Which of the following is not safe during pregnancy?
ACEI
ARB
Aliskiren
None are safe during pregnancy
Which of the following metabolic changes is not seen with use of loop diuretics?
Decrease in Ca
Decrease in K
Increase in Mg
Increase in Glucose
Which of the following is not a side effect of thiazides?
Hyponatremia
Metabolic alkalosis
Hypouricemia
Sexual dysfunction
Which of the following G IIb/IIIa receptor antagonists has a long half life and is irreversible?
ASA
Tirofiban
Abciximab
Eptifibatide
Which of the following is not a side effect of osmostic diuretics?
Electrolyte imbalance
Anuria
Local pain and venous irritation
Acute renal failure
Which of the following is a characteristic of LMWH?
Low bioavailability
Monitored with PTT
Inexpensive
Renally excreted
Which of the following is not a side effect of Aliskiren?
Decrease in uric acid
Diarrhea
Abdominal pain
Angioedema
Which of the following is not correct regarding eplerenone?
It is more expensive than spironolactone
Less endocrine-related side effects than spironolactone
Lower chance of hyperkalemia
Higher affinity for aldosterone receptors
Which of the following is not a side effect of ACEI?
Cough
Hypotension
Gynecomastia
Hyperkalemia
Acetazolamide causes metabolic alkalosis because you excrete bicarbonate, and therefore it is best to administer this diuretic to metabolic acidic patients.
Which of the following are better to avoid with use of potassium-sparing diuretics?
Lithium
Eplerenone
Amiloride
Choose which of the following you would administer to a CKD patient
Thiazide
CCB
Which of the following diuretics act on the distal convoluted tubule to block sodium reabsorption?
Aldosterone antagonists
Thiazides
Loop diuretics
CAIs
You always have drug interactions with NSAIDS with use of diurectics because they inhibit prostaglandins which antagonizes the action of diurectics
Which diuretic would you not want to use in a patient who has gout?
Sodium channel blockers
Aldosterone receptor antagonists
How does Conivaptan promote free water diuresis?
By stimulating cGMP resulting in vascular smooth muscle relaxation
By being excreted unchanged and causing water to be retained within the proximal tubule and descending loop of Henle due to the freely permeable water
By blocking the epithelial sodium channels on principal cells and cause sodium excretion
By antagonizing vasopressing
Lisinopril antagonizes the AT1 receptor
Which of the following metabolic changes would you see with the use of a thiazide?
Increase Mg
Increase Ca
Decrease glucose
Increase in potassium
Hydrochlorthiazide is used more than chlorthalidone because it is more potent and research has shown that it produces a greater reduction in systolic blood pressure.
In which of the following conditions would not benefit from the use of vasopressin receptor antagonists?
Urinary frequency
CHF
cirrhosis
SIADH
Which of the following is a side effect Bosentan?
Epistaxis
Visual disturbances
Liver cirrhosis
Dyspepsia
Which of the following would require careful dosing in a renal failure patient?
Fondaparinux
Warfarin
Argatraban
Which of the following drug combinations would not be beneficial?
Metolazone and Bumetanide
HCTZ and ARB
ACEI and ARBs
Furosemide and Lisinopril
Liver toxicity is a side effect of tolvaptan?
Which of the following have short half-lives
UFH
Vorapaxar
Why do we need to overlap warfarin and heparin or LMWH in a patient with a new VTE?
Because you want to deactivate antithrombin
It takes about 5 days to replace activated clotting factors with dysfunctional clotting factors
It takes about 5 days to replace Protein C and Protein S
You should never overlap warfarin with LMWH or UFH
Which of the following antiplatelets can cause dyspnea?
Prasugrel
Ticagrelor
Clopidogrel
Ticlopidine
Which of the following prostanoids can cause epistaxis?
Epoprosternol
Iloprost
Treprostinil (Remodulin)
Treprostinil (Tyvaso)
Which of the following is safe during lactation?
Dabigatran
Direct X inhibitors
Indirect X inhibitors
Which of the following antiplatelets can be used when a patient has had a cardiac event while taking clopidogrel?
Which of the following antiplatelets is used with aspirin in post-ACS patients?
Liver toxicity is a side effect of conivaptan
Which of the following antiplatelets is hardly used in clinical practice and can cause neutropenia?
Which of the following antiplatelets is contraindicated for patients with a history of stroke/TIA?
Ranolazine can be used ONLY in acute angina attacks
It is important to hold indirect factor X inhibitors for at least 48 hours
Why is it important to place a patient who develops HIT on another anticoagulant?
To decrease the platelet count.
To prevent a prothrombotic condition
To prevent bleeding.
To induce a prothrombotic condition
Which of the following is not part of the treatment for HIT?
Stop heparin products
Stop warfarin until platelet count is above 150,000
Use alternative anticoagulants
Give a high dose of warfarin when restarting
Which of the following drugs can cause serious cardiovascular and thromboemolic events if dose and hemoglobin range is not taken into account?
Calcitriol
ERAs
ESAs
Dopamine
Which of the following is not a characteristic of argatraban?
Monitored by PTT
Hepatic elimination
Decrease in INR
Can be used for treatment of HIT
Which of the following is absolutely not safe during pregnancy?
Heparin/LMWH
IV DTIs
Which of the following is correct regarding warfarin?
It causes less GI bleeding than dabigatran
It causes more GI bleed than Rivaroxaban
It causes less GI bleeds than Apixaban
It causes less ICH in Direct Factor X inhibitors and Dabigatran
How long should one hold warfarin before major surgery
24 hours
48 hours
6 hours
5 days
Which of the following has no reversal agent or is irreversible?
LMHW
Rivaroxaban
Which of the following is not a side effect of Acetazolamide?
Metabolic acidosis
Kidney stones
Paresthesia
Hypernatremia
Which of the following is NOT a cause for concern of sodium nitroprusside-induce cyanide toxicity?
Renal dysfunction
Increasing dose during therapy
Post-MI
Increasing duration of therapy
Which of the following is true about SELECTIVE beta blockers? Choose all that apply:
Safe to use in COPD patients
Has a slightly better metabolic effect
Loses selectivity at lower doses
Has little effect in patients with reversible airway disease
Which of the following is a correct rationale as to why we would use a beta blocker to treat MI/angina peri-operatively? Choose all that apply:
To decrease production of aqueous humor
To decrease HR
To decrease contractility
To decrease portal hypertension
To inhibit vasodilatation or arteriolar spasms over the cortex
To decrease oxygen demand
Which of the following is not a characteristic of fondaparinux?
It directly affects factor X
It is renally excreted
It has a long half-life, so not good for bridging with warfarin
There is still risk of HIT
The benefit to using calcitriol over vitamin D analogs is that it can decrease the chance of hypercalcemia and hyperphosphetemia.
Which of the following are nonselective beta blockers? Choose all that apply:
Atenolol
Carvedilol
Propranolol
Metoprolol
Nadolol
Timolol
Labetalol
Satelol
Which of the following diuretics is the most potent?
Potassium-sparing diuretics
Which of the following is correct regarding warfarin reversal agents?
PCC are more efficient than FFP
PCC is usually given in a large volume
FFP and PCC are given with Vitamin K
FFP has larger risk of thrombosis
Which of the following is a side effect of hydralazine ONLY?
Sodium and water retention
Hypertrichosis
Precipitation of angina
Induced MI
Which of the following would you never want to give with nitrates due to their drug interaction?
Prostanoids
Hydralazine
PDE-5 drugs
Which of the following prostanoids can cause sepsis?
Epoprostenol
Trerostinil (Tyvaso)
Which of the following prostanoids can cause severe hypotension?
Ilioprost
Treprostinil (Tyvaso) is an inhaled prostenoid
Which of the following are NOT safe to use during pregnancy? Choose all that apply:
Sodium nitroprusside
Prostenoids
Riociguat
Which of the following antiplatelets works by inhibiting ADP receptor?
GP IIb/IIIA inhibitors
P2Y12 inhibitors
Why are endothelin receptor antagonists used as a cardiac drug?
It's ability to block ETB receptor
Because of its vasoconstricting effects
Because of its ability to release NO to cause vasodilation
It's ability to block ETA receptor
Which of the following causes an increase in INR?
Hypothyroidism
Bactrim with use of warfarin
Short gut syndrome
Nitrate tolerance can be fixed by having a nitrate-free period lasting from 4-8 hours
How do calcium-channel blockers cause decrease in contractility, SA node rate, and AV node conduction velocity?
By blocking sodium influx, causing calcium overload through the sodium/calcium exchanger
Blocking calcium channels, blocking calcium influx, causing dilation in arterial smooth muscle leading to decrease in afterload
Blocking calcium channels, blocking calcium influx, causing dilation in venous smooth muscle leading to decrease in afterload
Blocking calcium channels, blocking calcium influx, causing dilation in venous smooth muscle leading to decrease in preload
When using dihydropyridines, one must be careful when using it with digoxin and beta blockers, as this may cause additive negative effects on cardiac conduction
Which of the following is correct regarding nitrates and their mechanism of action?
They cause arterial dilation
They are denitrated to NO, increasing cGMP and causing increase in dilation
They are denitrated to NO, decreasing cGMP and causing increase in dilation
Releases NO from the drug itself, causing vasodilation
Which of the following is a reason for loss of response to ESA therapy?
Hypertension
Benign process
Iron deficiency
Pure white cell aplasia
Which of the following adrenergic agonists can cause a decrease in renal blood flow as an adverse effect?
Epinephrine and Norepinephrine
Dobutamine and Epinephrine
Norepinephrine and Dopamine
Phenylephrine and Dobutamine
Which of the following adrenergic agonists can cause reflex bradycardia?
Dobutamine
Epinephrine
Phenylephrine
Which of the following is NOT a side effect of alpha-1 adrenergic blockers?
Floppy Iris Syndrome
Prolonged QT interval
Bradycardia
Orthostatic hypertension
ARBs are not used as first line therapy despite the less occurrence of side effects.
Which of the following is not a side effect of potassium-sparing diuretics?
GI symptoms
Ototoxicity
Which of the following IV iron products can alter magnetic resonance imaging studies?
Iron dextran
Ferric gluconate
Ferumoxytol
Ferric carboxymaltose
Which of the following IV iron products can cause an anaphylactic reaction?
Iron sucrose is given in divided doses, about 10 dialysis sessions
Which of the following is not a side effect of loop diuretics?
Hypomagnesemia
Hypocalcemia
Which of following phosphate binders can cause metabolic acidosis?
Calcium carbonate
Calcium acetate
Renagel
Renvela
Aliskiren inhibits the conversion of angiotensin I to angiotensin II.
Ranolazine inhibits myocardial cell sodium/calcium exchanger, preventing ischemia-induced contractile dysfunction and delaying the onset of angina
Which of the following a Class I drug?
Propafenone
Amiodarone
Diltiazem
Dronedarone is a
beta-blocker
potassium channel blocker
sodium channel blocker
calcium channel blocker
Lidocaine is
for atrial arrhythmias
the strongest among the sodium channel blockers
used as a local anesthetic
a class IC drug
Which is the best drug for use in patients with CHF or structural heart disease?
Flecainide
Verapamil
Dofetilide
Choose all that would be used for cardioversion of atrial fibrillation.
Ibutilide
Procainamide
Lidocaine
Digoxin
Which of the following is a side effects of Amiodarone?
Pulmonary fibrosis
Increase in iodine
Photosensitivity
These are all side effects of Amiodarone
Which of the following has beta-blocking activity?
Which of the following does NOT rely on renal function for elimination
Sotalol
How does adenosine function in stress testing?
Causes vasodilation in healthy arteries, revealing the diseased coronary arteries
Causes vasoconstriction in healthy arteries, revealing the diseased coronary arteries
Causes vasodilation in diseased arteries, revealing the healthy coronary arteries
Causes vasoconstriction in diseased arteries, revealing healthy coronary arteries
Which of the following is correct regarding digoxin?
Inhibits potassium channels, decreasing intracellular potassium
Inhibits sodium-potassium ATPase, increasing sodium concentration thereby increasing calcium concentration
Causes negative inotropic effects
Causes positive dromotropic/chronotropic effects
Choose which of the following is true for Amiodarone
Shorter half life than dronedarone
Slightly more effective than dronedarone in Afib patients
High risk of side effects
More GI side effects
I2 in structure and effects thyroid
Does not have negative inotropic effects
Cannot be used for CHF
How do calcium channel blockers work as antiarrhythmics?
They dilate arterial smooth muscle
Mostly effects the sodium channels in atrial and ventricular tissues and Purkinjie fibers
Acts on the SA and AV node
Blocks sodium channels
Which of the following is correct regarding the use of beta blockers perioperatively?
Should be continued in patients who are already on a beta blocker
Use of them perioperatively in any situation is standard of practice
Perioperative beta blockage started within one day or less before noncardiac surgery decreases risk of stroke, death, hypotension, and bradycardia
It is not a clinical contreversy
Which of the following drugs should you be cautious due to chance of developing QT prolongation?
Dronedarone
Beta-blockers
Felcainide
Which of the following drug classes could cause Torsades de Pointes?
Beta blockers
Class IA drugs
Class IB drugs
Calcium channel blockers
Which of the following drugs can be used for ventricular arrhythmias?
Which of the following CANNOT be used for cardioversion?
