CV Quiz Flashcards
Ramipril is different from valsartan in which of the following ways:
A. It is not recommended for patients with heart failure
B. It directly reduces the amount of aldosterone released
C. It can decrease potassium levels
D. It lowers the level of circulating angiotensin II
E. It lowers BP more than valsartan
D.
Irbesartan should NOT be used in patients with the following problems:
A. Chronic kidney disease
B. Heart failure with preserved ejection fraction
C. Allergy to sulfa
D. Bilateral renal artery stenosis
E. Systolic BP less than 110mmHg
D.
A patient asks you for assistance in dealing with a dry cough that has been bothering him for weeks. Which of the following drugs might be causing this problem?
A. Trandolapril
B. Olmesartan
C. Chlorthalidone
D. Furosemide
E. Amlodipine
A.
A patient started losartan last week and has returned for a follow-up blood test. Which of the following changes could have been caused by losartan over the past week?
A. Decrease in potassium from 4.2mmol/L to 3.8mmol/L
B. Increase in serum creatinine from 75mmol/L to 94mmol/L
C. Decrease in systolic blood pressure from 157mmHg to 122mmHg
D. Increase in blood sugar from 5.2mmol/L to 6.5mmol/L
E. All of the above could happen in 1 week
B.
A patient has a high potassium level of 5.7mmol per Litre. Which of the following drugs should not be prescribed:
A. Furosemide
B. Amlodipine
C. Verapamil
D. Perindopril
E. None of these drugs should be prescribed
D.
Metoprolol’s primary effect is to interrupt which of the following physiologic systems?
A. RAAS
B. Central nervous system neurotransmitters
C. Parasympathetic nervous system
D. Sympathetic nervous system
E. Hypothalamic-pituitary axis
D.
Carvedilol is unique because it has which of the following properties
A. It is a selective beta-1 receptor antagonist
B. It is a non-selective beta-1 and beta-2 antagonist
C. It is a non-selective beta antagonist and an alpha-1 antagonist
D. It has agonist properties on the beta-2 receptor
E. It is a selective beta-1 antagonist and a alpha-2 receptor agonist
C.
Atenolol should NOT be used in people with which of the following conditions?
A. 2nd degree heart block
B. Heart rate below 80 beats per minute
C. Chronic kidney disease
D. Well controlled asthma
E. Heart failure with left ventricular systolic dysfunction
A.
A patient with diabetes did not notice an episode of low blood sugar recently. Which of her drugs may have contributed to her lack of awareness?
A. Ticagrelor
B. L. thyroxine
C. Rosuvastatin
D. Lisinopril
E. Metoprolol
E.
The primary target of amlodipine is on which of the following tissues?
A. Cardiac smooth muscle
B. Vascular smooth muscle
C. Renal tubules (i.e., kidney)
D. Adrenal gland
E. Central nervous system
B.
A patient taking amlodipine should be advised that one of the following effects may occur:
A. Increased blood pressure
B. Increased heart rate
C. Swelling of the ankles
D. Increased potassium
E. Increase in blood sugar
C.
When counselling on the use of verapamil, the pharmacist should include which of the following side effects?
A. Constipation
B. Fast heart rate
C. Low calcium levels
D. Increased potassium levels
E. Angina
A.
Which of the following medications should be AVOIDED if possible in a person taking verapamil?
A. ASA
B. Clarithromycin
C. Rosuvastatin
D. Nitroglycerin
E. Levothyroxine
B.
Diltiazem should be considered in which of the following clinical situations?
A. To treat ongoing angina during an acute coronary syndrome
B. To convert atrial fibrillation to normal sinus rhythm
C. To treat stable angina in a patient with normal heart function
D. To treat hyperglycemia associated with type-2 diabetes
E. To treat heart failure associated with left ventricular systolic dysfunction
C.
Which of the following medications inhibits sodium reabsorption in the distal tubule of the nephron?
A. Furosemide
B. Amiloride
C. Perindopril
D. Aliskiren
E. Indapamide
E.
Which of the following medications would be expected to exert the strongest diuretic activity?
A. Furosemide
B. Triamterene
C. Chlorthalidone
D. Eplerenone
E. Acetazolamide
A.
Which of the following laboratory test results are most likely to occur in a patient taking hydrochlorothiazide?
A. Low sodium
B. Low potassium
C. Low uric acid
D. Low glucose
E. Low hemoglobin
B.
Spironolactone may cause which of the following physiologic changes?
A. Gout
B. High blood pressure
C. High potassium
D. High blood sugar
E. Low sodium
C.
Under which of the following circumstances would hydrochlorothiazide be considered an inappropriate treatment option?
A. If potassium is high
B. If GFR is 18ml/min
C. In isolated systolic hypertension
D. If a patient has diabetes
E. If patient already taking an angiotensin receptor blocker
B.
After receiving a dose of clonidine, all of the following actions would be expected EXCEPT:
A. Reduced sympathetic nervous system activity in the CNS
B. Lower blood pressure
C. Lower heart rate
D. Fatigue or tiredness
E. All of the above would be expected
E.
Monitoring plans for people using hydralazine should include the following parameters:
A. ECG (i.e., onset of atrial fibrillation)
B. Angina
C. Fasting blood sugar
D. Orthostatic hypotension
E. Uric acid
D.
In a person with left ventricular hypertrophy, which of the following medications should be considered?
A. All HF medications for people with reduced ejection fraction (i.e., systolic heart failure)
B. A DOAC medication to prevent cardioembolic stroke
C. An antihypertensive medication if BP is high
D. A statin because of damage from prior ACS
E. A loop diuretic to minimize fluid accumulation
C.
In a person who has not achieved their BP targets despite taking ramipril, atenolol, chlorthalidone, and amlodipine, what would be the best option to add to the regimen?
A. Spironolactone
B. Hydralazine
C. Clonidine
D. Doxazosin
E. Valsartan
A.
Low-dose ASA is indicated for the protection against ischemic events such as MI and stroke. What is the mechanism responsible for this action?
A. Vasodilation
B. ADP receptor inhibitition
C. Inhibition of thromboxane A2 production
D. Prostacyclin inhibition
E. Factor Xa inhibition
C.
Which of the following factors can increase the risk for bleeding in patient taking low-dose ASA?
A. Uncontrolled hypertension
B. Fluoxetine
C. Clopidogrel
D. Recent GI bleed
E. All of the above can increase the risk for bleeding with ASA
E.
Which of the following people should receive low dose ASA for primary prevention?
A. A 76 year old male who is otherwise healthy
B. A 76 year old female who is otherwise healthy
C. A 55 year old with slightly elevated cholesterol
D. A 60 year old with hypertension and a peptic ulcer
E. All of the above should receive low-dose ASA
F. None of the above should receive low-dose ASA
F.
Ticagrelor is different from clopidogrel in which of the following ways:
A. It is not a prodrug like clopidogrel
B. It inhibits the P2Y12 receptor but clopidogrel does not
C. Ticagrelor’s actions are less predictable
D. Ticagrelor blocks the GP IIb/IIIa receptor but clopidogrel does not
E. Ticagrelor does not require a loading dose before PCI
A.
Ticagrelor should NOT be used in which of the following patients?
A. Patients with low blood pressure
B. Patients with high blood sugar
C. Patients who are taking ASA
D. Patients with a low platelet count
E. Patients with a CrCl<50ml/min
D.
Over the past few weeks a patient has experienced difficulties in breathing. Which of the following medications would be most likely to cause dyspnea as a side effect?
A. Ticagrelor
B. Valsartan
C. Rosuvastatin
D. ASA
E. Atorvastatin
A.
Which of the following drug combinations would be appropriate for a patient requiring DAPT after an acute coronary syndrome?
A. Ticagrelor PLUS ASA
B. Clopidogrel PLUS Ticagrelor
C. Ticagrelor PLUS Prasugrel
D. Clopidogrel PLUS a DOAC
E. Any of the above options would be acceptable DAPT
A.
Which of the following statements are true about the use of warfarin?
A. Complete anticoagulation occurs within 2 days after starting the first dose.
B. Adults are treated with 5mg per day
C. The INR target is 1 (between 0.5 and 1.5)
D. Regular INR tests can be stopped once the therapeutic effect has been achieved
E. None of the above are true
E.
All of the following are advantages of DOACs compared to warfarin EXCEPT:
A. More rapid onset of action
B. No requirement for blood tests of clotting time
C. A very large reduction in the risk for bleeding
D. Fixed dosing applicable to most adults
E. All of the above statements are advantages of DOACs over warfarin
C.
Which of the following characteristics represent an advantage of low-molecular weight heparins compared to unfractionated heparin?
A. Faster elimination from the body
B. Greater anti-factor IIa activity (vs Xa)
C. More predictable dose-response relationship
D. Oral dosage form available
E. All of the above are advantages of LMWH
C.
Which of the following adverse effects can be caused by heparin anticoagulants?
A. Heparin-induced thrombocytopenia (HIT)
B. Thrombotic stroke
C. Venous thromboses
D. Hypokalemia
E. GI upset
A.
Oral anticoagulants should be considered for the following conditions EXCEPT:
A. Deep venous thromboses (DVT)
B. Atrial fibrillation
C. Mechanical heart valves
D. Pulmonary embolism
E. All of the above are indications for OACs
E.
Rosuvastatin can cause which of the following adverse effects?
A. Cause liver cells to degrade their LDL receptors
B. Cause a 50% reduction in triglyceride concentrations
C. Causes a 40% increase in HDL levels
D. Can cause difficulty breathing
E. None of the above
E.
Ezetimibe has which of the following effects in the body?
A. Binds directly to cholesterol in the GI tract
B. Inhibits cholesterol transport through small intestine
C. Can increase the risk for myopathy
D. Can lower LDL to the same extent as statins
E. Can increase HDL by over 20%
F. All of the above
B.
Atorvastatin should be discontinued in which of the following situations?
A. Patients with liver enzymes (AST and ALT) on the high end of normal
B. Patients with low LDL levels before treatment (i.e., LDL <2)
C. Patients with pre-diabetes
D. Patients with significant CK elevations
E. All of the above
D.
Rosuvastatin may be preferred over atorvastatin in which of the following situations?
A. Patients taking CYP 3A4 inhibitors
B. Patients requiring over 50% reduction in LDL
C. Patients who are post-MI
D. Patients with renal dysfunction
E. All of the above
A.
Which of the following situations would benefit from statin therapy?
A. Stable angina
B. Newly diagnosed diabetes (type 1)
C. Framingham risk score >5%
D. Obesity
E. All of the above
A.
T.S. has heart failure and an ejection fraction of 28%. His blood pressure is 110/71. Which of the following regimens should be considered as optimal therapy in his situation?
A. Ramipril, bisoprolol, diltiazem, and furosemide
B. Valsartan/sacubitril, bisoprolol, spironolactone, empagliflozin, and furosemide
C. Ramipril, metoprolol, and furosemide
D. Valsartan/sacubitril, diltiazem, and metoprolol
E. Ramipril and furosemide prn to prevent fluid accumulation
B.
What are the major differences between people with left ventricular systolic dysfunction (LVSD) and those with normal EF?
A. People with normal EF cannot get HF
B. Verapamil should be avoided in people with LVSD but are allowed if EF is normal
C. LVSD will cause people to have HF symptoms at rest
D. EF of 60% is considered LVSD
E. All of the above are TRUE
B.
Which of the following are risk factors for a pulmonary embolism?
A. Atrial fibrillation
B. Myocardial infarction
C. Asthma
D. Deep venous thromboses (DVT)
E. All of the above
D.
Which of the following drugs should be adjusted in people with renal dysfunction?
A. Atorvastatin
B. Dabigatran
C. Verapamil
D. ASA 81mg
E. All of the above should be adjusted
B.
Which of the following statements are true about dapagliflozin?
A. It is indicated for people with heart failure
B. It is indicated for people with diabetes
C. It has a diuretic effect
D. It can help people with renal dysfunction
E. All of the above
E.
Evolucumab should be used in the following circumstances
A. People with familial hypercholesterolemia
B. People with HF and reduced EF
C. People with renal failure
D. People with diabetes
A.
What would be the main difference between drug regimens following discharge from hospital for a patient who experienced unstable angina versus a STEMI.
A. Statin doses should be higher for those with STEMI vs UA
B. Antiplatelets are not needed after UA but are mandatory after STEMI
C. Ticagrelor (or clopidogrel) will likely not be needed unless a PCI was performed
D. Beta-blockers are more important for patients with UA compared to STEMI
E. In general, medications are NOT required after UA unless the patient has risk factors such as high BP
C.
Which of the following statements about QT prolongation is TRUE?
A. QT prolongation is a type of arrhythmia that requires immediate treatment
B. QT prolongation is asymptomatic but might be caused by certain medications
C. QT prolongation requires insulin treatment to prevent ketoacidosis
D. QT prolongation increases the risk for atrial fibrillation
E. QT prolongation is common in people with stable angina
B.
Which of the following is MOST likely to occur in someone with atrial fibrillation?
A. Heart rate less than 60 beats per minute
B. Fatigue
C. Pulmonary embolism
D. Myocardial infarction
E. All of the above are commonly caused by atrial fibrillation
B.
S.T. has a longstanding history of atrial fibrillation, hypertension, and type 2 diabetes. Which of the following options should NOT be listed as a “goal of therapy”?
A. Long-term anticoagulation to prevent cardioembolic stroke
B. Improve exercise tolerance and fatigue
C. Maintain heart rate below 100 beats per minute
D. Ensure blood pressure is controlled
E. Conversion to normal sinus rhythm regardless of patient presentation
E.
T.J. is a 58 year old male with uncomplicated hypertension. Four weeks ago he started taking chlorthalidone 25mg daily. Over the past week his average blood pressure readings at home have been 152/92. Which of the following options should be considered next?
A. Three more months should pass before any changes are made to his blood pressure drugs
B. Amlodipine should be started at a low dose
C. The chlorthalidone should be increased to its maximum allowed dose
D. Metoprolol should be started
E. Valsartan should be started
E.
Monica is a 58 year old woman who has high blood pressure, type 2 diabetes, and stable angina. Her current medications include:ASA 81mg daily, metoprolol 50mg BID, ramipril 10mg daily, atorvastatin 80mg daily, metformin 500mg BID, and nitrospray PRN. Her average blood pressure over the past 4 weeks is 147/94. Which of the following treatment options should be considered?
A. Amlodipine 10mg daily
B. Furosemide 20mg BID
C. Hydrochlorothiazide 25mg daily
D. Diltiazem (long acting) 240mg daily
E. Clonidine 0.1mg daily
A.
Jeff has stable angina and takes the following medications: metoprolol 50mg BID, ramipril 10mg daily, rosuvastatin 20mg daily, ASA 81mg daily. He is experiencing frequent anginal episodes and requires escalation of his therapy; HOWEVER, his average blood pressure is 90/60. Which of the following medications should be prescribed to address his frequent angina episodes?
A. Amlodipine
B. Verapamil instead of metoprolol
C. Add nitroglycerin patch
D. Use carvedilol instead of metoprolol
E. Add indapamide 2.5mg daily
C.
For the past 3 weeks, Rick has been experiencing stable angina episodes several times per week. These episodes are relieved quickly by his NTG spray. His current medications include the following:
ASA 81mg daily
Perindopril 8mg daily
Atorvastatin 80mg daily
NTG spray as needed
His heart rate is 72 beats per minute, his blood pressure is 149/89, and he has excellent cardiac function with no signs of heart failure. Which of the following alternatives would you recommend to reduce the number of angina episodes he is experiencing.
A. Add a NTG patch
B. Add diltiazem
C. Stop the ASA
D. Add ticagrelor to make DAPT
B.
T.W. has atrial fibrillation. He is 71 years old with diabetes but no other medical conditions. Which of the following drugs would be expected in his regimen with these basic details about his condition?
A. ASA, verapamil
B. Clopidogrel, ASA, metoprolol, perindopril
C. Apixaban, ASA, perindopril
D. Apixaban, metoprolol, perindopril,
D.
In an ECG, the ST segment typically reflects which of the following cardiac problems
A. Arrhythmia
B. Heart rate
C. Coronary perfusion
D. Heart block
E. Cardiac function
C.
In an ECG, the PR segment typically represents…..
A. Heart rate
B. Coronary perfusion
C. AV nodal function
D. Arrhythmia
E. Torsade de pointes
C.
In an ECG, the QT segment represents…..
A. Coronary perfusion
B. Risk for AV block
C. Heart rate
D. Risk for ventricular arrhythmia
E. Heart function
D.
