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IPCS 4 > Cardio 2 Quizzes > Flashcards

Cardio 2 Quizzes Flashcards

1
Q

Which of the following directly affects myocardial oxygen demand?
Myocardial wall tension
Presence of anemia
Large plaque burden
Coronary vasospasm

A

Myocardial wall tension

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2
Q

Which of the following best explains why ischemia does not typically occur with exertion in patients with CCD until coronary stenosis reaches 70% or more of the luminal diameter?
Atherosclerotic plaque rupture beyond this degree of coronary stenosis
Collateral circulation diminishes as coronary stenosis increases
Coronary flow reserve is exhausted as the degree of coronary stenosis increases
Vasospasm occurs once coronary stenosis exceeds 70% of luminal diameter

A

Coronary flow reserve is exhausted as the degree of coronary stenosis increases

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3
Q

Which of the following statements about organic nitrates is False?
a. They are sources of nitric oxide (NO)
b. Being small, lipophilic esters they are volatile
c. Being polar molecules they cannot cross cell membranes
d. They should be stored moisture free to minimize hydrolysis
e. They are explosive in concentered form

A

c. Being polar molecules they cannot cross cell membranes

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4
Q

Calcium channel blockers are used to manage exertional angina because they_______.
a. Increase oxygen demand
b. Decrease afterload
c. Decrease coronary blood flow
d. Increase contractility

A

Decrease afterload

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5
Q

Which of the following medications inhibits late sodium currents leading to a decrease in contractilty and oxygen demand?
a. Ranolazine
b. Amlodipine
c. Isosorbide mononitrate
d. Carvedilol

A

Ranolazine

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6
Q

Which of the following P2Y12 inhibitors reversibly inhibit the ADP receptor?
a. Clopidogrel
b. Ticagrelor
c. Prasugrel
d. Cangrelor

A

b. Ticagrelor
d. Cangrelor

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7
Q

Which of the following statements about aspirin is False?
a. At low doses it inhibits the enzyme cyclooxygenase-1 (COX-1)
b. At inhibits platelet aggregation
c. It inhibits the conversion of arachidonic acid to prostaglandin H2 (PGH2)
d. The carboxylic acid group of aspirin covalently (irreversibly) binds to COX-1 and inhibits the enzyme
e. At higher doses it inhibits both cyclooxygenase-1and 2 (COX-1 and COX-2) enzymes

A

d. The carboxylic acid group of aspirin covalently (irreversibly) binds to COX-1 and inhibits the enzyme

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8
Q

Which of the following statements about prasugrel is False?
a. Its bioactivation involves ester hydrolysis by human carboxyesterase hCE2
b. The platelets regain the ability to aggregate on discontinuing the administration of the drug
c. It forms an active thiol metabolite that forms a covalent bond with a cysteine residue of the P2Y12 receptor
d. It is administered orally

A

b. The platelets regain the ability to aggregate on discontinuing the administration of the drug

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9
Q

Cangrelor has a plasma half-life of 3-6 minutes. Which of the following is responsible for short half-life?
a. Highly ionic nature of the molecule
b. Metabolic dephosphorylation of the phosphate chain
c. Metabolic deamination of the amine side chain
d. Metabolic dehalogenation of the phosphate chain

A

b. Metabolic dephosphorylation of the phosphate chain

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10
Q

Which of the following statements about Eptifibatide is False?
a. It is a cyclic heptapeptide
b. Hydrophobic tryptophan ring system increase affinity to the receptor
c. The amino acid proline is introduced to increase conformational mobility of the ring system
d. Part of the molecule mimics the Arginine-glycine-Aspartic acid (RGD) sequence of fibrinogen

A

c. The amino acid proline is introduced to increase conformational mobility of the ring system

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11
Q

Which of the following statements about Vorapaxar is False?:
a. It inhibits the binding of thrombin to protease activated receptors (PAR-1)
b. It inhibits the activation of the protease activated receptors (PAR-1) by the N-terminus tethered ligand
c. The nitrogen atom of the pyridine ring is required for activity
d. The lactone ring is required for activity
e. The fluorine atom protects the ring from metabolism

A

a. It inhibits the binding of thrombin to protease activated receptors (PAR-1)

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12
Q

Which of the following statements is CORRECT concerning the inhibition of platelet activation by Aspirin (ecotrin)?
a. Aspirin activates the binding of arachidonic acid to COX-1
b. Aspirin inhibits the formation of thromboxane A2
c. Aspirin reversibly inactivates COX-1 by binding to its active site
d. Aspirin activates COX-1 increasing thromboxane A2

A

b. Aspirin inhibits the formation of thromboxane A2

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13
Q

Which drug IS NOT associated with producing vasodilation and activating sympathetic reflex?
a. Amlodipine (Norvasc)
b. Diltiazem (Cardizem)
c. Nifedipine (Adalat)
d. Felodipine (Cabren)

A

b. Diltiazem (Cardizem)

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14
Q

True or False: Beta-1 blockers are used to treat angina because they significantly increase coronary oxygen supply.
True
False

A

False

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15
Q

Which of the following is a common symptom of patients presenting with acute coronary syndrome?
a. Substernal chest pain
b. Headache
c. Indigestion
d. Back pain

A

a. Substernal chest pain

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16
Q

Which of the following is a biomarker that is elevated due to injury of the cardiac myocytes in acute coronary syndrome?
a. Troponin
b. BNP
c. Creatine kinase
d. Lactice acid

A

a. Troponin

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17
Q

Which of the following diagnostic tests is an invasive procedure with provides imaging of coronary flow and potential blockages in coronary arteries?
EKG
Stress test
Left heart catheterization
Transthoracic echocardiogram

A

Left heart catheterization

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18
Q

What total dose of alteplase should be given to a 60 kg man in whom alteplase is indicated to treat an acute ischemic stroke?
a. <20 mg
b. 20 - 40 mg
c. 41 - 60 mg
d. 61 - 80 mg
e. 81 - 90 mg
f. > 90 mg

A

c. 41 - 60 mg

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19
Q

Warfarin’s use to prevent strokes is best documented with which form of neurological disorder?
a. subarachnoid hemorrhage
b. TIA
c. cerebral infarction
d. embolic stroke

A

d. embolic stroke

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20
Q

The preferred treatment to prevent a second TIA is:
a. Aspirin
b. Aminocaproic acid
c. Dabigatran
d. Warfarin
e. Apixaban

A

a. Aspirin

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21
Q

A patient is at increased risk for angioedema while receiving alteplase to treat a stroke due to ischemia if the patient is on which medication?
a. Lisinopril
b. Clonidine
c. Metoprolol
d. Chlorthalidone
e. Amlodipine

A

a. Lisinopril

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22
Q

Which THREE are the most common presentation of TIAs?
a. Facial droop
b. Slurred speech
c. Headache
d. Stiff neck
e. Numbness in a limb

A

a. Facial droop
b. Slurred speech
e. Numbness in a limb

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23
Q

When is reteplase indicated for treatment?
a. Variant Angina
b. STEMI
c. NSTEMI
d. Unstable Angina

A

b. STEMI

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24
Q

Which of the following substances is central in the clotting cascade as well as involved in platelet activation and aggregation?
Von Willebrand Factor
Collagen
Thrombin
Tissue Factor

A

Thrombin

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25
Q

A 53 YOM
PMH: HTN, DLP, MI 3 yrs ago, previous 30 pack-year smoking
PE: bilateral lower leg and foot pain and cramping during daily walks
Vitals: H 5’11” Wt 91kg BP 138/90 mmHg HR 80 bpm T 47C
Labs: A1C 6.1% LDL 11 HDL 40 TG 150 TC 170
Which of the following patient findings is most indicative of PAD?
Hemoglobin 6.1%
HR of 80bpm
LDL-C 100 mg/dL
Lower extremity pain and cramping during exertion

A

Lower extremity pain and cramping during exertion

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26
Q

Which of the following ACS events is considered an emergency and needs to be treated with revascularization immediately?
NSTEMI
Unstable angina
Stable angina
STEMI

A

STEMI

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27
Q

What is the timeframe from symptom onset for when a fibrinolytic should be given for ACS?

A

<12 hours

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28
Q

Which of the following medications is not part of IMMEDIATE treatment of ACS?
Clopidogrel
Aspirin
Enoxaparin
Atorvastatin
Nitroglycerin
Lisinopril

A

Atorvastatin
Lisinopril

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29
Q

A 47yo pt weight 78kg
Hx of stable ischemic heat disease presents with substernal chest pressure
ECG shows ST segment depression
Initial troponin level is elevated
Patient undergoes PCI
In addition to aspirin 81mg daily, which P2Y12 is most appropriate at discharge?
Clopidogrel 75mg QD x 6mo
Prasugrel 10mg QD x 12mo
Ticagrelor 60mg BID x 12 mo
Ticagrelor 90mg QD x 6mo

A

Prasugrel 10mg daily for 12 months

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30
Q

57yo pt weight 92kg
Hx of SIHD presents with 4hr history of substernal chest pressure
ECG shows ST segment elevation
Nearest Cath lab is 2.5 hours away by ambulance
BP 210/85mmHG
Which of the following is the most appropriate reprefusion strategy for this patient?
Blood pressure must be lowered before fibrinolytic therapy is considered
Primary PCI is preferred over fibrinolytic therapy in this patient
Tenectaplase 50mg IVP once
Reteplase 10 units IVP once

A

Blood pressure must be lowered before fibrinolytic therapy is considered

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31
Q

Select the most appropriate statin regimen for use in a patient with CAD and recent hospitalization for STEMI:
a. Pravastatin 40 mg daily
b. Rosuvastatin 10 mg daily
c. Simvastatin 80 mg daily
d. Atorvastatin 40 mg daily

A

d. Atorvastatin 40 mg daily

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32
Q

Which of the following is an appropriate antithromotic therapy for a patient with PAD who recently had a femoral artery stent placed?
a. Warfarin 5 mg daily
b. Ticargrelor 90 mg twice daily
c. Rivaroxaban 2.5 mg twice daily + Aspirin 81 mg daily
d. Aspirin 325 mg daily

A

c. Rivaroxaban 2.5 mg twice daily + Aspirin 81 mg daily

33
Q

Which of the following is first-line therapy for treatment of anginal symptoms in stable ischemic heart disease?
Amlodipine 5 mg daily
Bisoprolol 5 mg daily
Cilostazol 100 mg BID
Ranolazine 500 mg BID

A

Bisoprolol 5 mg daily

34
Q

After an ACS event, ACE-inhibitors or ARBs are recommended in which of the following scenarios? Select ALL that apply.
a. Heart Failure with Reduced Ejection Fraction
b. Hyperlipidemia
c. Chronic kidney disease
d. Diabetes mellitus
e. Hypertension
f. Atrial fibrillation
g. Pericarditis

A

a. Heart Failure with Reduced Ejection Fraction
c. Chronic kidney disease
d. Diabetes mellitus
e. Hypertension

35
Q

A post-ACS patient who received a drug eluting stent is being discharged from the hospital on dual antiplatelet therapy and apixaban, for stroke prophylaxis in atrial fibrillation. What is the P2Y12 inhibitor of choice to send the patient home on?
a. Cangrelor
b. Clopidogrel
c. Ticagrelor
d. Prasugrel

A

b. Clopidogrel

36
Q

When is reteplase indicated for treatment?
a. Variant Angina
b. Unstable Angina
c. NSTEMI
d. STEMI

A

d. STEMI

37
Q

Which P2Y12 inhibitor is associated with causing dyspnea?
a. Ticagrelor
b. Prasugrel
c. Cangrelor
d. Clopidogrel

A

a. Ticagrelor

38
Q

What is a consideration to screen for when using prasugrel for antiplatelet therapy?
a. Prasugrel can cause significant bleeding in patients with a history of stroke or transient ischemic attack and should not be used
b. Prasugrel should not be used in patients with history of NSAID allergy due to cross reactivity
c. Prasugrel can cause atrioventricular (AV) block, leading to significant bradyarrhythmias and is contraindicated with AV blocks
d. Prasugrel can lead to additive hypotension when combined with PDE-5 inhibitors

A

a. Prasugrel can cause significant bleeding in patients with a history of stroke or transient ischemic attack and should not be used

39
Q

How long should an unfractionated heparin infusion be continued in an NSTE-ACS patient?
a. Until hospital discharge
b. 48 hours or after PCI completion
c. NSTE-ACS patients do not need anticoagulation
d. Lifelong, transition to oral anticoagulation on discharge

A

b. 48 hours or after PCI completion

40
Q

Which of the following drug classes increase coronary blood flow (increase oxygen supply)? Select all that apply.
a. Calcium channel blockers
b. Organic nitrates
c. Beta-blockers
d. ARBs
e. Vasoconstrictors

A

a. Calcium channel blockers
b. Organic nitrates

41
Q

Which of the following drug classes decreases heart rate and myocardial contractility (thereby decreasing oxygen demand)? Select all that apply.
a. Calcium channel blockers
b. Organic nitrates
c. Beta-blockers
d. ARBs
e. Calcium entry blockers

A

a. Calcium channel blockers
c. Beta-blockers

42
Q

Which of the following drug classes decreases ventricular wall stress (preload) and decreases systemic vascular resistance (afterload), thereby decreasing oxygen demand? Select all that apply.
a. Calcium channel blockers
b. Organic nitrates
c. Beta-blockers
d. ARBs
e. Calcium entry blockers

A

b. Organic nitrates
e. Calcium entry blockers

43
Q

Which of the following statements regarding organic nitrates is correct?
a. Nitroglycerin and isosorbide share the same onset and duration of action, irrespective of formulation.
b. Organic nitrates require metabolic activation to produce nitric oxide, their active form.
c. Organic nitrates exclusively reduce preload without affecting afterload.
d. Isosorbide mononitrate undergoes the most extensive first-pass metabolism.

A

b. Organic nitrates require metabolic activation to produce nitric oxide, their active form.

44
Q

What are two contraindications for organic nitrates?

A

a. PDE-5 inhibitors
b. Hypotension (IV)

45
Q

Which of the following statements accurately describes the mechanism of action for organic nitrates?
a. Nitrates are prodrugs that are converted into nitric oxide in endothelial cells. Nitric oxide within these cells activates guanylyl cyclase, leading to the formation of cGMP.
b. Nitrates exert their effect on smooth muscle by activating guanylyl cyclase, which increases cGMP levels. cGMP then activates protein kinase G (PKG), which in turn activates myosin light chain phosphatase (MLC phosphatase). This leads to the dephosphorylation of myosin light chains, causing smooth muscle relaxation.
c. Nitrates exert their effect in the endothelial cells by activating guanylyl cyclase, which increases cGMP levels. cGMP then activates protein kinase G (PKG), which in turn activates myosin light chain phosphatase (MLC phosphatase). This leads to the dephosphorylation of myosin light chains, causing smooth muscle relaxation. They also work by phosphorylating myosin light chain kinase, which deactivates the enzyme, decreasing the number of phosphorylated myosin chains.
d. Nitrates inhibit the release of endothelin-1, a potent vasoconstrictor, leading to smooth muscle relaxation through reduced endothelin-mediated signaling.

A

b. Nitrates exert their effect on smooth muscle by activating guanylyl cyclase, which increases cGMP levels. cGMP then activates protein kinase G (PKG), which in turn activates myosin light chain phosphatase (MLC phosphatase). This leads to the dephosphorylation of myosin light chains, causing smooth muscle relaxation.

46
Q

Which of the following statements is true regarding the pharmacokinetics of organic nitrates?
a. Organic nitrates are hydrophilic molecules highly absorbed through cell membranes, making them highly effective for emergency treatment.
b. Organic nitrates, being small and lipophilic esters, are volatile and rapidly absorbed through cell membranes, making them highly effective for emergency treatment.
c. Organic nitrates are large molecules that must undergo extensive metabolism before they can be absorbed and exert their therapeutic effect in emergencies.
d. Organic nitrates are stable compounds that do not require rapid absorption for their efficacy in acute settings, as their onset of action is delayed.

A

b. Organic nitrates, being small and lipophilic esters, are volatile and rapidly absorbed through cell membranes, making them highly effective for emergency treatment.

47
Q

Which of the following statements accurately reflects the proper storage conditions for nitrates?
a. Nitrates should be stored in high-humidity environments to ensure the stability of their ester bonds.
b. Nitrates should be stored moisture-free to prevent nitrogen deoxygenation of the ester bond, which can compromise their efficacy.
c. Nitrates should be stored moisture-free to prevent hydrolysis of the ester bond, which can compromise their efficacy.
d. Nitrates should be stored at low temperatures to prevent thermal degradation of their ester bonds.

A

c. Nitrates should be stored moisture-free to prevent hydrolysis of the ester bond, which can compromise their efficacy.

48
Q

What types of calcium channels do calcium channel blockers block to exert their mechanism of action?
a. D-type
b. T-type
c. R-type
d. L-type

A

d. L-type

49
Q

List the main effects of each type of calcium channel blocker:

A

a. Non-DHP- Cardiac tissue and vasculature
b. DHP- vasculature

50
Q

Which of the following statements is true regarding the differences between dihydropyridine and non-dihydropyridine calcium channel blockers?
a. Dihydropyridine calcium channel blockers primarily affect cardiac cells, which reduces the risk of reflex tachycardia.
b. Non-dihydropyridine calcium channel blockers have a greater effect on vascular smooth muscle cells than cardiac cells, leading to a higher risk of reflex tachycardia.
c. Dihydropyridine calcium channel blockers primarily target vascular smooth muscle cells. In contrast, non-dihydropyridine calcium channel blockers have equal potency for cardiac cells and smooth muscle cells, reducing the risk of a sympathetic reflex.
d. Verapamil has less effect on cardiac contractility compared to diltiazem, leading to a lower risk of bradycardia.

A

c. Dihydropyridine calcium channel blockers primarily target vascular smooth muscle cells. In contrast, non-dihydropyridine calcium channel blockers have equal potency for cardiac cells and smooth muscle cells, reducing the risk of a sympathetic reflex.

51
Q

Why should beta-blockers with intrinsic sympathomimetic activity (ISA) be avoided for the treatment of angina?

A

Increase heart rate and cardiac workload

52
Q

Which of the following statements is true regarding the selectivity of beta-blockers at high doses?
a. Beta-blockers remain highly selective for beta-1 receptors, even at high doses, without affecting beta-2 receptors.
b. At high doses, all beta-blockers lose their selectivity and can inhibit beta-2 receptors in addition to beta-1 receptors.
c. Nonselective beta-blockers only inhibit beta-2 receptors, even at therapeutic doses, without affecting beta-1 receptors.
d. Selective beta-blockers only inhibit beta-1 receptors, regardless of the dosage

A

b. At high doses, all beta-blockers lose their selectivity and can inhibit beta-2 receptors in addition to beta-1 receptors.

53
Q

Which of the following statements accurately describes the mechanism of action of ranolazine (Ranexa)?
a. Ranolazine inhibits early sodium currents during phase 0 of the action potential in cardiac muscle.
b. Ranolazine enhances sodium influx during phase 2 of the action potential, increasing contractility.
c. Ranolazine inhibits late inward sodium currents during phases 2 and 3 of the action potential in voltage-gated sodium channels of cardiac muscle.
d. Ranolazine blocks sodium and potassium channels during phase 3, prolonging repolarization in cardiac muscle.

A

c. Ranolazine inhibits late inward sodium currents during phases 2 and 3 of the action potential in voltage-gated sodium channels of cardiac muscle.

54
Q

Which of the following statements correctly describes the effect of aspirin on platelet aggregation?
a. Aspirin inhibits the conversion of ADP into thromboxane A2, thereby preventing platelet aggregation.
b. Aspirin reversibly blocks the COX-1 enzyme, preventing the conversion of arachidonic acid into PGH2 and reducing thromboxane A2 production.
c. Aspirin directly inhibits thromboxane A2 receptors on platelets, preventing aggregation by blocking the binding of ADP.
d. Aspirin inhibits the conversion of arachidonic acid into PGH2 by blocking the COX-1 enzyme, which leads to reduced thromboxane A2 production and inhibition of platelet aggregation.

A

d. Aspirin inhibits the conversion of arachidonic acid into PGH2 by blocking the COX-1 enzyme, which leads to reduced thromboxane A2 production and inhibition of platelet aggregation.

55
Q

What is the name of the fibrinogen receptor?

A

GIIb/IIIa receptor

56
Q

Which of the following statements accurately describes the role of the P2Y12 receptor in platelet aggregation?
a. Activation of the P2Y12 receptor (an ADP receptor) leads to a decrease in adenylate cyclase activity, which in turn activates the GP2b/3a receptor, promoting platelet aggregation.
b. Only one of the P2Y1 or P2Y12 receptors needs to be activated for platelet aggregation to occur, as both have identical roles in the process.
c. The P2Y12 receptor increases adenylate cyclase activity, which directly inhibits the GP2b/3a receptor, preventing platelet aggregation.
d. P2Y12 receptor activation blocks the GP2b/3a receptor, preventing fibrinogen binding and thus inhibiting platelet aggregation.

A

a. Activation of the P2Y12 receptor (an ADP receptor) leads to a decrease in adenylate cyclase activity, which in turn activates the GP2b/3a receptor, promoting platelet aggregation.

57
Q

Which of the following drugs blocks the thrombin receptor known as PAR-1?
a. Clopidogrel
b. Vorapaxar
c. Ticagrelor
d. Abciximab

A

b. Vorapaxar

58
Q

Which of the following drugs is a reversible inhibitor of the ADP receptor (P2Y12 receptor)?
a. Aspirin
b. Clopidogrel
c. Prasugrel
d. Ticagrelor

A

d. Ticagrelor

59
Q

Which of the following best describes the difference in the mechanism of action between ticagrelor and cangrelor?
a. Ticagrelor is a direct and irreversible P2Y12 receptor inhibitor, while cangrelor is an allosteric inhibitor of the P2Y12 receptor.
b. Both ticagrelor and cangrelor are irreversible inhibitors of the P2Y12 receptor, but ticagrelor has a faster onset of action.
c. Ticagrelor is an allosteric and reversible inhibitor of the P2Y12 receptor, while cangrelor is a reversible inhibitor of the P2Y12 receptor that binds to the active site.
d. Cangrelor is an allosteric and irreversible inhibitor of the P2Y12 receptor, while ticagrelor reversibly binds to the P2Y12 receptor.

A

c. Ticagrelor is an allosteric and reversible inhibitor of the P2Y12 receptor, while cangrelor is a reversible inhibitor of the P2Y12 receptor that binds to the active site.

60
Q

What is a major drug-drug interaction with Plavix?

A

Es/Omeprazole, Fluoxetine, Azoles

61
Q

Which of the following medications is a cyclic peptide that inhibits platelet aggregation by blocking fibrinogen receptors?
a. Integrelin (eptifibatide)
b. Aggrastat (tirofiban)
c. Pletal (cilostazol)
d. Ticlid (ticlopidine)

A

a. Integrelin (eptifibatide) – GIIb/IIIa receptor

62
Q

What is the preferred management strategy in a STEMI patient?

A

PCI, within 2 hours (transport), within 1 hour (at hospital)

63
Q

What are some nonpharmacological treatment options for acute coronary syndrome?

A

a. DASH diet, weight management, manage diabetes, reduce alcohol, smoking cessation

64
Q

What does MONA-B stand for?

A

a. M- Morphine
b. O- Oxygen
c. N- Nitrates
d. A- Aspirin
e. B- Beta Blocker

65
Q

What are some considerations for the use of morphine?

A

a. Usually reserved for STEMIs
b. Decreases absorption of other meds
c. Increased risk of mortality

66
Q

In which patient population should we use caution when using oxygen?

A

a. COPD
b. Not preferred due tp increased mortality and lack of benefit

67
Q

At what O2 stat is oxygen indicated?

A

O2 <94%

68
Q

What is a key consideration regarding the formulation of aspirin?

A

Not enteric coated or chewable for quick onset

69
Q

Within how many hours should a patient be started on a beta blocker after presenting with acute coronary syndrome?
a. 4 hours
b. 12 hours
c. 24 hours
d. 36 hours

A

c. 24 hours

70
Q

Which of the following options is an absolute contraindication for the use of thrombolytics?
a. Pregnancy
b. Ischemic stroke > 3 months ago
c. History of hemorrhagic stroke
d. Active peptic ulcer

A

c. History of hemorrhagic stroke

71
Q

Which of the following combination ant therapy is appropriate for a patient undergoing a PCI?
a. Effient and Aspirin
b. Plavix and Prasugrel
c. Brilinta and IV cangrelor
d. Aspirin and Plavix
e. Apixiban and Aspirin

A

a. Effient and Aspirin
d. Aspirin and Plavix

72
Q

What medications should be prescribed to all patients who have stable angina?

A

Nitroglycerin SL tablet and Aspirin

73
Q

What medication is considered the first line for a patient with stable angina for symptom management?

A

Beta Blocker

74
Q

Which calcium channel blocker is preferred in patients with heart failure?

A

Amlodipine

75
Q

After how many weeks should cilostazol be discontinued if no benefit is seen?

A

12 weeks – increased risk of mortality and Mis, takes 4 weeks to work

76
Q

Which of the following are the most common (top three) presentations of TIAs?
a. Slurred speech
b. Headache
c. Facial droop
d. Numbness in a limb
e. Stiff neck

A

a. Slurred speech
c. Facial droop
d. Numbness in a limb

77
Q

Which of the following statements is correct regarding antithrombotic therapy for primary prevention of TIA or stroke?
a. If atrial fibrillation is present, the CHA2DS2-VASc score should be used to determine the need for preventive therapy.
b. Daily low-dose aspirin (81 mg) is still recommended for primary prevention in the general population, even in the absence of atrial fibrillation.
c. In cases unrelated to atrial fibrillation, the CHA2DS2-VASc score is not needed to assess the need for antithrombotic therapy.
d. Daily aspirin therapy, even at low doses, is strongly advocated for primary prevention of stroke in all patients over the age of 50.

A

a. If atrial fibrillation is present, the CHA2DS2-VASc score should be used to determine the need for preventive therapy.

78
Q

What should the blood pressure be lowered to before the administration of thrombolytic therapy for a stroke?
a. <180/105 mmHg
b. <185/100 mmHg
c. <185/110 mmHg
d. <180/100 mmHg

A

c. <185/110 mmHg – maintain <180/105

79
Q

Which of the following patient scenarios reflects the correct dose and administration regimen for alteplase?
a. A 65-year-old male who weighs 110 kg. The patient received a total dose of 110 mg, with 10 mg given over the first 3 minutes and the remaining dose administered over the last 30 minutes.
b. A 65-year-old female who weighs 60 kg received a total dose of 54 mg, with 5.4 mg given in the first minute and the remainder administered over 60 minutes.
c. A 72-year-old male who weighs 80 kg. The total dose is 80 mg, with 8 mg given in the first minute and the rest administered over 60 minutes.
d. A 60-year-old female who weighs 95 kg received a total dose of 85.5 mg, with 9 mg administered over the first 5 minutes and the remaining dose given over the next 45 minutes.

A

b. A 65-year-old female who weighs 60 kg received a total dose of 54 mg, with 5.4 mg given in the first minute and the remainder administered over 60 minutes.

IPCS 4 (5 decks)

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