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Beta-Blocker Review

Total questions: 18

Worksheet time: 25mins

Name
Class
Date
1.

Which of the following disease states is NOT a contraindication to the use of immediate release beta-blockers?

a)

Untreated Pheochromocytoma

b)

Second Degree Heartblock

c)

Diabetes Mellitus Type II

d)

Severe Bradycardia

2.

Which of the following beta-blockers would be most appropriate for a pregnant patient?

a)

Labetalol

b)

Atenolol

c)

Propranolol

d)

Acebutolol

e)

No beta-blockers are safe in pregnancy

3.

Which of the following beta-blockers are known to reduce mortality in heart failure with reduced ejection fraction? (Select all that apply).

a)

Metoprolol Succinate

b)

Acebutolol

c)

Carvedilol

d)

Propranolol

e)

Bisoprolol

4.

Which of the following are common (1-10%) side effects of beta-blockers? (Select all that apply).

a)

Dizziness

b)

Photosensitivity

c)

Diarrhea

d)

Fatigue

e)

Xerostomia

5.

Beta-blockers are not considered first-line antihypertensives unless the patient:


(Select all that apply).

a)

Has CAD

b)

Has T2DM

c)

Is post-MI

d)

Has a History of Stroke

6.

Which of the following is NOT a possible mechanism of action for beta-blockers in hypertension?

a)

Beta-blockers inhibit sympathetic nervous system activity at the beta-1 receptors of cardiac tissue, reducing cardiac output.

b)

Beta-blockers inhibit sympathetic nervous system activity at the beta-1 receptors of juxtaglomerular cells, reducing renin expression.

c)

Beta-blockers inhibit sympathetic nervous system activity at the alpha-1 receptors of vascular endothelial cells, reducing systemic vascular resistance.

d)

Beta-blockers inhibit sympathetic nervous system activity at the beta-2 receptors of vascular endothelial cells, reducing total peripheral resistance.

7.

Which of the following statements regarding propranolol is false?

a)

Propranolol blocks sympathetic nervous system activity at both beta-1 and beta-2 receptors

b)

Propranolol is the most hydrophilic beta-blocker

c)

Propranolol is the beta-blocker of choice in migraine prophylaxis

d)

Propranolol has the greatest central nervous system penetration of any beta-blocker

8.

Which of the following beta-blockers have intrinsic sympathomimetic activity? (Select all that apply).

a)

Atenolol

b)

Carvedilol

c)

Acebutolol

d)

Pindolol

e)

Bisoprolol

9.

Which of the following beta-blockers target alpha-1 receptors? (Select all that apply).

a)

Bisoprolol

b)

Timolol

c)

Labetalol

d)

Atenolol

e)

Carvidelol

10.

Which of the following statements regarding beta-blockers is false?

a)

Cardioselective beta-blockers are safer than non-selective agents in patients with asthma or diabetes

b)

Beta-blockers with intrinsic sympathomimetic activity produce greater CV risk reduction than other beta-blockers

c)

Cardioselective beta-blockers are preferred to non-selective beta-blockers in hypertension

d)

Third generation beta-blockers can produce vasodilation

11.

Which of the following beta-blockers are cardioselective? (Select all that apply).

a)

Bisoprolol

b)

Atenolol

c)

Propanolol

d)

Metoprolol

e)

Carvedilol

12.

Which of the following beta-blockers are known to provide visual field protection in glaucoma? (Select all that apply).

a)

Timolol

b)

Metoprolol

c)

Betaxolol

d)

Propranolol

e)

Carvedilol

13.

Which of the following statements about beta-blocker use in post-MI patients is correct?

a)

Carvidelol, atenolol, and bisoprolol are among the preferred beta-blockers for post-MI therapy

b)

Beta-blockers should be considered for all patients post-STEMI, but not for patients post-NSTEMI

c)

A post-MI patient managed with ASA, rosuvastatin, and ramipril would not gain any additional cardioprotective benefit from adding a beta-blocker

d)

Beta-blockers should not be used in patients with reduced LV function post-MI

14.

Which of the following statements about beta-blocker therapy is least correct?

a)

Abrupt cessation of beta-blockers can trigger unstable angina or myocardial infarction

b)

Beta-blockers should not be used for hypertension in patients greater than 60 years old

c)

Beta-blockers may aggravate intermittent claudication or Raynaud's phenomenon

d)

Beta-blockers are less likely to be effective in African Americans

15.

Potential complications of beta-blockers include: (Select all that apply).

a)

Bradycardia

b)

Hypotension

c)

Heart block

d)

Acute heart failure

e)

Increased Serum Glucose

16.

Which of the following statements regarding beta-blocker overdose is incorrect?

a)

Beta-blocker overdose often presents with hypoglycemia, bradycardia, and respiratory depression

b)

Propranolol is the most common beta-blocker in overdose

c)

Activated charcoal can be given if the patient presents within 1-hour of ingesting the beta-blocker

d)

Glucagon can be given to reduce bronchospasms

e)

Atropine can be given to correct bradycardia

17.

Which of the following statements regarding beta-blocker dosing is incorrect?

a)

Effective angina control typically requires higher doses than effective blood pressure control

b)

The target dose for carvedilol in heart failure is 25mg BID

c)

When discontinuing beta-blockers, a short taper period is necessary

d)

Beta-blocker dosing does not need to be adjusted for hepatic function

18.

S. D. reports to your ED with retrosternal chest pain and is diagnosed with angina pectoris. She is 53-year-old woman who is hypertensive with a BP of 148/90. She has well-controlled asthma and diabetes. Her medications include metformin 1000mg BID, Clorthalidone 25mg once daily, beclomethasone 200mcg once daily, and salbutamol PRN. Amlodipine was previously tried for S.D's hypertension but was poorly tolerated. Which of the following beta-blockers would be most appropriate for managing S. D.'s new diagnosis?

a)

Carvedilol

b)

Metoprolol

c)

Acebutelol

d)

Pindolol

e)

A beta-blocker is contraindicated for this patient