Quiz 3 Anti arrhythmia/Anti hyperlipidemia Flashcards
A 58 year old woman is being treated for chronic suppression of a ventricular arrhythmia. After two months of therapy, she complains about feeling tired all the time. Examination reveals a resting heart rate of ten beats per minute lower than her previous rate. Her skin is cool and clammy. Laboratory test results indicate low thyroxin and elevated thyroid-stimulating hormone levels. Which of the following antiarrhythmic drugs is the likely cause of these signs and symptoms?
A. Amiodarone B. Quinidine C. Propanolol D. Verapamil E. Procainamide
A. Amiodarone
Which of the following drugs reduces LDL cholesterol by inhibiting an intestinal transport protein?
A. Atorvastatin B. Cholestyramine C. Gemfibrozil D. Ezetimibe E. Niacin
D. Ezetimibe
A 25 year old woman comes to her family physician for a routine check-up. Her physical examination shows a mildly overweight woman but is otherwise unremarkable. A fasting lipid panel, however, shows an LDL cholesterol level of 310 mg/dL, HDL cholesterol level of 42 mg/dL, triglyceride level of 150 mg/dL, and total cholesterol level of 382 mg/dL. Because a diagnosis of familial hpercholesterolemia is suspected, the doctor initiates treatment of her condition. Soon after starting treatment, however, she presents with myalgias. Laboratory values show elevated levels of aspartate aminotransferase, alanine aminotransferase, and creatinine kinase. Which of the following interventions is most likely responsible for the patient's myalgias? A. B complex vitamins B. hormone replacement therapy C. Liver transplant D. Low HDL E. Statin Medications
E. Statin Medications
A 35 year old woman appears to have familial combined hyperlipidemia. Her serum concentrations of total cholesterol, LDL cholesterol, and triglyceride are elevated. Her serum concentration of HDL cholesterol is somewhat reduced. If this patient is pregnant, which of the following drugs should be avoided because of a risk of harming the fetus? A. Cholestyramine B. Cholestipol C. Pravastatin D. Niacin E. Vitamin B3
C. Pravastatin
NO STATINS IN PREGNANCY
***A patient with a supraventricular tachycardia has an atrial rate of of 280/min with a ventricular rate of 140/min via a 2:1 AV nodal transmission. After treatment with a drug, the atrial rate slowed to 180/min, but the ventricular rate increased to 180/min. Which of the following drugs was most likely to have been given to this patient?
A. Adenosine B. Quinidine C. Digoxin D. Esmolol E. Verapamil
B. Quinidine (increase in AV conduction)
A 67 year old woman is brought to the emergency department with complaints of fever, malaise and the recent appearance of a malar “butterfly” rash on the face. The patient states that she is taking one medication for arrhythmias. If she is positive for antihistone and is mildly anemic, which of the following medications is she most likely taking?
A. Mexiletine B. Disopyramide C. Flecainide D. Procainamide E. Digoxin
D. Procainamide
***Which one of the following drugs causes a decrease in liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway?
A. Probucol B. Niacin C. Cholestyramine D. Lovastatin E. Fenofibrate
B. Niacin
If quinidine and digoxin are administered concurrently, which of the following effects does quinidine have on digoxin?
A. The absorption of digoxin form the GI tract is decreased
B. The effect of digoxin on the AV node is antagonized
C. The concentration of digoxin in the plasma is increased
D. The metabolism of digoxin is prevented
E. The ability of digoxin to inhibit the Na+K+ stimulated ATPase is reduced
C. The concentration of digoxin in the plasma is increased
A 44 year old obese man has extremely high plasma triglyceride levels, but cholesterol levels are within normal limits. Following treatment with a drug specifically indicated for hypertriglyceridemia, triglyceride levels decrease to almost normal. Which of the following agents is most likely to have caused this desired change?
A. Atorvastatin B. Cholestyramine C. Ezitemibe D. Colestipol E. Gemfibrozil
E. Gemfibrozil
Gemfibrozil - “fibrate” - clofibrate, ferofibrate +LPL Decrease TG
A patient in the coronary care unit develops episodes if paroxysmal AV nodal reentrant tachycardia (PSVT). Which of the following would generally be considered a first-line drug for promptly stopping the arrhythmia?
A. Adenosine B. Edrophonium C. Digoxin D. Phenylephrine E. Propranolol
A. Adenosine
***Following a myocardial infaraction, a patient in the emergency room of a hospital develops ventricular tachycardia. The best way to manage this situation is with the administration of
A. Dilitazem B. Flecainide C. Amiodorone D. Lidocaine E. Adenosine
D. Lidocaine
A 21 year old man is brought by his roommate to the emergency department because of abrupt onset of shortness of breath, mild chest pain and sensation of rapid heart beating. ECG documents. Supraventricular arrhythmias wiht pulse of 200 per minute. Under ECG monitoring gentle massage over right carotid sinus is attempted but attack doesn’t cease. Which of the following is most appropriate next step of managaement?
A. IV Lignocaine B. Further carotid massage C. IV Procainamide D. IV Verapamil E. IV Amlodipine
D. IV Verapimil
A 68 year old woman with a history of coronary insufficiency suffers a heart attack and begins taking anticoagulant. One year later, her physician prescribes colestyramine to treat her hypercholesterolemia. A few months after the patient begins colestyramine treatment, she develops gastrointestinal bleeding and is found to have hypothrombinemia. Which of the following mechanisms accounts for how colestyramine causes hypoprothrombinemia?
A. Distribution B. Absorption C. competes with plasma proteins D. Metabolism E. Pharmacodynamics
B. Absorption
***A 63 year old woman develops tachyarrhythmia after recovering from an MI. Her physician prescribes a new medication. Five montgs later she presents to the clinic complaining of difficulty breathing and dry coughing. Neither of which she has experienced previously. Physical examination reveals decreased breath sounds. After ruling out cardiac causes for her symptoms, her physician conducts a series of tests. X ray of the chest shows decreased lung volume. Lung function tests show decreased vital capacity. Which agent most likely caused her current condition?
A. Amiodarone B. Procainamide C. Quinidine D. Verapamil E. Proponolol
A. Amiodarone
Restrictive lung disease
Amiodarone - thyroid dysfunction, causes pulmonary fibrosis and smurf skn.
levels checked during her company's "Wellness Fair" since she has a family history of "bad lipids": her findising include a non fasting high density lipoprotein (HDL) cholesterol concetration of 58mg/dL, total cholesterol concentration of 310 mg/dL and tendinous xanthomas. Results of a fasting lipoprotein profile indicate no elevation in TAG concentration but elevated LDL cholesterol concentration. The woman is counseled about appropriate dietary modifications and is instructing to begin therapy with drug that blocks the synthesis of cholesterol. Which drug? A. Gemfibrosil B. Niacin C. Lovastatin D. Colestipol E. Cholestyramine
C. Lovastatin
