed by 80mg subcutaneously every other week
E) 80mg subcutaneously every other week
Correct Answer: B) 160mg subcutaneously once, followed by 80mg subcutaneously every 4
weeks
Rationale: The standard PsA dosing regimen for Taltz is a

160 mg

starting dose (two

80 mg

injections), followed by

80 mg

every 4 weeks (Q4W).

, Question 8
A 45 y/o, 200lb patient is struggling with severe dermatitis and the provider wants to potentially
start a biologic. Which medication would you recommend?
A) Protopic (tacrolimus)
B) Humira (adalimumab)
C) Stelara (ustekinumab)
D) Dupixent (dupilumab)
E) Enbrel (etanercept)
Correct Answer: D) Dupixent (dupilumab)
Rationale: Dupixent (dupilumab) is an IL-4 and IL-13 antagonist that is specifically
indicated and commonly used for the treatment of moderate-to-severe atopic dermatitis
(eczema), which aligns with the description of severe dermatitis.

Question 9
A 56 y/o, 140lb patient with psoriasis will be starting Stelara (ustekinumab). What starting dose
would you recommend for this patient whose weight is

≤ 100 kg

?
A) Inject 45 mg subcutaneously at weeks 0 and 4, followed by 45 mg every 12 weeks
B) Inject 90 mg subcutaneously at weeks 0 and 4, followed by 90 mg every 12 weeks
C) Infuse 260 mg IV over at least 1 hour as a single dose, followed 8 weeks later with 90 mg
subcutaneously every 8 weeks
D) Infuse 520 mg IV over at least 1 hour as a single dose, followed 8 weeks later with 90 mg
subcutaneously every 8 weeks
E) Inject 45 mg subcutaneously at weeks 0 and 4, followed by 90 mg every 12 weeks
Correct Answer: A) Inject 45 mg subcutaneously at weeks 0 and 4, followed by 45 mg every
12 weeks
Rationale: For Stelara in psoriasis, the dosing is weight-based. Patients weighing

≤ 100 kg

(