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Pharm - Cardio Block 2 - Lectures 1-3

Total questions: 92

Worksheet time: 51mins

Name
Class
Date
1.

Prolong refractory period

Prolong action potential duration

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

2.

Shortens refractory period

Shortens action potential

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

3.

GI side effects (severe nausea)

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

4.

Type 1A sodium channel blockers

a)

Disopyramide

b)

Quinidine

c)

Procainamide

d)

Lidocaine

e)

Mexiletine

5.

Type 1B sodium channel blockers

a)

Disopyramide

b)

Quinidine

c)

Procainamide

d)

Lidocaine

e)

Mexiletine

6.

Type 1C sodium channel blockers

a)

Lidocaine

b)

Mexiletine

c)

Flecainide

d)

Propafenone

7.

Class I Antiarrhythmic drugs primary block which ion?

a)

Sodium

b)

Calcium

c)

Potassium

8.

Class II Antiarrhythmic drugs primary block which ion?

a)

Sodium

b)

Calcium

c)

Potassium

9.

Class III Antiarrhythmic drugs primary block which ion?

a)

Sodium

b)

Calcium

c)

Potassium

10.

Class IV Antiarrhythmic drugs primary block which ion?

a)

Sodium

b)

Calcium

c)

Potassium

11.

No change in refractory period

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

12.

Adrenergic stimulation increases conduction velocity, shortens the refractoriness, and increases automaticity of the cells

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

13.

Prolongs phase 3 of the cardiac action potential (repolarization)

Prolongs refractoriness

Prolongs the QT interval

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

14.

Affect slow response myocardial tissue by blocking calcium currents

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

15.

Only used for ventricular arrhythmias

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

16.

Primarily used for atrial arrhythmias; can be used for “life threatening” ventricular arrhythmias

a)

Type 1A sodium channel blockers

b)

Type 1B sodium channel blockers

c)

Type 1C sodium channel blockers

17.

-Terminate re-entrant arrhythmias at the AV node

-Control ventricular rate in atrial fibrillation/flutter

-Exercise-related tachycardias or other tachycardias

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

18.

Used to control tachyarrhythmias (atrial and ventricular)

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

19.

Used for supraventricular tachyarrhythmias as well as rate control in atrial fibrillation, flutter and tachycardias

a)

Class II Antiarrhythmic drugs

b)

Class III Antiarrhythmic drugs

c)

Class IV Antiarrhythmic drugs

20.

-Preventing recurrent ventricular arrhythmias

-Maintain sinus rhythm in patients with paroxysmal atrial fibrillation

a)

Amiodarone

b)

Sotalol

c)

Dofetilide

d)

Ibutilide

21.

Used for atrial and ventricular arrhythmias

a)

Amiodarone

b)

Sotalol

c)

Dofetilide

d)

Ibutilide

22.

Used in patients with atrial fibrillation/flutter

a)

Amiodarone

b)

Sotalol

c)

Dofetilide

d)

Ibutilide

23.

Sinus Bradycardia Caused by SND Treatment:

Symptoms or hemodynamic compromise

a)

Atropine

b)

Isoproterenol, Dopamine, Dobutamine or Epinephrine

c)

Temporary pacing until permanent pacemaker can placed

d)

PACEMAKER

24.

Sinus Bradycardia Caused by SND Treatment:

Symptoms or hemodynamic compromise with a low likelihood of coronary ischemia

a)

Atropine

b)

Isoproterenol, Dopamine, Dobutamine or Epinephrine

c)

Temporary pacing until permanent pacemaker can placed

d)

PACEMAKER

25.

Sinus Bradycardia Caused by SND Treatment:

Symptoms, hemodynamically unstable and refractory to medical therapy

a)

Atropine

b)

Isoproterenol, Dopamine, Dobutamine or Epinephrine

c)

Temporary pacing until permanent pacemaker can placed

d)

PACEMAKER

26.

Treatment of 2nd or 3rd Degree AV Block

a)

Atropine

b)

Isoproterenol, Dopamine, Dobutamine or Epinephrine

c)

Temporary pacing until permanent pacemaker can placed

d)

PACEMAKER

27.

Asystole is

a)

NOT a shockable rhythm

b)

a shockable rhythm

28.

Tx for Asystole

a)

Epinephrine

b)

Reverse underlying cause

c)

Pacemaker

d)

Shock

e)

Atropine

29.

Symptomatic PVC patients can be treated with a

a)

beta blocker

b)

calcium channel blocker

30.

VT Treatment:

Hemodynamically stable

a)

IV procainamide or IV amiodarone or IV sotalol

b)

Defibrillation (Follow ACLS recommendations based upon response)

c)

Beta blockers

31.

VT Treatment:

Hemodynamically unstable (i.e. cardiac arrest)

a)

IV procainamide or IV amiodarone or IV sotalol

b)

Defibrillation (Follow ACLS recommendations based upon response)

c)

Beta blockers

32.

VT Treatment:

Polymorphic VT due to myocardial ischemia

a)

IV procainamide or IV amiodarone or IV sotalol

b)

Defibrillation (Follow ACLS recommendations based upon response)

c)

Beta blockers

33.

Tx for Torsades de pointes (TdP)

a)

Magnesium sulfate IV

b)

Discontinue offending agent

c)

Beta blockers

d)

IV procainamide or IV amiodarone or IV sotalol

e)

Defibrillation

34.

Tx for Ventricular Fibirillation

a)

Shock!!! (Follow ACLS recommendations based upon response)

b)

Beta blockers

c)

IV procainamide or IV amiodarone or IV sotalol

35.

SVT Treatment:

Hemodynamically stable

a)

Vagal maneuvers

b)

IV Adenosine

c)

IV beta blocker or IV Non-DHP CCB

d)

Direct current cardioversion (DCC)

36.

SVT Treatment:

Hemodynamically unstable

a)

Vagal maneuvers

b)

IV Adenosine

c)

IV beta blocker or IV Non-DHP CCB

d)

Direct current cardioversion (DCC)

37.

How long does a pt need to be active in afib to require anticoagulation before cardioversion?

a)

12

b)

24

c)

48

d)

2

38.

How long must a pt have an INR btwn 2-3 before cardioverting them?

a)

1 week

b)

2 weeks

c)

3 weeks

39.

Which is more effective DCC or pharmacologic cardioversoin?

a)

DCC

b)

pharmacologic cardioversoin

40.

What are preferred agents for rate control?

a)

beta blockers

b)

Non DHP CCBs

c)

Digoxin (in combo w other)

d)

sodium channel blockers

41.

What is the target heart rate for rate control asymptomatic pts w stable LV function?

a)

< 110

b)

< 80

42.

Which agents can be used in afib pts w no structural heart disease

a)

Flecainide

b)

Propafenone

c)

Sotalol

d)

Dofetilide

e)

Amiodarone

43.

Which agents can be used in afib pts w CAD

a)

Flecainide

b)

Propafenone

c)

Sotalol

d)

Dofetilide

e)

Amiodarone

44.

Which agents can be used in afib pts w heart failure ***

(only drugs that will NOT worsen HF)

a)

Flecainide

b)

Propafenone

c)

Sotalol

d)

Dofetilide

e)

Amiodarone

45.

Pregnancy class X

a)

Dronedarone

b)

Amiodarone

46.

Pregnancy class D

a)

Dronedarone

b)

Amiodarone

47.

CHA2DS2-VASc recommended to assess stroke risk in patients with _________ ***

a)

atrial fibrillation

b)

ventricular tachycardia

c)

ventricular fibrillation

d)

SVT

48.

CHA2DS2-VASc ≥ 1 in males, or ≥ 2 in females ***

a)

Reasonable to omit antithrombotic therapy

b)

Consider an oral anticoagulant (DOACs preferred)

49.

Which agents can be used in afib pts w no structural heart disease

a)

Class Ia

b)

Class Ib

c)

Class Ic

d)

Class II

e)

Class III

50.

Which agents can be used in afib pts w CAD

a)

Class Ia

b)

Class Ib

c)

Class Ic

d)

Class II

e)

Class III

51.

High-intensity statins

a)

Rosuvastatin 20-40 mg daily

b)

Rosuvastatin 40-80 mg daily

c)

Atorvastatin 40-80 mg daily

d)

Atorvastatin 20-40 mg daily

52.

Goal for LDL if multiple high-risk conditons

a)

< 100 mg/dL

b)

< 70 mg/dL

53.

General goal for BP

a)

< 130/80

b)

< 140/90

c)

< 100/60

54.

General goal for A1C

a)

< 7%

b)

< 9%

c)

< 8%

55.

only effective medication for claudication ***

a)

cilostazol

b)

pentoxifylline

56.

if LDL remains ≥70 mg/dL after high-intensity statin and multiple high-risk conditions

a)

consider initiation of ezemtimibe

b)

consider initiation of PCSK9 inhibitor (alirocumab or evolocumab)

c)

consider initiation of low intensity statin

d)

consider initiation of SGLT2 inhibitor

57.

if LDL remains ≥70 mg/dL after high-intensity statin and ezetimibe

a)

consider initiation of PCSK9 inhibitor (alirocumab or evolocumab)

b)

consider initiation of low intensity statin

c)

consider initiation of SGLT2 inhibitor

58.

Statins are recommended for

a)

ALL pts with PAD

b)

pts with PAD and Diabetes

c)

pts with PAD and claudication

d)

pts with PAD and HTN

59.

preferred meds for pts with PAD and Diabetes that are proven to have CV benefit ***

a)

Metformin

b)

SGLT2 Inhibitors

c)

GLP-1 receptor agonists

d)

DPP-4 inhibitors

60.

reasonable to initiate _____ in a pt with HTN and PAD bc they may improve walking distance

a)

ACEI

b)

ARB

c)

Thiazide

d)

Alpha blockers

61.

Vorapaxar

a)

can be used as monotherapy

b)

combo with aspirin or clopidogrel

c)

combo with aspirin

62.

Rivaroxaban (Xarelto)

[Cross lecture]

a)

can be used as monotherapy

b)

combo with aspirin or clopidogrel

c)

combo with aspirin

63.

BBox warning: history of stroke/TIA/ICH

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Cilostazol

d)

Aspirin

64.

BBox warning: spinal hematoma

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Cilostazol

d)

Aspirin

65.

BBox warning: heart failure of any stage

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Cilostazol

d)

Aspirin

66.

Side effects: Headache, diarrhea, dizziness, palpitations

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Cilostazol

d)

Aspirin

67.

AVOID omeprazole/esomeprazole

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Clopridogrel

d)

Aspirin

68.

Side effects: bleeding, GI upset

a)

Vorapaxar

b)

Rivaroxaban (Xarelto)

c)

Clopridogrel

d)

Aspirin

69.

HF unlikely when BNP

a)

< 100 pg/mL

b)

> 400 pg/mL

70.

HF unlikely when NT-pro-BNP ***

a)

< 300 pg/mL

b)

> 450 pg/mL

c)

> 900 pg/mL

d)

> 1800 pg/mL

71.

NT-pro-BNP cut offs for heart failure _____ as age increases ***

a)

increase

b)

decrease

72.

No limitation of physical activity. Ordinary physical activity does not cause symptoms of HF ***

a)

NYHA Class I

b)

NYHA Class II

c)

NYHA Class III

d)

NYHA Class IV

73.

Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF. ***

a)

NYHA Class I

b)

NYHA Class II

c)

NYHA Class III

d)

NYHA Class IV

74.

Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes symptoms of HF. ***

a)

NYHA Class I

b)

NYHA Class II

c)

NYHA Class III

d)

NYHA Class IV

75.

Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest. ***

a)

NYHA Class I

b)

NYHA Class II

c)

NYHA Class III

d)

NYHA Class IV

76.

Who should receive diuretics?

a)

All HF pts

b)

HF pts with hx/sx of fluid retention

77.

Loops

a)

increase free water clearance

b)

decrease free water clearance

c)

↑ Na excretion by 20-25%

d)

↑ Na excretion by 5-10%

78.

Thiazides

a)

increase free water clearance

b)

decrease free water clearance

c)

↑ Na excretion by 20-25%

d)

↑ Na excretion by 5-10%

79.

Who should receive an ACEI? *unless contraindicated*

a)

HF pts with hx/sx of fluid retention

b)

all HFrEF pts

80.

Who should receive an ARB?

a)

all HFrEF pts

b)

HF patients who are intolerant to ACE Inhibitors due to intractable cough

81.

Who should receive ARNI (Sacubitril/valsartan)?

a)

all HFrEF pts

b)

all HFrEF pts who can afford it (first line in the place of ACEI or ARB)

82.

ARNI (Sacubitril/valsartan): Allow a ______ washout period in patients on an ACEI ***

a)

24

b)

36

c)

48

83.

ARNI (Sacubitril/valsartan) side effect ***

a)

Hypotension

b)

Fatigue

84.

Beta blocker adverse effect ***

a)

Hypotension

b)

Fatigue

85.

BB drugs for HF ***

a)

Bisoprolol

b)

Carvediol

c)

Metoprolol Succinate

d)

Metoprolol Tartate

86.

Who should receive BBs?

a)

all HFrEF pts

b)

HF patients who are intolerant to ACE Inhibitors due to intractable cough

87.

All HFrEF pts should receive SGLT2 inhibitors

a)

True

b)

False

c)

True -- unless contraindicated Type 1 DM, lactation, dialysis

d)

True -- if they also have Type 1 DM, lactation, dialysis

88.

Aldosterone antagonists contraindications

a)

Potassium > 5

b)

CrCl < 30

c)

Potassium < 3

d)

CrCl < 40

89.

HFrEF pts should take Hydralazine & Isosorbide Dinitrate if they cannot take ACEs or ARBs due to

a)

drug intolerance

b)

cough

c)

hypotension

d)

angioedema

e)

renal insuffiency

90.

symptomatic HFrEF who are in sinus rhythm with a resting heart rate ≥ 70 bpm

a)

Digoxin

b)

Ivabradine

c)

Vericiguat

91.

Consider for symptomatic heart failure despite optimal doses of an ACE, diuretics, & beta blockers and aldosterone antagonists

a)

Digoxin

b)

Ivabradine

c)

Vericiguat

92.

HFpEF treatment to reduce hospitalizations w the best data ***

a)

SGLT2 inhibitors

b)

ARNI

c)

Aldosterone Antagonists

d)

ACEI or ARBs

e)

Beta blockers

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