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Review 1

Total questions: 90

Worksheet time: 50mins

Name
Class
Date
1.

What is considered PAH?

a)

10 mmHg

b)

20 mmHg

c)

25 mmHg

d)

40 mmHg

2.

Which classifications are matched correctly?

a)

Group 1: asymptomatic

b)

Group 2: PAH due to multiple factors

c)

Group 3: PAH due to COPD, PE, or Emphysema

d)

Group 4: Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

e)

Group 5: PAH due to left heart disease

3.

How many WHO classification groups are there for PAH?

a)

2

b)

3

c)

5

d)

6

4.

Most frequently used CCBs in PAH are?

a)

Verapamil

b)

Amlodipine

c)

Felodipine

d)

Nifedipine ER

e)

Diltiazem

5.

What are some complications that are seen in Sickle Cell Disease?

a)

Priapism

b)

Hair Loss

c)

Gallstones

d)

Acute Chest Syndrome

e)

Impotence

6.

Most common chronic complications in sickle cell disease?

a)

Anemia

b)

Pain

c)

Renal Impairment

d)

Infection

e)

Stroke

7.

Non-Drug Treatment for Sickle Cell?

a)

Blood Transfusions

b)

Penicillin

c)

Bone Marrow Transplantation

d)

Exercise

e)

Healthy Diet

8.

Vaccines in Sickle Cell?

a)

Hib

b)

Rotavirus

c)

Pneumococcal

d)

HPV

e)

Meningococcal

9.

Medications used in Iron Chelation include Exade, Deferipone, Dexamethasone and Drixua.

a)

True

b)

False

10.

Possible treatment options for Sickle Cell?

a)

Droxia

b)

Voxeletor

c)

Penicillin

d)

Crizanlizumab

e)

All of the above

11.

How does Metronidazole affect Warfarin?

a)

No effect

b)

Increases APPT

c)

Increases INR

d)

Decreases INR

12.

1st line treatment for Sickle Cell is:

a)

Droxia

b)

Hydrea

c)

Siklos

d)

Hydroxyurea

e)

All of the above

13.

Boxed warning for Cleocin?

a)

Contraindicated with MAO Inhibitors

b)

Colitis

c)

Myelosuppression

d)

Terratogenic

14.

Which penicillins require no renal adjustments?

a)

Ampicillin

b)

Oxacillin

c)

Amoxicillin

d)

Penicillin V Potassium

15.

Which substance can not be mixed with Ceftriaxone?

a)

Levothyroxine

b)

Phosphate

c)

Lactated Ringer

d)

Omeprazole

16.

Which quinolone has the lowest risk of QT prolongation?

a)

Moxifloxacin

b)

Delafloxacin

c)

Ciprofloxacin

d)

Levofloxacin

17.

Which antibiotic requires dose to be taken with 8oz of water and to sit upright for at least 30 minutes?

a)

Daptomycin

b)

Delafloxacin

c)

Doxorubicin

d)

Doxifloxacin

18.

How long after discontinuing Metronidazole should a patient avoid alcohol?

a)

1-2 days

b)

5 days

c)

7 days

d)

3 days

19.

Which drug should be avoided with Marplan?

a)

Linezolid

b)

Leucovorin

c)

Levothyroxine

d)

Levofloxacin

20.

Which drug indicated for MRSA of the nares?

a)

Vancomycin

b)

Meropenem

c)

Mupirocin

d)

Ceftriaxone

21.

What is the ratio of Sulfamethoxazole to Trimethoprim?

a)

4:1

b)

2:1

c)

1:1

d)

5:1

22.

Which quinolone has coverage against MRSA?

a)

Moxifloxacin

b)

Delafloxacin

c)

Levofloxacin

d)

Gatifloxacin

23.

An 80-year old patient is taking Ecotrin The prescriber orders Aggrenox. Is this a contraindication?

a)

Decline to dispense due to the therapeutic duplication

b)

Verify the prescription

c)

Hold Aggrenox and recommend Clopidgrel instead

24.

What is the recommended dosing of Alteplase (Activase) for acute ischemic stroke?

a)

0.6 mg/kg IV bolus over 5 minutes

b)

0.9 mg/kg IV, 10% bolus then infusion over 60 minutes

c)

1 mg/kg IV infusion over 24 hours

d)

Fixed dose of 100 mg IV

25.

Which statement correctly differentiates ischemic from hemorrhagic stroke?

a)

Ischemic stroke is caused by vessel rupture

b)

Hemorrhagic stroke results from arterial occlusion

c)

Ischemic stroke is due to reduced cerebral blood flow

d)

Hemorrhagic stroke is treated with thrombolytics

26.

What is the primary mechanism of action of mannitol when used in acute stroke management?

a)

Inhibits sodium reabsorption in the ascending loop of henle

b)

Increases plasma osmolality, drawing water out of brain tissue

c)

Reduces CSF production via Carbonic Anhydrase Inhibition

d)

Causes cerebral vasodilation to increase oxygen delivery

27.

Which guideline is used to guide acute and secondary prevention management of stroke?

a)

ACC/AHA Cholesterol Guidelines

b)

CHEST Antithrombotic Guidelines

c)

AHA/ASA Stroke Guidelines

d)

KDIGO Guidelines

28.

Which of the following are modifiable risk factors for acute coronary syndrome (ACS)?

a)

Hypertension

b)

Tobacco Use

c)

Male Sex

d)

Dyslipidemia

29.

What is the maximum recommended dose of alteplase for STEMI?

a)

50 mg

b)

90 mg

c)

100 mg

d)

120 mg

30.

Angiotensin converting enzyme inhibitors (ACEi) or Angiotensin receptor blocker (ARB) is the initial drug of choice for patients with stage 3 CKD or CKD with albuminuria?

a)

True

b)

False

31.

Which P2Y12 inhibitors cause irreversible platelet inhibition?

a)

Clopidogrel

b)

Prasugrel

c)

Ticagrelor

d)

Cangrelor

32.

What is the primary pathophysiologic cause of acute coronary syndrome?

a)

Coronary artery spasm

b)

Gradual coronary artery narrowing

c)

Rupture of an atherosclerotic plaque with thrombus formation

d)

Increased myocardial oxygen demand alone

33.

Which DHP CCB leaves a ghost tablet (empty shell in stool)?

a)

Amlodipine

b)

Procardia XL

c)

Nicardipine

d)

Diltiazem

34.

Which of the following medications causes DILE? Select all that apply

a)

Hydralazine

b)

Methyldopa

c)

Lisinopril

d)

Spironolactone

35.

What antihypertensive should be avoided in pregnancy? Select all that apply

a)

Altace

b)

Lisinopril

c)

Labetalol

d)

Nifedipine XR

e)

Benicar

36.

  1. What drug use in dyslipidemia through REMS due to the risk of hepatotoxicity

a)

Vascepa

b)

Niacin

c)

Gemfibrozil

d)

Lomatiapide

37.

  1. How often do you apply clonidine patches?

a)

Twice a week

b)

Daily

c)

Twice a day

d)

Monthly

e)

Weekly

38.

How are the PCSK9 inhibitors administered?

a)

PO

b)

IM

c)

SC

d)

IV

39.

  1. Statins cannot be used with which of the following medication because of increased risk of myopathy

a)

Gemfibrozil

b)

Welchol

c)

Ezetimibe

d)

Repatha

40.

What is desirable LDL?

a)

>100

b)

<100

c)

<150

d)

>40

e)

<50

41.

What's the MOA of statins?

a)

Inhibits absorption of cholesterol in the small intestine

b)

Inhibits the enzyme 3-hydroxy-3-melthyglutaryl coenzyme A reductase, which prevents the conversion of 3-hydroxy-3-melthyglutaryl coenzyme A to mevalonate

c)

Bind bile acids in intestines, forming a complex that is excreted in feces

42.

From the following list, choose the drugs that can cause pulmonary arterial hypertension (PAH):

a)

SSRI use during pregnancy

b)

Cocaine

c)

Amitriptyline

d)

Methamphetamine/amphetamine

e)

Fenfluramine

43.

What is the MOA of prostacycline analogs (or prostanoids) and receptor agonist?

a)

Potent vasodilators and inhibitors of platelet aggregation

b)

Improves cardiac output or control heart rate

c)

Vasoconstrictor with cellular proliferative effects

d)

Increased cGMP concentrations lead to pulmonary vasculature relaxation and vasodilation

44.

What is the most common cause of death in people who have pulmonary arterial hypertension (PAH)?

a)

Liver Failure

b)

Heart Failure

c)

Pulmonary Failure

d)

Renal Failure

e)

Pancreatitis

45.

Flolan (eproprosterol) stating infusion dose is:

a)

2 ng/kg/min

b)

5 ng/kg/min

c)

10 ng/kg/min

d)

2 ng/kg/hr

e)

5 ng/kg/hr

46.

What is the boxed warning of the endothelin receptor antagonist?

a)

Glaucoma

b)

Seizures

c)

Hyperthyroidism

d)

Teratogenic

e)

Increased asthma related deaths

47.

What are some drugs that can increase or prolong the QT interval? Select all that apply

a)

Haloperidol

b)

Macrolides

c)

Lefamulin

d)

Tricyclic antidepressants

e)

Hydralazine

48.

What are the side effects of amiodarone? Select all that apply

a)

Photosensitivity

b)

Tachycardia

c)

Corneal Microdeposits

d)

Drug-Induced Lupus Erythematosus (DILE)

e)

Constipation

49.

If starting amiodarone, while on digoxin and/or warfarin: what is the recommended dosing?

a)

Increase digoxin dose by 25%, increase warfarin by 30-50%

b)

Decrease digoxin by 25%, decrease warfarin by 30-50%

c)

Decrease digoxin dose by 50%, decrease warfarin by 30-50%

d)

Increase digoxin dose by 50%, decrease warfarin by 30-50%

e)

Make no changes

50.

What is the therapeutic range of digoxin for Atrial fibrillation?

a)

0.5- 0.9 ng/mL

b)

0.5 – 0.9 mg/mL

c)

0.8-2 mg/mL

d)

0.8-2 ng/mL

e)

0.125-0.25 mg

51.

Adenocard (adenosine) is used in what type of tachycardia?

a)

Atrial Flutter

b)

AV nodal reentrant

c)

Atrial Fibrilation

d)

Paroxysmal Supraventricular

e)

Ventricular

52.

A patient with nonvalvular atrial fibrillation is started on apixaban. Which renal function parameter is MOST important when determining dose adjustments?

a)

Serum potassium

b)

Serum creatinine

c)

Creatinine Clearance

d)

Blood Urea Nitrogen

53.

Which anticoagulant requires routine INR monitoring?

a)

Dabigatran

b)

Apixaban

c)

Warfarin

d)

Rivaroxaban

54.

A patient on warfarin presents with an INR of 9.5 and no signs of bleeding. What is the most appropriate management?

a)

Hold warfarin and give IV Vitamin K

b)

Hold warfarin and give oral Vitamin K

c)

Hold warfarin only

d)

Administer fresh frozen plasma

55.

Which anticoagulant is CONTRAINDICATED in patients with mechanical heart valves?

a)

Warfarin

b)

Apixaban

c)

Heparin

d)

Enoxaparin

56.

What is the mechanism of action of unfractionated heparin?

a)

Direct factor Xa inhibition

b)

Direct thrombin inhibition

c)

Antithrombin III-mediated inhibition of factor Xa and IIa

d)

Vitamin K antagonism

57.

Which laboratory parameter is used to monitor unfractionated heparin therapy?

a)

INR

b)

aPTT

c)

Anti-Xa (routine)

d)

Platelet count

58.

A patient develops thrombocytopenia 7 days after starting heparin. Which condition is most likely?

a)

TTP

b)

DIC

c)

Heparin-induced thrombocytopenia

d)

Immune thrombocytopenic purpura

59.

Which agent is used to reverse the anticoagulant effects of dabigatran?

a)

Protamine sulfate

b)

Vitamin K

c)

Idrucizumab

d)

Andexanet alfa

60.

Which anticoagulant is most appropriate for a patient with severe renal impairment (CrCl <15 mL/min)?

a)

Dabigatran

b)

Rivaroxaban

c)

Apixaban

d)

Warfarin

61.

What is the target INR range for a patient with a mechanical mitral valve?

a)

1.5-2.0

b)

2.0-3.0

c)

2.5-3.5

d)

3.0-4.0

62.

Which statement about digoxin in heart failure is correct?

a)

It is negative inotropic and positive chronotropic

b)

It has no effect on contractility or heart rate

c)

It is positive inotropic and negative chronotropic

d)

It improves mortality but not symptoms in failure

63.

Which drug is IV only and used for acute end stage heart failure in the hospital?

a)

Spironolactone oral doses

b)

Dapagliflozin oral tablets

c)

Milrinone given as IV infusion

d)

Metoprolol succinate tablets

64.

A heart failure patient has EF <40% and very high PCWP with severe dyspnea.

What should be added now?

a)

Add spironolactone today

b)

Start Entresto immediately

c)

Increase the beta blocker dose

d)

Start IV furosemide (Lasix) now

65.

Which group represents the four base therapies every HFrEF patient should be on

if possible?

a)

Loop diuretic, ACE, nitrates, digoxin daily

b)

ACE/ARB/Entresto, beta blocker, aldosterone blocker, SGLT2

c)

ARB, vericiguat, ivabradine, thiazide pills

d)

Entresto, hydralazine, isosorbide, verapamil

66.

Which beta blocker is among the three recommended for heart failure?

a)

Metoprolol succinate (Toprol XL)

b)

Propranolol long acting tablets

c)

Metoprolol tartrate (Lopressor)

d)

Atenolol extended release dose

67.

Which antibiotic inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs)?

a)

Azithromycin

b)

Ciprofloxacin

c)

Ceftriaxone

d)

Doxycycline

68.

Which antibiotic is most appropriate for atypical pneumonia caused by Mycoplasma pneumoniae?

a)

Amoxicillin

b)

Cefazolin

c)

Azithromycin

d)

Vancomycin

69.

A patient receiving gentamicin should be closely monitored for which adverse effect?

a)

QT Prolongation

b)

Nephrotoxicity

c)

Bone marrow suppresion

d)

Tendon Rupture

70.

Which antibiotic does NOT require renal dose adjustment?

a)

Vancomycin

b)

Gentamicin

c)

Piperacillin/Tazobactam

d)

Doxycycline

71.

Which antibiotic class carries a black box warning for tendon rupture?

a)

Macrolides

b)

Fluoroquinolones

c)

Tetracyclines

d)

Sulfonamides

72.

Which antibiotic is most strongly associated with C. difficile infection?

a)

Clindamycin

b)

Nitrofurantoin

c)

Azithromycin

d)

Fosfomycin

73.

Which antibiotic is effective for MRSA skin and soft tissue infections?

a)

Cephalexin

b)

Amoxicillin

c)

Trimethoprim-sulfamethoxazole

d)

Ceftriaxone

74.

Which antibiotic is contraindicated in pregnancy due to risk of fetal tooth discoloration?

a)

Amoxicillin

b)

Cephalexin

c)

Tetracycline

d)

Azithromycin

75.

Which antibiotic provides strong anaerobic coverage, especially for Bacteroides fragilis?

a)

Ciprofoxacin

b)

Metronidazole

c)

Gentamicin

d)

Aztreonam

76.

Extended-spectrum beta-lactamase (ESBL) producing organisms are best treated with:

a)

Cefepime

b)

Piperacillin/tazobactam

c)

Meropenem

d)

Amoxicillin/clavulanate

77.

Which antibiotics require therapeutic drug monitoring (TDM)?

a)

Vancomycin

b)

Gentamicin

c)

Linezolid

d)

Tobramycin

e)

Azithromycin

78.

Which antibiotics provide coverage against anaerobic bacteria?

a)

Metronidazole

b)

Clindamycin

c)

Piperacillin/Tazobactam

d)

Aztreonam

e)

Imipenem

79.

Which antibiotics should be avoided in pregnancy?

a)

Doxycycline

b)

Ciprofloxacin

c)

Trimethoprim-Sulfamethoxazole

d)

Amoxicillin

e)

Tetracycline

80.

Which antibiotics are beta-lactams?

a)

Amoxicillin

b)

Ceftriaxone

c)

Meropenem

d)

Azithromycin

e)

Piperacillin

81.

A patient 23 year old patient with mild intermittent asthma is prescribed Ventolin HFA (albuterol) 90 mcg per actuation for acute symptom relief.

Sig: Inhale 2 puffs every 4-6 hours as needed for shortness of breath or wheezing.

The pharmacy dispenses Ventolin HFA inhaler containing 60 inhalations. What is the maximum number of days this inhaler could last if the patient uses it at the highest recommended frequency?

a)

2 days

b)

5 days

c)

14 days

d)

30 days

82.

Bridget is starting on Singulair. Which warning should be communicated with the use of Singulair?

a)

Neuropsychiatric events

b)

Floppy Iris Syndrome

c)

Bone Marrow Suppression

d)

Hepatotoxicity

e)

Peripheral neuropathy

83.

What are the medications in Breo Ellipta?

a)

Fluticasone + Salmeterol

b)

Budesonide + Formoterol

c)

Fluticasone + Vilanterol

d)

Mometasone + Formoterol

84.

Majority of metered-dose inhalers need to be shaken will immediately before use. Which metered-dose inhaler does not have to be shaken before use?

a)

Synbicort

b)

Xopenex HFA

c)

Flovent HFA

d)

Asmanex HFA

e)

QVAR RediHaler

85.

Danny uses Spiriva Respimat 2.5 mcg/inhalation. He inhales 5 mcg once daily. If each cartridge contains 60 metered actuations, how long will each cartridge last?

a)

20 days

b)

14 days

c)

30 days

d)

90 days

e)

60 days

86.

Behavioral counseling along is the preferred first-line treatment for tobacco cessation in which of the following patient populations

a)

Patients ≥ 18 years old making a first quit attempt

b)

Patients ≥ 18 years old who smoke < 10 cigarettes daily

c)

Patients who are pregnant

d)

Patients who smoke up to 35 cigarettes daily

e)

Patients < 18 years old with mild tobacco dependence

87.

Which of the following are adverse effects of Varenicline?

a)

Hiccups

b)

Depressed mood

c)

Headache

d)

Nausea

e)

Vivid Dreams

88.

Bella has smoked one pack of cigarettes per day for 10 years and does not drink alcohol. She is ready to quit and started on NicoDerm CQ. Which daily dose is most appropriate for initiation of the selected smoking cessation therapy?

a)

4 mg

b)

8 mg

c)

7 mg

d)

14 mg

e)

21 mg

89.

Jackson's biggest concern with quitting smoking is the potential for weight gain. Based on this concern, which treatment options are best to consider?

a)

Bupropion sustained-release

b)

Electronic cigarettes

c)

Nicorette

d)

Nicorette Mini

e)

Vareniciline

90.

Which statement is FALSE for a Nicotine Lozenge?

a)

Do not chew or swallow. Allow it dissolve slowly.

b)

May cause a warm or tingling sensation

c)

Do not eat or drink 15 minutes during or after use

d)

Do not use more than one lozenge at a time or continously

e)

Move the lozenge from one side of the mouth to the other until it has completely dissolved.

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