Toxicities Flashcards
- Patient Case MCQ 1:
A 65-year-old male with a history of hypertension is started on a new medication. One week later, he complains of frequent urination. Which medication was most likely started?
a) Metoprolol
b) Amlodipine
c) Lisinopril
d) Hydrochlorothiazide
d) Hydrochlorothiazide
Rationale: Thiazide diuretics like hydrochlorothiazide can increase urination frequency as they increase the excretion of water from the body.
- Patient Case MCQ 2:
A patient presents with a persistent cough after starting a new antihypertensive medication. Which drug is the most likely culprit?
a) Losartan
b) Lisinopril
c) Amlodipine
d) Metoprolol
b) Lisinopril
Rationale: ACE inhibitors like lisinopril can cause a persistent cough due to the accumulation of bradykinin.
- Patient Case MCQ 3:
A 58-year-old female is noted to have a slow heart rate and fatigue after starting a new blood pressure medication. Which drug was she most likely prescribed?
a) Furosemide
b) Amlodipine
c) Propranolol
d) Valsartan
c) Propranolol
Rationale: Beta-blockers like propranolol can cause bradycardia and fatigue as side effects.
- Patient Case MCQ 4:
A patient with hypertension is started on a new medication. After a week, she complains of swollen ankles. Which drug was she most likely given?
a) Clonidine
b) Amlodipine
c) Lisinopril
d) Prazosin
b) Amlodipine
Rationale: Dihydropyridine calcium channel blockers like amlodipine can cause peripheral edema.
- Patient Case MCQ 5:
A man with a history of gout presents with an acute flare after starting a new hypertension medication. Which drug might have contributed?
a) Hydrochlorothiazide
b) Diltiazem
c) Minoxidil
d) Losartan
a) Hydrochlorothiazide
Rationale: Thiazide diuretics like hydrochlorothiazide can elevate uric acid levels, precipitating gout.
- Patient Case MCQ 6:
A patient presents with palpitations and headache after starting a new hypertension medication. Which drug is the most likely cause?
a) Furosemide
b) Hydralazine
c) Propranolol
d) Clonidine
b) Hydralazine
Rationale: Direct vasodilators like hydralazine can cause reflex tachycardia and headaches.
- Patient Case MCQ 7:
A pregnant woman is diagnosed with hypertension. Which of the following antihypertensive agents should be avoided?
a) Methyldopa
b) Losartan
c) Nifedipine
d) Hydrochlorothiazide
b) Losartan
Rationale: ARBs like losartan are contraindicated in pregnancy due to potential fetal toxicity.
- Patient Case MCQ 8:
A patient with hypertension is noted to have elevated potassium levels after starting a new medication. Which drug was he most likely prescribed?
a) Amlodipine
b) Valsartan
c) Furosemide
d) Metoprolol
b) Valsartan
Rationale: ARBs like valsartan can lead to hyperkalemia.
- Patient Case MCQ 9:
A patient presents with increased hair growth on her face after starting a new hypertension medication. Which drug might be responsible?
a) Minoxidil
b) Diltiazem
c) Lisinopril
d) Hydrochlorothiazide
a) Minoxidil
Rationale: Minoxidil, a direct vasodilator, can cause hypertrichosis or increased hair growth.
- Patient Case MCQ 10:
A 60-year-old male complains of breast enlargement after starting a new medication for his hypertension. Which medication is most likely responsible?
a) Hydrochlorothiazide
b) Spironolactone
c) Amlodipine
d) Metoprolol
b) Spironolactone
Rationale: Spironolactone, a potassium-sparing diuretic, can cause gynecomastia or breast enlargement in men.
- Patient Case MCQ 11:
A patient presents with constipation after starting a new antihypertensive medication. Which drug is the most likely cause?
a) Verapamil
b) Losartan
c) Minoxidil
d) Furosemide
a) Verapamil
Rationale: Non-dihydropyridine calcium channel blockers like verapamil can cause constipation.
- Patient Case MCQ 12:
A patient with hypertension has been started on a new medication. She now complains of dizziness when standing up from a seated position. Which medication is most likely responsible?
a) Prazosin
b) Amlodipine
c) Hydrochlorothiazide
d) Lisinopril
a) Prazosin
Rationale: Alpha-blockers like prazosin can cause orthostatic hypotension, leading to dizziness upon standing.
- Patient Case MCQ 13:
A patient with hypertension develops ringing in the ears after starting a new medication. Which drug might be the culprit?
a) Furosemide
b) Metoprolol
c) Amlodipine
d) Losartan
a) Furosemide
Rationale: Loop diuretics like furosemide can cause ototoxicity, which may manifest as tinnitus or ringing in the ears.
- Patient Case MCQ 14:
A patient started on a new hypertension medication complains of dry mouth and drowsiness. Which drug might be responsible?
a) Clonidine
b) Amlodipine
c) Valsartan
d) Furosemide
a) Clonidine
Rationale: Central alpha-2 agonists like clonidine can cause dry mouth and sedation.
- Patient Case MCQ 15:
A man with hypertension is found to have decreased sodium levels after starting a new medication. Which drug is most likely responsible?
a) Amlodipine
b) Valsartan
c) Hydrochlorothiazide
d) Propranolol
c) Hydrochlorothiazide
Rationale: Thiazide diuretics like hydrochlorothiazide can lead to hyponatremia or decreased sodium levels.
- Patient Case MCQ 16:
A patient with hypertension is noted to have increased calcium levels after starting a new medication. Which drug is most likely responsible?
a) Furosemide
b) Hydrochlorothiazide
c) Amlodipine
d) Lisinopril
b) Hydrochlorothiazide
Rationale: Thiazide diuretics like hydrochlorothiazide can lead to hypercalcemia or elevated calcium levels.
- Patient Case MCQ 17:
A patient recently started on a new antihypertensive medication complains of swelling in her face and lips. Which drug might be responsible?
a) Amlodipine
b) Lisinopril
c) Metoprolol
d) Furosemide
b) Lisinopril
Rationale: ACE inhibitors like lisinopril can cause angioedema, which is swelling of the deeper layers of the skin, often around the eyes and lips.
- Patient Case MCQ 18:
A patient develops bronchospasm after starting a new medication for hypertension. Which drug is the most likely culprit?
a) Amlodipine
b) Propranolol
c) Valsartan
d) Minoxidil
b) Propranolol
Rationale: Non-selective beta-blockers like propranolol can cause bronchospasm, especially in patients with asthma.
- Patient Case MCQ 19:
A patient with hypertension develops worsening of her peripheral arterial disease after starting a new medication. Which drug might be responsible?
a) Propranolol
b) Amlodipine
c) Valsartan
d) Furosemide
a) Propranolol
Rationale: Non-selective beta-blockers like propranolol can exacerbate peripheral arterial disease.
- Patient Case MCQ 20:
A patient complains of frequent muscle cramps after starting a new antihypertensive medication. Laboratory tests reveal low potassium levels. Which drug might be responsible?
a) Spironolactone
b) Lisinopril
c) Furosemide
d) Valsartan
c) Furosemide
Rationale: Loop diuretics like furosemide can cause hypokalemia or low potassium levels, leading to muscle cramps.
- Patient Case MCQ 21:
A 72-year-old male with hypertension is started on a new medication. He complains of difficulty urinating. Which medication was most likely started?
a) Amlodipine
b) Prazosin
c) Clonidine
d) Metoprolol
b) Prazosin
Rationale: Alpha-blockers like prazosin can exacerbate urinary symptoms, especially in males with an enlarged prostate.
- Patient Case MCQ 22:
A patient presents with severe headache and palpitations shortly after starting a new hypertension medication. Blood pressure is noted to be significantly elevated. Which drug might be responsible?
a) Clonidine
b) Amlodipine
c) Valsartan
d) Furosemide
a) Clonidine
Rationale: Abrupt withdrawal from clonidine can lead to a rebound hypertension, which can present with headache and palpitations.
- Patient Case MCQ 23:
A patient with hypertension is started on a new medication. After a week, she complains of flushing and warmth. Which drug was she most likely given?
a) Amlodipine
b) Metoprolol
c) Lisinopril
d) Hydralazine
d) Hydralazine
Rationale: Direct vasodilators like hydralazine can cause flushing due to vasodilation.
- Patient Case MCQ 24:
A pregnant woman with hypertension is started on a medication known to cause positive Coombs test and hemolytic anemia. Which drug was she most likely prescribed?
a) Minoxidil
b) Methyldopa
c) Amlodipine
d) Valsartan
b) Methyldopa
Rationale: Methyldopa can cause a positive direct Coombs test and hemolytic anemia.
- Patient Case MCQ 25:
A man with hypertension complains of nightmares and vivid dreams after starting a new medication. Which drug might be responsible?
a) Amlodipine
b) Propranolol
c) Valsartan
d) Furosemide
b) Propranolol
Rationale: Beta-blockers like propranolol can cause nightmares and vivid dreams as side effects.
- Patient Case MCQ 26:
A patient recently diagnosed with hypertension is prescribed a medication that acts by blocking the activation of angiotensin II receptors. Which drug was he most likely given?
a) Lisinopril
b) Losartan
c) Minoxidil
d) Amlodipine
b) Losartan
Rationale: Losartan is an angiotensin II receptor blocker (ARB) that prevents the activation of angiotensin II receptors.
- Patient Case MCQ 27:
A patient presents with electrolyte abnormalities after starting a new hypertension medication. Which drug is known to cause both hyperkalemia and hyponatremia?
a) Spironolactone
b) Amlodipine
c) Propranolol
d) Hydrochlorothiazide
a) Spironolactone
Rationale: Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia. While less common, it can also contribute to hyponatremia.
- Patient Case MCQ 28:
A patient with a history of asthma is noted to have wheezing after starting a new hypertension medication. Which drug was she most likely prescribed?
a) Amlodipine
b) Propranolol
c) Valsartan
d) Hydrochlorothiazide
b) Propranolol
Rationale: Non-selective beta-blockers like propranolol can cause bronchospasm, especially in patients with asthma.
- Patient Case MCQ 29:
A patient recently started on a hypertension medication presents with lethargy, confusion, and muscle weakness. Lab tests reveal elevated potassium levels. Which drug might be responsible?
a) Amlodipine
b) Hydrochlorothiazide
c) Lisinopril
d) Furosemide
c) Lisinopril
Rationale: ACE inhibitors like lisinopril can lead to hyperkalemia or elevated potassium levels, which can present with symptoms like lethargy, confusion, and muscle weakness.
- Patient Case MCQ 30:
A 70-year-old male with hypertension and benign prostatic hyperplasia is started on a new medication to help with both conditions. He reports improvement in his urinary symptoms. Which medication was he most likely prescribed?
a) Amlodipine
b) Prazosin
c) Valsartan
d) Hydrochlorothiazide
b) Prazosin
Rationale: Alpha-blockers like prazosin are used to treat hypertension and can also alleviate urinary symptoms in males with benign prostatic hyperplasia.
Mr. Johnson, a 54-year-old male, presents with chest pain that worsens with activity and relieves with rest. He has been prescribed nitroglycerin.
Question:
Which of the following is a common side effect of nitroglycerin?
A) Diarrhea
B) Headache
C) Hyperkalemia
D) Bronchospasm
B) Headache
Rationale:
Nitroglycerin, an organic nitrate, commonly causes headaches due to its vasodilatory effects.
Mrs. Lee, a 62-year-old female, has angina and asthma. She has been prescribed a new medication for her angina.
Question:
Which drug should be used with caution in Mrs. Lee?
A) Nifedipine
B) Ranolazine
C) Propranolol
D) Isosorbide dinitrate
C) Propranolol
Rationale:
Beta-blockers like Propranolol can cause bronchospasm, especially in patients with asthma.
Mr. Ahmed, a 58-year-old male with angina, has been experiencing constipation recently after starting a new medication.
Question:
Which drug is likely responsible for his constipation?
A) Verapamil
B) Nitroglycerin
C) Atenolol
D) Ranolazine
A) Verapamil
Rationale:
Verapamil, a calcium channel blocker, is known to cause constipation.
Mrs. Smith, a 65-year-old female, is on a medication for angina which can prolong the QT interval.
Question:
Which medication is Mrs. Smith likely on?
A) Metoprolol
B) Amlodipine
C) Ranolazine
D) Aspirin
C) Ranolazine
Rationale:
Ranolazine is known to cause QT prolongation.
Mr. Rodriguez, a 60-year-old male with angina, has been experiencing peripheral edema after starting a new medication.
Question:
Which drug is likely responsible for his peripheral edema?
A) Nifedipine
B) Propranolol
C) Isosorbide dinitrate
D) Ranolazine
A) Nifedipine
Rationale:
Nifedipine, a calcium channel blocker, can cause peripheral edema.
Mrs. Green, a 59-year-old female, experiences chest pain that is relieved by sublingual nitroglycerin but returns upon exertion.
Question:
What type of angina is Mrs. Green likely experiencing?
A) Stable angina
B) Unstable angina
C) Variant angina
D) Microvascular angina
A) Stable angina
Rationale:
Stable angina is characterized by chest pain that occurs with exertion and is relieved by rest or nitroglycerin.
Mr. Patel, a 57-year-old male, has been prescribed a drug that inhibits the late phase of the inward sodium current, reducing diastolic wall tension and oxygen consumption.
Question:
Which drug has Mr. Patel been prescribed?
A) Atenolol
B) Nifedipine
C) Ranolazine
D) Nitroglycerin
C) Ranolazine
Rationale:
Ranolazine works by inhibiting the late phase of the inward sodium current.
Mrs. Turner, a 63-year-old female, is on a medication for her angina which she has been told can mask the symptoms of hypoglycemia.
Question:
Which medication is Mrs. Turner likely on?
A) Propranolol
B) Verapamil
C) Isosorbide dinitrate
D) Ranolazine
A) Propranolol
Rationale:
Beta-blockers like Propranolol can mask the symptoms of hypoglycemia.
Mr. Kim, a 56-year-old male with a history of angina, recently started experiencing dizziness after a new medication was added to his regimen.
Question:
Which drug is likely responsible for his dizziness?
A) Aspirin
B) Nitroglycerin
C) Nifedipine
D) Atenolol
C) Nifedipine
Rationale:
Nifedipine, a calcium channel blocker, can cause dizziness due to its vasodilatory effects.
Mrs. Walker, a 61-year-old female with angina, was recently prescribed a medication that can cause reflex tachycardia.
Question:
Which drug is she likely on?
A) Amlodipine
B) Nitroglycerin
C) Ranolazine
D) Propranolol
B) Nitroglycerin
Rationale:
Nitroglycerin can cause reflex tachycardia due to its vasodilatory effects.
Mr. White, a 67-year-old male, has been prescribed a drug that reduces myocardial oxygen demand by decreasing heart rate and contractility.
Question:
Which drug has he been prescribed?
A) Verapamil
B) Nitroglycerin
C) Atenolol
D) Nifedipine
C) Atenolol
Rationale:
Atenolol, a beta-blocker, reduces myocardial oxygen demand by decreasing heart rate and contractility.
Mrs. Harris, a 66-year-old female, has been prescribed a drug for her angina that also has a beneficial effect on her hypertension.
Question:
Which drug is she likely on?
A) Nitroglycerin
B) Ranolazine
C) Verapamil
D) Isosorbide dinitrate
C) Verapamil
Rationale:
Verapamil, a calcium channel blocker, is used in the treatment of both angina and hypertension.
Mr. Martinez, a 68-year-old male with angina, has been prescribed a drug that can cause hair growth as a side effect.
Question:
Which drug has he been prescribed?
A) Ranolazine
B) Atenolol
C) Nifedipine
D) Minoxidil
D) Minoxidil
Rationale:
While Minoxidil is primarily known for its use in hair growth, it is also a potent vasodilator and can be used in severe hypertension. Hair growth is a known side effect.
Mrs. Thompson, a 70-year-old female with angina, is on a medication that inhibits platelet aggregation, reducing the risk of thrombus formation.
Question:
Which medication is Mrs. Thompson likely on?
A) Ranolazine
B) Amlodipine
C) Clopidogrel
D) Verapamil
C) Clopidogrel
Rationale:
Clopidogrel is an antiplatelet agent that inhibits platelet aggregation.
Mr. Davis, a 55-year-old male, presents with chest pain that occurs at rest and is associated with transient ECG changes but without an increase in cardiac enzymes.
Question:
What type of angina is Mr. Davis likely experiencing?
A) Stable angina
B) Unstable angina
C) Variant angina
D) Microvascular angina
B) Unstable angina
Rationale:
Unstable angina can occur at rest and is associated with ECG changes but without an increase in cardiac enzymes.
Mrs. Anderson, a 58-year-old female, has been prescribed a drug for angina that decreases afterload.
Question:
Which drug has she been prescribed?
A) Atenolol
B) Ranolazine
C) Nifedipine
D) Nitroglycerin
C) Nifedipine
Rationale:
Nifedipine, a calcium channel blocker, causes arterial dilation and reduces afterload.
Mr. Lewis, a 64-year-old male with angina, was recently prescribed a drug that can lead to an increased risk of bleeding.
Question:
Which drug has he been prescribed?
A) Propranolol
B) Aspirin
C) Amlodipine
D) Ranolazine
B) Aspirin
Rationale:
Aspirin is an antiplatelet agent and can increase the risk of bleeding.
Mrs. Jackson, a 60-year-old female, is on a medication that reduces anginal frequency and increases exercise tolerance but doesn’t reduce the risk of myocardial infarction or death.
Question:
Which medication is Mrs. Jackson likely on?
A) Ranolazine
B) Clopidogrel
C) Nitroglycerin
D) Lisinopril
A) Ranolazine
Rationale:
Ranolazine helps in reducing anginal frequency and increasing exercise tolerance, but it doesn’t reduce the risk of myocardial infarction or death.
Mr. Wilson, a 56-year-old male, presents with chest pain that is most severe at night and is associated with transient ECG changes.
Question:
What type of angina is Mr. Wilson likely experiencing?
A) Stable angina
B) Unstable angina
C) Variant angina
D) Microvascular angina
C) Variant angina
Rationale:
Variant angina (Prinzmetal’s angina) occurs at rest, often at night, and is associated with transient ECG changes due to coronary artery spasm.
Mrs. Taylor, a 59-year-old female, is on a drug for angina that can also be beneficial for her migraines.
Question:
Which drug is she likely on?
A) Nitroglycerin
B) Propranolol
C) Ranolazine
D) Clopidogrel
B) Propranolol
Rationale:
Propranolol, a beta-blocker, is used in the treatment of angina and is also beneficial for migraines.
Case 21:
Mr. Moore, a 62-year-old male, presents with chest pain. He has been prescribed a drug that acts by increasing the intracellular concentration of cyclic GMP.
Question:
Which drug has he been prescribed?
A) Verapamil
B) Nitroglycerin
C) Ranolazine
D) Atenolol
B) Nitroglycerin
Rationale:
Nitroglycerin acts by increasing the intracellular concentration of cyclic GMP, leading to smooth muscle relaxation and vasodilation.
Mrs. Martin, a 64-year-old female, is experiencing reflex tachycardia after starting a new medication for her angina.
Question:
Which drug is likely responsible for this side effect?
A) Atenolol
B) Ranolazine
C) Nifedipine
D) Isosorbide dinitrate
C) Nifedipine
Rationale:
Nifedipine, a calcium channel blocker, can cause reflex tachycardia due to its vasodilatory effects.
Mr. Thomas, a 60-year-old male, was prescribed a drug that can lead to bradycardia and AV block.
Question:
Which drug is he likely on?
A) Nitroglycerin
B) Verapamil
C) Ranolazine
D) Clopidogrel
B) Verapamil
Rationale:
Verapamil, a calcium channel blocker, can lead to bradycardia and AV block.
Mrs. Garcia, a 63-year-old female, is on a medication that reduces myocardial oxygen demand by decreasing preload.
Question:
Which medication is Mrs. Garcia likely on?
A) Amlodipine
B) Atenolol
C) Nitroglycerin
D) Ranolazine
C) Nitroglycerin
Rationale:
Nitroglycerin reduces myocardial oxygen demand by causing venodilation, which decreases preload.
Mr. Walker, a 66-year-old male with a history of angina, has been prescribed a drug that primarily causes arterial dilation.
Question:
Which drug has he been prescribed?
A) Nitroglycerin
B) Isosorbide dinitrate
C) Nifedipine
D) Propranolol
C) Nifedipine
Rationale:
Nifedipine, a calcium channel blocker, primarily causes arterial dilation, reducing afterload.
Mrs. Hall, a 62-year-old female, has been experiencing fatigue and depression after starting a new medication for her angina.
Question:
Which drug is likely responsible for these side effects?
A) Nifedipine
B) Ranolazine
C) Atenolol
D) Nitroglycerin
C) Atenolol
Rationale:
Beta-blockers like Atenolol can cause fatigue and depression as side effects.
Case 27:
Mr. Adams, a 57-year-old male, was prescribed a drug that can lead to bronchospasm in asthmatic patients.
Question:
Which drug has he been prescribed?
A) Nifedipine
B) Nitroglycerin
C) Propranolol
D) Ranolazine
C) Propranolol
Rationale:
Beta-blockers like Propranolol can cause bronchospasm, especially in patients with asthma.
Mrs. Lopez, a 55-year-old female with a history of angina and hypertension, has been prescribed a drug that acts on both cardiac and vascular smooth muscle.
Question:
Which drug has she been prescribed?
A) Amlodipine
B) Nitroglycerin
C) Atenolol
D) Ranolazine
A) Amlodipine
Rationale:
Amlodipine, a calcium channel blocker, acts on both cardiac and vascular smooth muscle, leading to relaxation and vasodilation.
Mr. Allen, a 59-year-old male, has been prescribed a drug that acts by inhibiting the late phase of the inward sodium current in the heart.
Question:
Which drug has he been prescribed?
A) Verapamil
B) Nitroglycerin
C) Atenolol
D) Ranolazine
D) Ranolazine
Rationale:
Ranolazine works by inhibiting the late phase of the inward sodium current, reducing diastolic tension and oxygen consumption in the heart.
Mrs. Roberts, a 63-year-old female with angina, was recently prescribed a drug that can lead to hyperkalemia as a side effect.
Question:
Which drug is she likely on?
A) Nitroglycerin
B) Verapamil
C) Ranolazine
D) Lisinopril
D) Lisinopril
Rationale:
Lisinopril, an ACE inhibitor, can lead to hyperkalemia as a side effect.
- Case: A 58-year-old man with a history of chronic heart failure presents to the clinic complaining of increasing dyspnea and fatigue. His current medications include enalapril and metoprolol.
Question: Which of the following side effects is most commonly associated with enalapril?
a. Bradycardia
b. Cough
c. Bronchospasm
d. Visual disturbances
b. Cough
Rationale: Enalapril is an ACE inhibitor. A common side effect of ACE inhibitors is a persistent dry cough, which results from the accumulation of bradykinin in the respiratory tract.
- Case: A 70-year-old woman is being treated for heart failure. She is currently taking digoxin.
Question: Which symptom would be most concerning for digoxin toxicity?
a. Yellow vision
b. Diarrhea
c. Hypertension
d. Dry mouth
a. Yellow vision
Rationale: Yellow vision (xanthopsia) is a classic sign of digoxin toxicity. Other symptoms include nausea, vomiting, and arrhythmias.
- Case: A 60-year-old man with heart failure is prescribed spironolactone.
Question: What side effect is more commonly associated with spironolactone than with other drugs in its class?
a. Hyperkalemia
b. Gynecomastia
c. Cough
d. Bradycardia
b. Gynecomastia
Rationale: Spironolactone, an aldosterone antagonist, can cause gynecomastia due to its anti-androgenic effects.
- Case: A 65-year-old woman with heart failure is started on a beta-blocker.
Question: Which of the following is a common side effect of beta-blockers?
a. Hypertension
b. Tachycardia
c. Fatigue
d. Diarrhea
c. Fatigue
Rationale: Fatigue is a common side effect of beta-blockers due to their negative inotropic and chronotropic effects.
- Case: A patient with heart failure is prescribed sacubitril/valsartan.
Question: Which mechanism of action is associated with sacubitril?
a. Aldosterone antagonism
b. Beta blockade
c. Neprilysin inhibition
d. ACE inhibition
c. Neprilysin inhibition
Rationale: Sacubitril is a neprilysin inhibitor. Neprilysin is an enzyme that degrades atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), which are beneficial in heart failure. By inhibiting neprilysin, sacubitril increases the levels of ANP and BNP.
- Case: A 50-year-old man with heart failure is started on ivabradine.
Question: Which of the following is a known side effect of ivabradine?
a. Visual disturbances
b. Cough
c. Diarrhea
d. Hypertension
a. Visual disturbances
Rationale: Ivabradine can cause visual disturbances known as phosphenes.
- Case: A patient with heart failure is prescribed an SGLT2 inhibitor.
Question: Which of the following side effects is most commonly associated with SGLT2 inhibitors?
a. Bronchospasm
b. Genital fungal infections
c. Gynecomastia
d. Dry cough
b. Genital fungal infections
Rationale: SGLT2 inhibitors increase the excretion of glucose in the urine, which can predispose to genital fungal infections.
- Case: A 68-year-old man with heart failure is given milrinone.
Question: What is the primary mechanism of action of milrinone?
a. Beta blockade
b. ACE inhibition
c. Phosphodiesterase inhibition
d. Aldosterone antagonism
c. Phosphodiesterase inhibition
Rationale: Milrinone is a phosphodiesterase inhibitor, which increases intracellular cAMP, leading to increased myocardial contractility and vasodilation.
- Case: A patient with heart failure is given a diuretic.
Question: Which of the following electrolyte imbalances is most commonly associated with the use of loop diuretics?
a. Hyperkalemia
b. Hypernatremia
c. Hypokalemia
d. Hypercalcemia
c. Hypokalemia
Rationale: Loop diuretics, such as furosemide, can lead to the excretion of potassium, causing hypokalemia.
- Case: A 72-year-old woman with heart failure is started on an ARB.
Question: Which of the following side effects is more specific to ARBs compared to ACE inhibitors?
a. Hyperkalemia
b. Renal dysfunction
c. Cough
d. Angioedema
c. Cough
Rationale: While both ARBs and ACE inhibitors can cause hyperkalemia and renal dysfunction, cough is less commonly associated with ARBs than with ACE inhibitors.
- Case: A patient with a history of asthma and heart failure requires pharmacological management.
Question: Which class of medication should be used with caution in this patient due to the risk of bronchospasm?
a. Beta-blockers
b. Diuretics
c. ACE inhibitors
d. Aldosterone antagonists
a. Beta-blockers
Rationale: Beta-blockers can cause bronchospasm, especially in patients with a history of asthma.
- Case: A 55-year-old man with heart failure is prescribed hydralazine and isosorbide dinitrate.
Question: What is the primary benefit of this combination therapy in heart failure?
a. Increased diuresis
b. Vasodilation
c. Beta blockade
d. Inhibition of aldosterone
b. Vasodilation
Rationale: The combination of hydralazine (an arterial vasodilator) and isosorbide dinitrate (a venous vasodilator) promotes vasodilation, decreasing both preload and afterload in heart failure.