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IT1 Exam 4 Part 3

Total questions: 69

Worksheet time: 43mins

Name
Class
Date
1.

Which drug is known as the 1st avenger and has both alpha and beta effects?

a)

Norepinephrine

b)

Epinephrine

c)

Phenylephrine

d)

Vasopressin

2.

What does alpha 1 receptor do?

a)

Vasodilation

b)

Vasoconstriction

c)

Increase SVR

d)

Increase MAP

e)

Decrease SVR

3.

Which is the 2nd line agent for septic shock?

a)

Norepinephrine

b)

Epinephrine

c)

Phenylephrine

d)

Butalbital

4.

Which drug combines both beta and alpha agonists?

a)

Epinephrine

b)

Norepinephrine

c)

Phenylephrine

d)

Digoxin

5.

What are some adverse reactions for epinephrine?

a)

Arrhythmia

b)

Extravasation

c)

Splenic and renal ischemia

d)

Lactic acidosis

e)

Hypoglycemia

6.

Which is used for severe sepsis, ACLS and anaphylaxis?

a)

Epinephrine

b)

Norepinephrine

c)

Phenylephrine

d)

Digoxin

7.

Which is a PURE alpha 1 agonists?

a)

Epinephrine

b)

Norepinephrine

c)

Phenylephrine

d)

Digoxin

8.

Which causes peripheral vasoconstriction?

a)

Phenylephrine

b)

Epinephrine

c)

Norepinephrine

d)

Neostigmine

9.

Which is commonly used for sepsis during anesthetia?

a)

Phenylephrine

b)

Norepinephrine

c)

Epinephrine

d)

Vasopressin

10.

Which is used ADJUNCT to norepinephrine?

a)

Vasopressin

b)

Epinephrine

c)

Dopamine

d)

Dobutamine

11.

Which is true about dopamine?

a)

The dosage range affects the effects

b)

Low dose is used normally

c)

High dose used to attain MAP goals

d)

May cause tachycardia

e)

Used to treat renal failure

12.

Which is commonly used for acute HF or cardiogenic shock?

a)

Dobutamine

b)

Digoxin

c)

Vasopressin

d)

Milrinone

13.

Which is a syntheic catecholamine?

a)

Dobutamine

b)

Epinephrine

c)

Vasopressin

d)

Milrinone

14.

Which is used more often in cardiogenic shock to increase perfusion and oxygen delivery?

a)

Milrinone

b)

Vasopressin

c)

Dobutamine

d)

Epinephrine

e)

Norpinephrine

15.

What is the FIRST step in hypovolemic shock?

a)

stop the bleed

b)

fluid resuscitation

c)

oxygenation

d)

treat the cold

e)

address fluid overload

16.

What is your goal for distributive shock?

a)

MAP > 65 mmHg

b)

End organ perfusion

c)

MAP <65 mmHg

17.

What can you add if hypoperfusion is continuing but you met the fluid and MAP goals?

a)

Inotrope

b)

Vassopressin

c)

Aldosterone

d)

CCB

18.

What are the clinical endpoints to look for when treating distributive shock?

a)

Lactate clearance

b)

CO

c)

HR

d)

Weight

19.

Which shock should you be cautious w/ fluid as you can go over fluids bc they do have increased preload?

a)

Obstructive

b)

Cardiogenic

c)

Distributive

d)

Hypovolemic

20.

Which shock causes: Hemorrhage, Dehydration, third spacing

a)

Hypovolemic

b)

Cardiogenic

c)

Distributive

d)

Obstructive

21.

Which shock causes: Heart failure, MI, bradycardia

a)

Hypovolemic

b)

Cardiogenic

c)

Distributive

d)

Obstructive

22.

Which shock causes: Sepsis, anaphylaxis, adrenal insufficiency, CNS injury, trauma, and toxin/poisons

a)

Hypovolemic

b)

Cardiogenic

c)

Distributive

d)

Obstructive

23.

Which shock causes: Pneumothorax, pulmonary embolism

a)

Hypovolemic

b)

Cardiogenic

c)

Distributive

d)

Obstructive

24.

What are some presentations of shock?

a)

Thirst

b)

Nausea

c)

Anxiousness

d)

Weak

e)

Low urine output/yellow

25.

Signs of shock?

a)

Fast HR

b)

Rapid breathing

c)

Low BP

d)

Altered mental status

e)

Cold extremeties

26.

What are the different types of dyslipidemia?

a)

Hyperlipidemia

b)

Hyperlipoproteinemia

c)

Hypolipidemia

d)

Hypolipoproteinemia

27.

Which of these fall under the Hyperlipidemia category?

a)

Hypercholesterolemia

b)

Hypertriglyceridemia

c)

Hyperlipoproteinemia

28.

What are the different types of lipoproteins

a)

HDL

b)

LDL

c)

VLDL

d)

Chylomicrons

e)

Chitin

29.

If you don't control lipids.... what are some damages it can do to your heart?

a)

CAD

b)

CHD

c)

Heart murmur

d)

Rapid heart beat

e)

A

30.

Low HDL can be caused by:

a)

Malnutrition

b)

Diabetes

c)

Cigarette smoking

d)

Low TG

e)

Extreme activeness

f)

Pregnancy

31.

Some secondary causes of hypercholesterolemia and elevated LDL-C include:

a)

Malnutrition

b)

Hyperthyroidism

c)

Hypothyroidism

d)

Obstructive liver disease

e)

Anorexia

32.

Which of these could be a reason someone has hypercholesterolemia and elevated LDL-C?

a)

Pregnancy

b)

High sat and transfat

c)

Nephrotic syndrome

d)

Cigarette smoking

33.

_______ is the group of risk factors associated with an increased risk of ASCVD, diabetes and all cause death

a)

Metabolic syndrome

b)

Cardiovascular dysfunction sybndrome

c)

Triglyceride syndrome

d)

Hyperelevated cholesterol

e)

Heart failure

34.

Presense of _ symptoms can cause metabolic syndrome:

a)

3

b)

5

c)

4

d)

2

35.

What is considered increased BP for metabolic syndrome

a)

130/85

b)

140/90

c)

135/90

d)

150/100

36.

According to AHA: what is a high level of triglycerides?

a)

>150

b)

>130

c)

>120

d)

>170

37.

Which waistline is considered LARGE?

a)

Men: 35"

b)

Men: 40"

c)

Women: 40"

d)

Women: 35"

38.

Which of the following is a low level of HDL?

a)

Men: <50

b)

Women: <50

c)

Men: <40

d)

Men: <60

39.

What is considered elevated fasting blood sugar?

a)

>100 mg/dL

b)

>120mg/dL

c)

>140mg/dL

d)

>90 mg/dL

e)

60 mg/dL

40.

At what age and how many years should ppl get their cholesterol checked?

a)

>20 y/o

b)

>18 y/o

c)

2-3 years

d)

4-6 years

e)

every 5 years

41.

What doe lipid panel measure:

a)

TC

b)

HDL

c)

TG

d)

LDL-C

e)

Non-HDL-C

42.

if your TG are >____ it should not be calculated

a)

400

b)

300

c)

200

d)

500

43.

What is true about ApoB measurements:

a)

Useful for treatment portion

b)

Should we start a statin or not

c)

It doesn’t really guide what you’re doing

d)

May not be available in a lot of places

e)

Widely accesible

44.

What's the 1st line of lipid lowering medications?

a)

ACE

b)

ARB

c)

CCB

d)

Statin

e)

Norepinephrine

45.

True or false: Simvastatin is a high intensity statin

a)

True

b)

False

46.

High are high intensity lowering statins?

a)

Atorvastatin (40/80 mg)

b)

Rosuvastatin (20/40 mg)

c)

Simvastatin 10 mg

d)

Pravastatin 10-20 mg

47.

Which simvastatin strength should be avoided?

a)

80

b)

10

c)

20

d)

40

48.

What effects does statin drugs provide?

a)

Improves endothelial function

b)

Reduces vascular inflammation

c)

Stabilizes plaque

d)

Reduces oxidative stress

e)

Inhibition of platelet aggregation and anticoagulation effects

49.

If LFTs are >3x what do you do?

a)

Continue treatment

b)

Discontinue treatment

50.

Which medication causes muscle pain?

a)

Statin

b)

ACE

c)

ARB

d)

CCB

e)

Digoxin

51.

Which statins have been shown to have LOWER rates of myalgia?

a)

Pravastatin

b)

Fluvastatin

c)

Pitavastatin

d)

Lovastatin

e)

Simvastatin

52.

Which statins have a strong concomitant link to CYP3A4 inhibitors?

a)

Simvastatin

b)

Lovastatin

c)

Fluvastatin

d)

Atorvastatin

53.

What are 3A4 inducers?

a)

Cabamazepine

b)

Phenobarbital

c)

Phenytoin

d)

Rifampin

e)

St john's

54.

Which are 3A4 inhibitors?

a)

Macrolide

b)

Azole antifungal

c)

Protease inhibitors

d)

Paroxetine

e)

Amiodarone

55.

Which statin has NO CYP metabolism?

a)

Fluvastatin

b)

Pravastatin

c)

Atorvastatin

d)

Lovastatin

e)

Simvastatin

56.

Which statins are inhibited by 2C9?

a)

Rosuvastatin

b)

Fluvastatin

c)

Atorvastatin

d)

Simvastatin

57.

If you drink grapefruit juice which medications will be affected?

a)

Atorvastatin

b)

Lovastatin

c)

Simvastatin

d)

Rosuvastatin

e)

Fluvastatin

58.

Which statins should be taken in PM?

a)

Lovastatin

b)

Simvastatin

c)

Fluvastatin

d)

Rosuvastatin

e)

Pitavastatin

59.

How should you monitor lipid levels?

a)

Lipid panel

b)

SCr

c)

CK

d)

BP

60.

Which product has statin like qualities?

a)

Red yeast rice

b)

St.John's wort

c)

Omega fish oil

61.

Why isn't red yeast rice recommended?

a)

May affect kidneys

b)

Not a safer option

c)

Statin content varies

d)

Contain nephrotoxin, citrinin

62.

In patients with clinical ASCVD, what should you do?

a)

reduce LDL-C with high-intensity statin therapy

b)

maximally tolerated statin therapy

c)

start moderate-intensity statin therapy

63.

In patients with a very high-risk for ASCVD, use a LDL-C threshold of __ mg/

a)

70

b)

50

c)

60

d)

80

64.

In patients with severe primary hypercholesterolemia >___mg/dL

a)

>200

b)

>180

c)

>170

d)

>190

65.

In patients with severe primary hypercholesterolemia, what should you do ?

a)

begin high intensity statin therapy

b)

begin moderate intensity statin therapy

c)

begin low intensity statin therapy

66.

In patients ___-___ years of age with diabetes and LDL-C ≥ 70 mg/dL, start moderate-intensity statin therapy without calculating 10-year ASCVD 149

a)

40-70

b)

18-35

c)

60-70

d)

50-65

67.

In patients 40 – 75 years of age evaluated for primary ASCVD prevention, what should they do?

a)

Start high intensity statin therapy

b)

Start low intensity statin therapy

c)

See PCP

d)

Start moderate intensity statin therapy

68.

Assess adherence and percentage response to LDL-C lowering medications how long after prescription?

a)

4-12 weeks

b)

8-12 weeks

c)

9-12 weeks

69.

True or false: Epinephrine is the 1st line agent (vasopressor) in ALL forms of shock

a)

False

b)

True

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