Cardiology

Question 1

Only anti-lipid drug allowed with pregnancy

Answer 1

Bile Acid Sequestrants (Cholestyramine, Colestipol, Colesevelam)

Question 2

Best anti-lipid to decrease triglycerides

Answer 2

Fibrates (fenofibrate, gemfibrozil)

Question 3

Which anti-lipid drug is associated with hyperuricemia/gout?

Answer 3

Niacin (Nicotinic Acid, Vitamin B3)

Question 4

What can a patient due to decrease side effects on Niacin (flushing, headaches, warm sensations, pruritus)

Answer 4

Take ASA or ibuprofen prior to use

Question 5

What are contraindications to using statins

Answer 5

Patient on antibiotics/tetracyclines

Question 6

When is the best time to take a statin and reason why

Answer 6

Best at bedtime (when cholesterol synthesis is maximal)

Question 7

Which anti-lipid drug is associated with gallstones and why?

Answer 7

Fibrates (Gemfibrozil, Fenofibrate), it increases bile lithogenicity because it blocks enterohepatic reabsorption of bile acids

Question 8

Which anti-lipid medication can be used to also treat pruritus associated with biliary obstruction?

Answer 8

Bile acid sequestrants (Cholecystyramine, colestipol, colesevelam)

Question 9

Which anti-lipid is associated with hyperglycemia and thus should be avoided in diabetics?

Answer 9

Niacin

Question 10

What are Omega 3 fatty acids used for?

Answer 10

For hypertriglyceridemia

Question 11

Sources of Omega 3s

Answer 11

Salmon, Flaxseed, canola oil, soybean oil, nuts

Question 12

Medications associated with causing secondary HTN

Answer 12

OCPs, NSAIDs, Antidepressants (TCAs, SSRIs), Glucocorticoids, Decongestants (Pseudophedrine), Weight loss medications, stimulants (methylphenidate, amphetamines), Illicit drugs, cyclosporine, erythropoietin

Question 13

Endocrine Disorders associated with causing secondary HTN

Answer 13

Pheochromocytoma
Cushing’s Syndrome
Hypo/Hyperthyroidism
Hyperparathyroidism

Question 14

Resistant HTN - consider what other causes

Answer 14

OSA, Pheochromocytoma, primary aldosteronism, Coarctation of the aorta (in childlren)

Question 15

JNC-8 HTN Guidelines for patients >60 years

Answer 15

<150/90

Question 16

JNC-8 HTN Guidelines for patients <60 years

Answer 16

<140/90

Question 17

JNC-8 HTN Guidelines for patients >18 with diabetes

Answer 17

<140/90

Question 18

JNC-8 HTN Guidelines for patients >18 with CKD

Answer 18

<140/90

Question 19

Initial monotherapy for HTN in African Americans

Answer 19

Thiazide diuretic or long-acting calcium channel blocker dihydropyridine (amlodipine)

Question 20

Initial Monotherapy in Diabetes or CKD

Answer 20

ACE or ARB

Question 21

HTN medications associated with Hyperuricemia/gout

Answer 21

ACE inhibitors, Thiazides

Question 22

First line HTN medication in elderly

Answer 22

Thiazide

Question 23

Strongest diuretic class

Answer 23

Loop diuretics

Question 24

Diuretic associated with gynecomastia

Answer 24

Spironolactone

Question 25

Which Calcium channel blockers are used in treating HTN?

Answer 25

Dihydropyridines aka

Amlodipine (Norvasc), Nifedipine (Procardia)

Question 26

Considerations with B-blockers and Diabetics:

Answer 26

May mask tachycardia associated with hypoglycemia, be cautious with use

Question 27

Which beta blockers are cardioselective?

Answer 27

Atenolol
Metoprolol
Esmolol

Question 28

What are the non-selective Beta blockers?

Answer 28

Propranolol

Question 29

Which are alpha and beta associated beta blockers?

Answer 29

Labetalol

Carvedilol

Question 30

Which B-blockers are contraindicated/avoided in COPD/Asthma?

Answer 30

Non-selective: Propranolol, Labetalol, Carvedilol

Question 31

Which antihypertensives are also good for BPH?

Answer 31

Alpha-1 blockers (Prazosin, Terazosin, Doxazosin)

Question 32

Which anti-hypertensive may improve osteoporosis, reduce hypercalciuria, and reduce nephrolithiasis?

Answer 32

Thiazide

Question 33

What is the most common cause of HTN in children <10 years?

Answer 33

Renal parenchymal disease