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Cardio remediation exam 2 drug quiz

Total questions: 66

Worksheet time: 38mins

Name
Class
Date
1.

Which of the following is a contraindication for Warfarin?

a)

Pregnancy

b)

Alopecia

c)

Autoimmune diseases

d)

Stopping the medication suddenly

2.

Which Apolipoprotein is found on LDL only?

a)

C2

b)

B100

c)

E

d)

B48

3.

Which drug is an NPC1L1 inhibiter that can be paired with certain statins to reduce LDL?

a)

Juxtapid

b)

Lomitapide

c)

Zetia

d)

Mipomersan

4.

Which of the following are PSCK9 inhibitors?

a)

Alirocumab

b)

Repatha

c)

Inclisiran

d)

Lomitapide

5.

What do statin drugs target?

a)

HMG-COA

b)

De novo

c)

Acety-COA

d)

Malonyl-COA

6.

The maximum effect of statins are not seen until...

a)

3 weeks

b)

4 weeks

c)

12 weeks

d)

6 weeks

7.

Which statin drugs can be taken any time of day?

a)

Atorva-

b)

Rosuva-

c)

Pitava-

d)

Prava-

8.

Which statin drug is the most hydrophilic?

a)

Atorva-

b)

Fluva-

c)

Lova-

d)

Rosuva-

9.

Which statin drug is the most lipophilic?

a)

Atorva-

b)

Simva-

c)

Lova-

d)

Rosvua-

10.

Which statin drugs have CYP3A4 interactions?

a)

Lova-

b)

Simva-

c)

Prava-

d)

Atorva-

11.

Which statins have CYP2C9 interactions?

a)

Atorva-

b)

Pita-

c)

Rosuva-

d)

Fluva-

12.

Which statins can be used with cyclosporin?

a)

Fluva-

b)

Simva-

c)

Rosuva-

d)

Lova-

13.

Which statin can be used with Gemfibrozil at 5 mg maximum?

a)

Fluva-

b)

Atorva-

c)

Rosuva-

d)

Lova-

14.

Which statins are considered to be high intensity and at what dose?

a)

Atorva (60 mg)

b)

Atorva (80 mg)

c)

Rosuva (10 mg)

d)

Rosuva (20 mg)

15.

Which statins are considered to be low intensity and what is their correct dosing?

a)

Lova (10 mg)

b)

Lova (20 mg)

c)

Prava (15 mg)

d)

Prava (10 to 20 mg)

16.

Which of the following people would you calculate an ASCVD score for?

a)

A 20 year old with familial hypercholesterolemia.

b)

A 40 year old with a history of a CV event.

c)

A 55 year old with LDL greater than 160 and has diabetes.

d)

A 40 year old with an LDL of 150 that does not have diabetes.

17.

For someone who has an ASCVD score considered to be of high risk, what should their LDL treatment goal be?

a)

Under 190

b)

Under 100

c)

Under 90

d)

Under 50

18.

Which of the following are bile acid sequestrants?

a)

Bempedoic acid

b)

Colestipol

c)

Welchol

d)

Anatara

19.

Who would be a good candidate for a bile acid sequestrant?

a)

Someone with high triglyceride levels.

b)

Someone who cannot be on a statin due to myopathy concerns.

c)

Someone with hyperuricemia who needs to reduce circulating LDL.

d)

Someone with a ruptured tendon and cannot be on a fibrate.

20.

Who would be a good candidate for a fibrate drug?

a)

Someone with gallbladder disease can cannot tolerate a statin.

b)

Someone with LDL levels over 160.

c)

Someone with severe renal dysfunction.

d)

Someone on Rosuvastatin the needs to lower LDL levels more.

21.

Which of the following classes of drugs can show a decrease in triglycerides?

a)

Fibrates

b)

Niacin

c)

PSCK9

d)

Fish oil

22.

Which factors are activated in the intrinsic pathway?

a)

12

b)

11

c)

9

d)

8

23.

Which of the following are direct thrombin inhibitors?

a)

Idarucizumab

b)

Apixaban

c)

Dabigatran

d)

Argatroban

24.

Which of the following is NOT an anticoagulant class?

a)

Direct thrombin inhibitor

b)

Direct Xa inhibitor

c)

Glycoprotein 2b&3a inhibitor

d)

Vitamin K epoxide reductase

25.

Which of the following drugs are PDE inhibitors?

a)

Dipyridamole

b)

Clopidogrel

c)

Prasugrel

d)

Cilostazol

26.

Which ADP receptor inhibitor binds irreversibly?

a)

Clopidogrel

b)

Prasugrel

c)

Ticagrelor

d)

Aspirin

27.

A patient has intermittent claudication, which drug will they be placed on?

a)

Aspirin

b)

Clopidogrel

c)

Cilostazol

d)

Vytorin

28.

Which of the following drug classes bind to fibrinogen and prevent cross-linking?

a)

PDE inhibitors

b)

GP 2b&3a antagonists

c)

COX inhibitors

d)

direct thrombin inhibitors

29.

A patient is being considered for a statin drug but genetic testing shows that the patient has a SLCO1B1*1b/*5 diplotype, what is the fphenotype function level?

a)

High function

b)

intermediate function

c)

Low function

d)

No function

30.

A patient enters a hospital with a ischemic stroke, they should begin therapy within...

a)

30 minutes

b)

45 minutes

c)

90 minutes

d)

60 minutes

31.

Which factors are involved the extrinisic pathway?

a)

3

b)

7

c)

tissue factor

d)

12

32.

What is the correct dosing for Alteplase? Select all that apply.

a)

Max dose is 90 mg

b)

10% of the treatment should be administered as a bolus for the first minute of treatment.

c)

it should be infused intravenously over the course of an hour

d)

Decrease the dose by half if it is the patient's second occurence of a stroke occurs within 24 hours of the 1st stroke.

33.

Which of the following MUST be done before a tPA is administered?

a)

Blood glucose test

b)

Genetic testing

c)

Blood pressure check

d)

Non-contrast CT scan

34.

A patient just had a stroke. It is discovered that the patient had a stroke a month ago, which of the following is true?

a)

They can be given Alteplase.

b)

They can be given Tenecteplase.

c)

Wait it out.

d)

They can undergo a mechanical thrombectomy.

35.

A triple therapy unit involving a steroid, an antihistamine, and a H2RA is used for which kind of patient?

a)

A patient who is hemorrhaging.

b)

A patient with horner's syndrome.

c)

A patient who broke out in hives after treatment.

d)

A patient who have tPA associated orolingual angioedema.

36.

Which of the following can be use to stop intracranial bleeding after a tPA has been administered?

a)

Cyroprecipitate

b)

Trenexamic acid

c)

Aminocaproic acid

d)

Warfarin

37.

A patient enters the hospital. It is discovered that they have a hemorrhagic stroke, which of the following can be given to help prevent expansion?

a)

Nimodipine

b)

Vitamin K injection

c)

Fresh frozen plasma

d)

Mannitol

38.

A patient enters the hospital with a hemorrhagic stroke, what can be given to them to prevent cerebral edema?

a)

Mannitol

b)

Hypertonic Saline

c)

Furosemide

d)

Nimodipine

39.

What is carnitine used for?

a)

Beta oxidation of fatty acids in the mitochondria

b)

Beta oxidation of fatty acids in the cytoplasm

c)

Reducing fatty acids in the mitochondria

d)

Reducing fatty acids in the cytoplasm

40.

Which of the following statements is/are true?

a)

Bile acids emulsify fat since they are not water soluble.

b)

Triglycerides are transported via chylomicrons.

c)

APO-C2 activates lipoprotein lipase

d)

Fatty acids travel from adipose to other tissues by adhering to albumin.

41.

How does insulin affect the synthesis of cholesterol?

a)

By decreasing cholesterol synthesis

b)

By increasing cholesterol synthesis

c)

By shifting cholesterol from the adipose to the liver

d)

By shifting cholesterol from the liver to adipose.

42.

Which of the following help form chylomicrons?

a)

CETP

b)

ACAT

c)

NPC1L1

d)

MTTP

43.

Which of the following is NOT a side effect of a statin drug?

a)

Teratogenicity

b)

Hyperuricemia

c)

Myopathy

d)

Hepatotoxicity

44.

A patient has just been placed on Gemfibrozil, which of the following drugs should NOT be given to her in conjunction to her new therapy?

a)

Niacin

b)

Atorvastatin

c)

Mipomersan

d)

Fish oil supplement

45.

Patient on simvastatin with the SLCO1B1 521C genetic variant are at increased risk for which of the following adverse event?

a)

Myopathy

b)

Neuropathy

c)

Retinopathy

d)

Telepathy

46.

What would be the expected effect of the c.521T.C genetic polymorphism on OATP1B1 activity and statin plasma concentration?

a)

Increase OATP1B1 activity, decrease statin plasma concentration

b)

Increase OATP1B1 activity, increase statin plasma concentration

c)

Decrease OATP1B1 activity, increase statin plasma concentration

d)

Decrease OATP1B1 activity, decrease statin plasma concentration

47.

JL is a 54 year old female being considered for treatment with simvastatin 20 mg PO daily. She has a history of hypertension for which she takes amlodipine 5 mg PO daily. Genetic testing is done and reveal SLCO1B1 5/15 diplotype. Which of the following recommendations is the most appropriate for this patient?

a)

Stop simvastatin

b)

Decrease simvastatin to 10 mg daily

c)

Decrease simvastatin to 10 mg twice a day

d)

Increase simvastatin to 40 mg a day

48.

How do the three types of bile acid sequestrants differ chemically?

a)

One of them has Ring A

b)

One of them has Ring B

c)

They vary in carbon degrees.

d)

They vary in amine degrees.

49.

A patient has both diabetes and gout, what medication should they avoid?

a)

Vascepa

b)

Lovaza

c)

Trilipix

d)

Niaspan

50.

A 64 year old female has a history of a stroke, LDL is 115, and her blood pressure is 132/82. Which of the following medications should she be put on?

a)

Atorvastatin 80 mg

b)

Pravastatin 10 mg

c)

Fluvastatin 2 mg

d)

Rosuvastatin 10 mg

51.

A 64 year old female has a history of a stroke, LDL is 115, and her blood pressure is 132/82. What should her LDL goal?

a)

Reduce by 30%

b)

Reduce by 50%

c)

Reduce by 50% or more

d)

Reduce by 30% or more

52.

A 52 year old man has a history of type 2 DM and hypertension. His LDL levels are 166 and he is currently taking metformin, lisinopril, and diltiazem. Which cholesterol reducing medication should he be put on?

a)

Atorvastatin 80 mg

b)

Atorvastatin 40 mg

c)

Rosuvastatin 20 mg

d)

Rosuvastatin 10 mg

53.

Mutation in the exon region of the VKORC1 enzyme will likely cause...

a)

A slowed down rate of blood clotting.

b)

An increase in warfarin metabolism.

c)

A decrease in warfarin metabolism.

d)

An increase in blood clotting rate.

54.

Mutations in the upstream region of the VKORC1 enzyme is most likely to cause...

a)

An increase in VKORC1 concentration.

b)

A decrease in VKORC1 concentration.

c)

A increase in rate in metabolizing warfarin.

d)

A decrease in rate of metabolizing warfarin.

55.

Mutations of the exon region of the CYP2C9 enzyme will likely cause...

a)

A slowed down rate of metabolizing warfarin.

b)

An increase rate of metabolizing warfarin.

c)

The likelihood of clot formation increases.

d)

The likelihood of clot formation decreases.

56.

How should warfarin be adjusted for someone who has the homozygous *2 allele?

a)

Double the dose

b)

Decrease the dose

c)

Give them the standard dose

d)

Increase the dose

57.

What is the correct order from first to last of coagulation factors in the cascade?

a)

X, II, I, VII

b)

X, I, II, VII

c)

VII, X, I, II

d)

VII, X, II, I

58.

Which of the following would be the most appropriate indication for pursuing CYP2C19 genetic testing prior to initiation of clopidogrel?

a)

NSTEMI undergoing PCI

b)

Fibrinolysis for STEMI

c)

A.Fib

d)

Secondary stroke prevention

59.

Which of the following diplotypes is associated with a normal or increased level of platelet inhibition with clopidogrel?

a)

1/3

b)

1/2

c)

3/3

d)

1/17

60.

A patient is scheduled for an elective PCI(Percutaneous Coronary Intervention) and has the CYP2C19 1/2 diplotype. Based on CPIC guidelines, which of the following is the most appropriate recommendation for this patient?

a)

Standard dose of clopidogrel

b)

High dose clopidogrel

c)

Consider an alternative treatment

d)

This patient cannot be on any antiplatelet therapy

61.

A 78-yo Asian male is scheduled for an elective PCI (percutaneous coronary intervention). CYP2C19 genetic testing is performed and he is found to have the CYP2C19 2/17 genotype. What is the phenotype of this patient in terms of clopidogrel metabolism?

a)

Extensive

b)

Ultrarapid

c)

Intermediate

d)

Poor

62.

Dipyridamole can be used with which drug to prevent ischemic thrombotic stroke in those with previous stroke history?

a)

Warfarin

b)

Prasugrel

c)

Clopidogrel

d)

Aspirin

63.

Dipyridamole can be used with which drug for post-op primary prophylaxis of thromboemboli in those with a prosthetic heart valve?

a)

Aspirin

b)

Warfarin

c)

Prasugrel

d)

Bempedoic acid

64.

A 76 year old man has been diagnosed with a.fib, which of the following drugs would be given to him for primary stroke prevention? He is currently taking lisinopril, metformin, hydrochlorothiazide, and insulin.

a)

Aspirin 81 mg

b)

Endoxaparin 40 mg sc

c)

Heparin 5000 units

d)

Warfarin 2.5 mg

65.

What is the CHADS2VASC score for 77 year old patient with a prior history of stroke?

a)

1

b)

2

c)

3

d)

4

66.

If someone score higher than a 2 on the CHA2DSCASC score what should be given?

a)

Nothing

b)

Oral anticoagulant

c)

Aspirin

d)

Oral antiplatelet