Ratio 2nd Shifting Exam

Question 1

A 70 year old patient complains of paresthesias and occasional nausea with one of her maintenance drugs. She also has hyperchloremic metabolic acidosis. She is probably taking this anti-HTN drug

Answer 1

Acetazolamide:

It‟s known for causing hyperchloremic metabolic acidosis (Metabolic acidosis is due to decreased bicarbonate stores in the body. Remember the concept of anion gap, since nagdecrease ng concentration of bicarbonate, another anion should fill its place, therefore may increase Cl concentration, hence, hyperchloremic metabolic acidosis.)

ACIDazolamide causes ACIDOSIS

Question 2

Type of acid-base imbalance caused by:

1. Carbonic anhdyrase inhibitor
2. Loop diuretics
3. Thiazides
4. Potassium-sparing diuretics

Answer 2

1. Carbonic anhdyrase inhibitor: hyperchloremic metabolic acidosis
2. Loop diuretics: hypokalemic metabolic alkalosis
3. Thiazides: hypokalemic metabolic alkalosis
4. Potassium-sparing diuretics : hyperchloremic metabolic acidosis

Question 3

type of diuretics given in combination with saline infusion would be most useful in the treatment of severe hypercalcemia?

Answer 3

Loop diuretic (furosemide)

Question 4

This drug increases the formation of dilute urine in water-loaded subjects and is used to treat SIADH:

Answer 4

Conivaptan (ADH antagonist)

Question 5

this antihypertensive inhibitis vesicular catecholamine transport and storage

Answer 5

Reserpine

Question 6

DOC for prinzmetal angina

Answer 6

CCBs

Question 7

which is more cardioselective between verapamil and diltiazem

Answer 7

verapamil

Question 8

node that is preferentially acted upon by verapamil vs diltiazem

Answer 8

verapamil: AV node
diltiazem: SA node

Question 9

This drug is an enzyme that converts plasminogen to plasmin:

Answer 9

streptokinase

Question 10

40 y/o female has a history of frequent episodes of renal colic with calcium-containing renal stones. What is the most appropriate diuretic to give?

Answer 10

Thiazides can be given in nephrolithiasis due to hypercalciuria by enhancing Ca reabsorption in the proximal tubules.

Furosemide will increase urinary Ca excretion which will aggravate the problem.

Question 11

A patient with long-standing diabetic nephropathy and hyperkalemia and recent-onset mild heart failure requires a diuretic. Which of the following agents would be the safest to give?

A. Acetazolamide
B. HCTZ
C. Triamterene
D. Amiloride

Answer 11

Usually you give ACEI/ARBs in diabetics and patients with HF pero avoid these drugs din if the patient has hyperkalemia.

In this case, HTCZ can be given

Question 12

Anticoagulant that:

1. Blocks the carboxylation of several glutamate residues in prothrombin and factors 7,9,10
2. Binds tightly to- and produces a conformational change to- antithrombin
3. Binds directly to the active site of thrombin

Answer 12

1. Warfarin
2. Heparin
3. Dabigatran

Question 13

anticoagulant used in prevention of VTE following hip or knee surgery and stroke in patients with AF

Answer 13

Rivaroxaban (Factor Xa inhibitor)

Question 14

Diuretic that can cause hyperkalemia

Answer 14

potassium sparing (Spironolactone)

Question 15

diuretic that can cause hyperglycemia

Answer 15

HTCZ

Question 16

diuretic that can cause pulmonary edema

Answer 16

mannitol

Question 17

antiplatelet used for intermitted claudication

Answer 17

cilostazol (PDE inhibitor)

Question 18

antiplatelet used for px who just had percutaneous coronary intervention (PCI)

Answer 18

GII2/IIIa inhibitors (Abciximab)

Question 19

only types of anti-HTN drugs that can decrease cardiac output (the rest decreases TPR)

Answer 19

diuretics and betablockers

Question 20

only types of anti-HTN that can both decrease CO and decrease TPR

Answer 20

diuretics and betablockers

Question 21

Has beta blocking and vasodilating property, useful in the treatment of hypertensive emergency

Answer 21

labetalol

Question 22

Beta 1 selective blocker that is rapidly metabolized via hydrolysis by RBC esterases; used for management of intraoperative hypertension

Answer 22

Esmolol