Pharmacology

Question 1

Heparin MOA

Answer 1

activates anti-thrombin III

Question 2

Clopi MOA

Answer 2

P2Y12 inhibitor

Question 3

Abciximab MOA

Answer 3

glycoprotein IIb/IIIa inhibitor

Question 4

Dabigatran MOA

Answer 4

direct thrombin inhibitor

Question 5

Rivaroxaban MOA

Answer 5

direct factor X inhibitor

Question 6

Amiodarone MOA

Answer 6

Blocks K+ channels

Question 7

furosemide site of action

Answer 7

ascending loop of henle

Question 8

Furosemide MOA

Answer 8

inhibits the Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle

Question 9

ACE inhibitor MOA

Answer 9

inhibits conversion of angiotensin I to angiontensin II

Question 10

Where are ACE inhibitors activated?

Answer 10

Liver

Question 11

Common SE of ACE Inhibitors?

Answer 11

cough, angioedema, High K+

Question 12

Can you give ACE inhibitors in pregnancy?

Answer 12

No

Question 13

Beta Blockers MOA

Answer 13

Bind to beta-adrenoreceptors which prevents adrenaline/noradrenaline binding. This inhibits sympathetic effects

Question 14

Beta blockers SE

Answer 14

bronchospasms, cold peripheries, fatigue, erectile dysfunction

Question 15

Beta blockers CI

Answer 15

asthma, sick sinus syndrome, verapamil

Question 16

Ivabradine SE

Answer 16

visual effects, particular luminous phenomena, are common
headache
bradycardia, heart block

Question 17

Nicorandil MOA

Answer 17

potassium-channel activator with vasodilation through activation of guanylyl cyclase which results in increase cGMP

Question 18

Nicorandil SE

Answer 18

headache
flushing
skin, mucosal and eye ulceration
gastrointestinal ulcers including anal ulceration

Question 19

Renal causes of secondary hypertension

Answer 19

glomerulonephritis, pyelonephritis, PCKD

Question 20

Endocrine causes of secondary hypertension

Answer 20

primary hyperaldosteronism
Cushings, Liddles

Question 21

Drug causes of secondary hypertension

Answer 21

Steroids, COCP, NSAIDS

Question 22

What normally happens to BP during pregnancy?

Answer 22

Decreases until 20-24 weeks then increases back to pre-pregnancy level

Question 23

What is considered HTN in pregnancy

Answer 23

140/90 or an increase of 30/15

Question 24

1st line management of HTN

Answer 24

<55/T2DM: ACE inhibitor or ARB
>55 or A/AC: CCB

Question 25

2nd line management of HTN

Answer 25

A+C or A+D
C+A or C+D

Question 26

3rd line management of HTN

Answer 26

A+C+D

Question 27

4th line management of HTN

Answer 27

if K <4.5 - spiro
If K >4.5 - Alpha or beta blocker

Question 28

pathophysiology of HOCM

Answer 28

autosomal dominant
defect in gene encoding contractile proteins
LVH causes decreased compliance and decreased CO
septal hypertrophy causes LV outflow obstruction

Question 29

which specific genes can be affected in HOCM

Answer 29

beta-myosin heavy chain protein
myosin binding protein C

Question 30

How does HOCM present

Answer 30

mostly asymptomatic
exertional SOB
angina
syncope often following exercise
sudden death

Question 31

HOCM examination findings

Answer 31

jerky pulse, double apex beat
ESM
Pansytolic murmur

Question 32

Investigation HOCM

Answer 32

ECHO: MR SAM ASH
- MR
- systolic arterior motion of anterior mitral valve leaflets
asymmetric hypertrophyBo

Question 33

Biopsy HOCM

Answer 33

myofibrillar hypertrophy with chaotic and disorganised myocytes and fibrosisHOCM

Question 34

HOCM management

Answer 34

Amiodarone
Beta blockers
Cardioversion
Dual chamber pacemaker
Endocarditis prophylaxis

Question 35

Meds CI in HOCM

Answer 35

nitrates, ACE I, inotropes