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PHARMA > 2nd BLOCK > Flashcards

2nd BLOCK Flashcards

1
Q 
Class IV Antiarrhythmic 
• Verapamil
• Lidocaine
• Hydralazine
• Dobutamine
• Flecainide
A

Verapamil

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2
Q

A 59-year-old man with hypertension presents to his primary care physician with lower extremity edema.
Physical examination reveals pitting edema from the ankles to the knees bilaterally. The patient has begun on
furosemide. It is important for the physician to be aware of which of the following drug-to-drug interactions?

  • Improves orthostatic hypotension
  • Potentiates other antihypertensives
  • Ototoxic when combined with thiazide diuretics
  • Hyperkalemia with corticosteroids
A

Ototoxic when combined with thiazide diuretics

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3
Q

A man was knifed to the chest and is now in the ER presenting with the classic Beck’s triad. Which of the ff statements is true?

  • This patient needs an emergency heart surgery
  • The jugular veins are not prominent
  • There will be sinus bradycardia
  • The patient will have normal blood pressure
A

This patient needs an emergency heart surgery

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4
Q

Which of the following is an indication for surgical repair replacement of the mitral valve in a patient with mitral insufficiency?

  • Abnormal exercise testing
  • All of the above
  • Recent onset of atrial fibrillation
  • Any symptom, even if LV function is normal
A

All

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5
Q

A 20-year woman starts to develop subcutaneous nodules associated with erythema marginatum of the skin. She also begins to complain of pain in her knees and hips. The woman was hospitalized 3 weeks earlier due to a severe bout of acute tonsillopharyngitis. Which of the following serum laboratory findings is most characteristic of the disease?

  • Elevated anti-streptolysin O
  • Elevated C-reactive protein
  • Positive RPR test
  • Positive ANA test
A

Elevated anti-streptolysin O

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6
Q

Positive Inotropic Drug

  • Dobutamine
  • Hydralazine
  • Flecainide
  • Verapamil
  • Lidocaine
A

Dobutamine

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7
Q

Which of the following pericardial diseases is likely to produce thick, pearly non-adherent epicardial plaque
more commonly referred to as “soldier’s plaque”?
• Caseous pericarditis
• Serous pericarditis
• none of the above
• Purulent pericarditis
• Chronic pericarditis

A

Chronic pericarditis

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8
Q

DESIRED VALUES: LDL Cholesterol

A

<100mg/dL

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9
Q

INTERPRET THE LEVELS OF LD: CSF in Hydrocephalus & seizures

A

LD2>LD1>LD3>LD4 >LD5

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10
Q

A patient was extracted at 6:00AM for Lipid Profile, with the following results: TAG = 200mg/dL
Total Cholesterol = 220mg/dL HDL cholesterol = 35mg/dL.
Analyze the patient’s LDL & VLDL, using Friedewald Equation:

A

145.0mg/dL LDL, 40.0mg/dL VLDL

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11
Q

General recommended age for surgical repair in patients with Aortic Coarctation

A

< 6 months

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12
Q

The most characteristic lesion seen in the heart of patients with acute rheumatic fever: [2 answers based on rc]

A

MacCallum plaques

Aschoff bodies

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13
Q

The following are considered cardinal anatomic changes seen in a heart affected with chronic rheumatic heart disease except:

  • Well delineated valvular cusps and non-fusion of the commisures
  • Thickening of the involved valve leaflets
  • Shortening and fusion of the tendinous cords
  • none of the above
  • All of the above
A

All

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14
Q

Normal amount of fluid in pericardial sac

A

30-50 cc

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15
Q

When compared to percutaneous coronary intervention, coronary artery bypass

A

Provides a more complete relief of angina

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16
Q

The most common cyanotic heart anomaly

A

tetralogy of fallot

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17
Q

Not an acute adverse effect of organic nitrates:

  • glaucoma
  • tachycardia
  • orthostatic hypotension
  • throbbing headache
A

Glaucoma

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18
Q

What physical examination findings would be consistent with early signs of cardiac tamponade?

A

Muffled heart sounds

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19
Q

Which is the most appropriate statement regarding the difference between pericardial effusion and cardiac tamponade?

  • Cardiac tamponade is a physiologic diagnosis with resultant hemodynamic consequences
  • Pericardial effusion is a physiologic diagnosis with no hemodynamic consequences.
  • Pericardial effusion is an anatomic diagnosis that has resultant hemodynamic consequences
  • Cardiac tamponade is an anatomic diagnosis with no hemodynamic consequences
A

Pericardial effusion is an anatomic diagnosis that has resultant hemodynamic consequences

20
Q

Stage B Heart Failure Therapy:

A

ACE inhibitors or ARBs in all patients; beta blocker in selected patients

21
Q

The action potential in cardiac cells is divided into 5 phases, which include:

  • Phase 0: a fast upstroke from the spontaneous increase in Na permeability
  • Phase 1: partial repolarization from the activation of Na+ channels & leaking of K+
  • Phase 2: plateau from the opening of calcium channels & outward leaking of K+
  • Phase 3: spontaneous depolarization from gradual increase in Na permeability
  • Phase 4: repolarization from opening of potassium channels
A

Phase 0: a fast upstroke from the spontaneous increase in sodium permeability

22
Q

During the past 2 years, a 34-year old woman has had palpitations, fatigue and worsening chest pain. She was afebrile on physical examination. Her PR is 75/minute, RR of 15/ minute and BP of 110/70 mmHg. A midystolic click with late holosystolic murmur is noted on chest auscultation. The patient admitted to having one or two anxiety attach each month. Which of the following best explains the midsystolic click noted on auscultation?

  • Incompetent valve
  • Rupture of the tendinous cords
  • Annular dilatation
  • Snapping of the everted cusp
A

Annular dilatation

23
Q

A 72-year old man who is very athletic and walks half marathons has been successfully treated for exercise-induced angina for several years. He recently has been complaining about being awakened at night with chest pain. Which of the following drugs would be useful in preventing this patient’s nocturnal angina?

  • Nitroglycerin (transdermal)
  • Esmolol
  • Hydralazine
  • Amyl nitrite
  • Nitroglycerin (sublingual)
A

Nitroglycerin (transdermal)

24
Q

A 54-year-old woman on antiarrhythmic drug therapy complained to her physician of palpitations, insomnia, diarrhea, and increased sweating for the past 3 weeks. Physical examination revealed a patient in moderate distress with mild hand tremors and exophthalmos. ECG showed atrial tachycardia. Which of the following drugs is she most likely taking?

  • Amiodarone
  • Propanolol
  • Quinidine
  • Digoxin
  • Verapamil
A

Amiodarone

25
Q

Which of the following is regarding the clinical manifestation of chronic pericardial effusion?

  • Beck’s triad
  • Hypertension
  • Some patients maybe asymptomatic even on physical exertion
  • Dyspnea and fatigue are common symptoms
A

Beck’s triad

26
Q

A 45-year old female has had increasing fatigue, exertional dyspnea and episodes of mild chest pain for the past 7 months. On physical examination, she is afebrile. Her pulse is 79/ minute, respiratory rate of 15/minute and blood pressure if 120/70 mmHg. Her laboratory studies show normal levels of serum troponin I, glucose, creatinine and cholesterol. The patient was diagnosed of mediastinal malignancy 1 1/2 year prior to this admission. She received 7 cycles of radiation therapy, with the last treatment received 10 months prior to the current admission. Which of the following morphologic findings in the heart is most compatible with the condition?

  • Asymmetric septal hypertrophy
  • Bi-atrial dilatation and firm myocardium
  • Four Chamber dilation and flabby myocardium
  • Concentric hypertrophy
A

Bi-atrial dilatation and firm myocardium

27
Q

Dronaderone:

A

An amiodarone derivative that does not have the iodine moieties that are responsible for thyroid dysfunction associated with amiodarone

28
Q

REFERENCE VALUES: Lactate dehydrogenase (LDH)

A

80-280 U/L at 37 ⁰C

29
Q

FREDRICKSON LIPOPROTEIN PHENOTYPING: Phenotypes - 111

Lipoprotein Elevation?

A

VLDL and CM

30
Q

The drug of choice for torsades de pointes and digoxin-induced arrhythmias.

A

Magnesium sulfate

31
Q

Electrical alternans is characterized by

A

Alternating low voltage and high voltage height of the QRS on the ECG tracing

32
Q

Tamponade compresses the heart and the pressure increases the cardiac output.

A

False

33
Q

A patient presents four weeks post myocardial infarction with fever, chest pain, dyspnea, palpitations,
lightheadedness, and confusion. The Cardiologist predicts the patient has Dressler’s Syndrome which is an
inflammatory condition of the pericardium. What will you most likely find on echocardiogram?

A

Pericardial effusion

34
Q

A 20 year – old boy developed rapid onset of fever, with associated chills and malaise. Heart murmurs are
noted upon auscultation at the emergency room. He was immediately brought to the intensive care unit where
he expired after 4 days of confinement. The patient is a known Intravenous drug user. What clinical condition
did the patient likely succumbed to?

A

Acute infective endocarditis

35
Q

Which medication should be administered to all patients with acute angina?

A

Nitroglycerin sublingual tablet

36
Q

Which of the following statements is true regarding Atrial Septal Defect:

A

ASD result in an increase in pulmonary blood flow secondary to left to right shunting through the
defect

37
Q

Class II antiarrhythmic drugs:

A

Inhibits phase 4 depolarization in SA and AV nodes

38
Q

Class 1B Antiarrhythmic

A

Lidocaine

39
Q

The closure of the ductus creates a fibrous cord called:

A

ligementum arteriosum

40
Q

A pericardial effusion involves the presence of an abnormal amount or type of fluid within the pericardial space

A

True

41
Q

FREDRICKSON LIPOPROTEIN PHENOTYPING: Phenotypes - 11a

Major Plasma Lipid Elevation?

A

Cholesterol

42
Q

FREDRICKSON LIPOPROTEIN PHENOTYPING: Phenotypes - 11b

Lipoprotein Elevation?

A

LDL and VLDL

43
Q

Centrally-acting sympathoplegic:

A

Clonidine

44
Q

Cardiac tamponade is best defined as excessive fluid in the

A

Pericardium that leads to increased ventricular filling and decreased cardiac output.

45
Q

The diagnostic procedure with the highest sensitivity of detecting a pericardial effusion or cardiac tamponade
is:

A

Two-dimensional echocardiogram.

PHARMA (26 decks)

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