USMLE World

Question 0

What drug is angioedema associated with?

Answer 0

ACE inhibitors

Question 1

What is the most serious and fatal toxicity of digoxin?

Answer 1

Ventricular tachyarrythmias

Others include nausea, anorexia, and color vision changes

Question 2

What are the cardiac meds with a negative chronotropic effect?

Answer 2

Beta blockers, non-DHP CCBs, cardiac glycosides, amiodarone and sotalol, cholinergic agonists (pilocarpine, rivastigmine)

Question 3

What are the commonly used drugs for MRSA?

Answer 3

Vancomycin, daptomycin, linezolid

Question 4

What are the “hyper” and “hypo” side effects of thiazides?

Answer 4

Hyper: uricemia, calcemia, glycemia, lipidemia
Hypo: tension, kalemia

Question 5

What drugs can cause Lupus-like syndromes?

Answer 5

Hydralazine, procainamide, quinidine, isoniazid, minocycline

Question 6

Dobutamine

Answer 6

Relatively selective B1 agonist, some B2 and a1. Increases HR, contractility, conduction velocity, and myocardial O2 consumption.

Used for acute heart failure w/decreased myocardial contractility (cardiogenic shock)

Question 7

What is the cardiac toxicity of daunorubicin?

Answer 7

-rubicins = anthracyclines. Dilated cardiomyopathy. Prevented with dexrazoxane.

Other toxicities include myelosuppresion, alopecia.

Question 8

Tx for a-fib

Answer 8

First line = CCBs or b-blockers

Second line = glycosides

Question 9

What is a good antihypertensive for a pt with prolonged AV conduction time?

Answer 9

Want something that will cause peripheral vasodilation and reflex tachycardia. DHP CCBs that are most effective in vascular smooth muscle such as nifiedipine

Question 10

Best aspirin alternative for angina with aspirin allergy

Answer 10

Clopidogrel (also synergistic with aspirin)
Blocks ADP receptors for platelet activation and aggregation
Prevent’s thromboembolic disease

Question 11

Drug of choice for paroxysmal supraventricular tachycardia, and common side effects

Answer 11

Adenosine; side effects include flushing, chest burning, hypotension, AV block

Question 12

Drug that can cause both bradycardia and prolong QT interval

Answer 12

Solatol - beta blocking causes bradycardia (prolongs PR), class 3 properties prolong QT

Question 13

Antiarrythmics that prolong qt interval

Answer 13

Class 1a and class 3

Question 14

Which antiarrythmics preferentially affect ischemic cardiac tissue, and thus are good for MI?

Answer 14

Class 1b: lidocaine, tocainide, mexiletine

Question 15

What is the intracellular consequence of nitrates at the target tissues?

Answer 15

NO –> increased cGMP –> deceased intracellular [Ca2+] –> decreased activity of MLCK –> dephosphorylation of myosin light chains

Question 16

Why must there be a “nitrate free” daily interval when dosing?

Answer 16

Nitrate tolerance develops rapidly. Normally this period is timed to night, when cardiac work is least.

Question 17

What is the effect of phosphodiesterase 3 inhibitors?

Answer 17

Increase cAMP, which causes increased cardiac contractility and vasodilation.

Question 18

What is Ebstein’s anomaly and what causes it?

Answer 18

Apical displacement of tricuspid valve leaflets, decreased RV volume, atrialization of RV

Caused by exposure to lithium in utero