Pharm Heart Failure

20 Questions | Total Attempts: 1547

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Pharm Heart Failure - Quiz

Heart failure is about as terrifying as it sounds, but suffering from it doesn’t necessarily mean the end every time. In this quiz, we’ll be looking at some of the means of treating this terrible condition with the use of pharmaceuticals. Let’s take a look and see how many questions you can get right.


Questions and Answers
  • 1. 
    Directions: questions 1-5 Match each drug used in cardiac failure with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can cause peripheral vasodilation by increasing cAMP levels.
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Dobutamine

    • D. 

      Furosemide

    • E. 

      Losartan

    • F. 

      Milrinone

    • G. 

      Nesiritide

    • H. 

      Propranolol

    • I. 

      Spironolactone

  • 2. 
    Directions: questions 1-5 Match each drug used in cardiac failure with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can increase the synthesis of cAMP in the heart
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Dobutamine

    • D. 

      Furosemide

    • E. 

      Losartan

    • F. 

      Milrinone

    • G. 

      Nesiritide

    • H. 

      Propranolol

    • I. 

      Spironolactone

  • 3. 
    Directions: questions 1-5 Match each drug used in cardiac failure with the appropriate description (each lettered option can be selected once, more than once, or not at all): The chronic use of this diuretic can reduce mortality in patients with heart failure
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Dobutamine

    • D. 

      Furosemide

    • E. 

      Losartan

    • F. 

      Milrinone

    • G. 

      Nesiritide

    • H. 

      Propranolol

    • I. 

      Spironolactone

  • 4. 
    Directions: questions 1-5 Match each drug used in cardiac failure with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can cause peripheral vasodilation by increasing the synthesis of cGMP
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Dobutamine

    • D. 

      Furosemide

    • E. 

      Losartan

    • F. 

      Milrinone

    • G. 

      Nesiritide

    • H. 

      Propranolol

    • I. 

      Spironolactone

  • 5. 
    Directions: questions 1-5 Match each drug used in cardiac failure with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can increase central parasympathetic firing
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Dobutamine

    • D. 

      Furosemide

    • E. 

      Losartan

    • F. 

      Milrinone

    • G. 

      Nesiritide

    • H. 

      Propranolol

    • I. 

      Spironolactone

  • 6. 
    A 68-year-old man recently diagnosed with heart failure, started a treatment with metoprolol, losartan, furosemide and digoxin. Which of the following molecular actions most likely mediated the positive inotropic action of digoxin?
    • A. 

      Closing of calcium channels in cardiac cell membranes

    • B. 

      Increased release of Ca++ from sarcoplasmic reticulum during systole

    • C. 

      Activation of Na+/K+ ATPase

    • D. 

      Activation of Ca++/Na+ exchanger in cardiac cell membranes

    • E. 

      Opening of K+ channels in cardiac cell membranes

  • 7. 
    A 57-year-old man suffering from persistent atrial fibrillation started a treatment with digoxin, one tablet daily. Which of the following actions most likely mediated the therapeutic effect of digoxin in the present case?
    • A. 

      Opening of Ca++ channels of cardiac cell membranes

    • B. 

      Stimulation of vagal activity

    • C. 

      Blockade of Ca++/Na+ exchanger

    • D. 

      Blockade of Na+/K+ pump

    • E. 

      Inhibition of phosphodiesterase

  • 8. 
    A 57-year-old woman suffering from persistent atrial flutter started a treatment with digoxin, one tablet daily. Which of the following cardiac actions most likely occurred during the therapy?
    • A. 

      Increased end systolic volume

    • B. 

      Decreased abnormal cardiac automaticity

    • C. 

      Decreased diastolic time

    • D. 

      Increased atrial refractoriness

    • E. 

      Decreased heart rate

  • 9. 
    A 61-year-old man, recently diagnosed with stage C heart failure, was admitted to the hospital for a control visit. It was found that he had an ejection fraction of 30% at rest and a treatment which included digoxin was started. Which of the following cardiovascular parameters did digoxin most likely increase in this patient?
    • A. 

      Stroke volume

    • B. 

      Total peripheral resistance

    • C. 

      Oxygen consumption of the heart

    • D. 

      End-diastolic volume

    • E. 

      Heart rate

  • 10. 
    A 42-year-old man was admitted to the hospital in acute distress with breathlessness, markedly distended neck veins and atrial fibrillation. The blood pressure was 100/90 mm Hg, the pulse 120 bpm. An echocardiogram revealed an ejection fraction of 35%. A treatment was started with furosemide, captopril and digoxin. In this patient digoxin most likely decreased which of the following cardiovascular parameters?
    • A. 

      Stroke volume

    • B. 

      End-systolic volume

    • C. 

      End diastolic volume

    • D. 

      Systolic pressure

    • E. 

      Pulse pressure

  • 11. 
    A 68-year-old woman recently diagnosed with C heart failure, started a treatment with digoxin, 1 tablet daily. Knowing that digoxin has a CL of 7L/h and an oral bioavailability of 70%, which of the following doses was most likely given to achieve a steady state plasma concentration of 1 ng/mL?
    • A. 

      1.4

    • B. 

      0.125

    • C. 

      0.24

    • D. 

      2.0

    • E. 

      0.5

    • F. 

      2.4

  • 12. 
    A 63-year-old man complained to his physician of nausea, vomiting and visual sensation of green-yellow halos around bright objects. The man, recently diagnosed with cardiac failure and atrial fibrillation, had started an appropriate treatment two weeks previously. Which of the following drugs most likely caused the patient’s symptoms?
    • A. 

      Verapamil

    • B. 

      Propranolol

    • C. 

      Digoxin

    • D. 

      Lidocaine

    • E. 

      Furosemide

    • F. 

      Captopril

  • 13. 
    A 63-year-old woman, admitted to the hospital for a control visit, was found to have a third degree AV block. The woman, who had been suffering from stage C heart failure, had been receiving captopril, furosemide and digoxin for two months and the disease was well controlled. The physician believed that the block was due to digoxin therapy. Which of the following would be an appropriate therapeutic conduct for this patient?
    • A. 

      Discontinue digoxin and start milrinone

    • B. 

      Add physostigmine and decrease digoxin dose

    • C. 

      Add atropine and decrease digoxin dose

    • D. 

      Discontinue digoxin and start metoprolol

    • E. 

      Add dobutamine and decrease digoxin dose

    • F. 

      Discontinue digoxin and start losartan

  • 14. 
    A 54-year-old woman presented to the hospital complaining of palpitations. The woman, recently diagnosed with stage C heart failure, started a therapy with metoprolol, digoxin and captopril one month ago. Her medications also included estrogens and calcium supplement for postmenopausal osteoporosis. Patient’s vital signs were: blood pressure 145/90, pulse 130 bpm. An ECG showed ventricular tachycardia. Significant plasma levels on admission were: K 5.8 mEq/L, Ca 12.2 mEq/L, creatinine 3.5 mg/dL . Which of the following events most likely triggered the patient’s arrhythmia?
    • A. 

      The metoprolol-induced decrease in cardiac contractility

    • B. 

      The increased serum K+ level

    • C. 

      The captopril-induced vasodilation

    • D. 

      The increased serum Ca++ level

    • E. 

      The estrogen-induced hypertension

  • 15. 
    A 61-year-old alcoholic male was admitted to the hospital with a 2-day history of epigastric pain associated with nausea and vomiting. The man had been suffering from systolic heart failure for two years. Present medications were captopril, furosemide and digoxin. Pertinent serum data on admission were: K+ 2.8 mEq/L, creatinine 3.2 mg/dL. An ECG showed an heart rate of 65 bpm with occasional premature ventricular contractions and runs of bigeminy. Which of the following would be an appropriate therapeutic conduct for this patient?
    • A. 

      Add potassium supplementation and reduce digoxin dosage

    • B. 

      Add atropine and reduce digoxin dosage

    • C. 

      Increase furosemide dosage and reduce digoxin dosage

    • D. 

      Discontinue digoxin and start losartan

    • E. 

      Discontinue digoxin and start milrinone

  • 16. 
    A 72-year-old man was admitted to the hospital because of anuria. The man had a long history of severe systolic cardiac failure and chronic obstructive pulmonary disease. Shortly after the admission the patient started vomiting, then become agitated, verbally abusive, and disoriented in space and time. He was telling the nurse that he heard laud voices cursing him. An ECG showed atrial tachycardia with AV block. Which of the following drugs most likely caused the patient’s symptoms?  
    • A. 

      Captopril

    • B. 

      Digoxin

    • C. 

      Ipratropium

    • D. 

      Metoprolol

    • E. 

      Ethacrynic acid

    • F. 

      Albuterol

  • 17. 
    A 65-year-old woman presented to the hospital with a chief complain of palpitations. The woman suffering from stage C heart failure had been receiving digoxin, furosemide and losartan for six months. Laboratory data on admission included: potassium 3.9 mEq/L (normal: 3.5 – 5.0), calcium 9.2 mg/dL (normal: 8.5 – 10.5), magnesium 2.5 mEq/L (normal 1.5 – 2.0) total T4 42 ng/mL (normal 50-110), TSH 15 mIU/mL (normal 0.5-5.5). An ECG showed junctional tachycardia that, according to the physician, was most likely due to digoxin treatment. Which of the following pathological conditions most likely increased the risk of digoxin toxicity in this patient?
    • A. 

      Hypermagnesemia

    • B. 

      Hyperaldosteronism

    • C. 

      Hyperparathyroidism

    • D. 

      Concomitant furosemide treatment

    • E. 

      Hypothyroidism

  • 18. 
    A 65-year-old man was brought to the emergency room in acute distress. He was agitated, incoherent, disoriented in time and space, and seemed to be hallucinating. The patient had been suffering from severe chronic cardiac failure for two years and his wife referred she found an empty bottle of digoxin tablets near the husband’s bed. Vital sings of the patient were: blood pressure 100/50 mm Hg, heart rate 45 bpm. An emergency treatment was instituted and a drug was given IV. Which of the following drugs was most likely administered?
    • A. 

      Lidocaine

    • B. 

      Atropine

    • C. 

      Phenytoin

    • D. 

      Potassium chloride

    • E. 

      Digoxin antibodies

    • F. 

      Amiodarone

  • 19. 
    A 73-year-old man complained to his physician of increasing fatigue and increasing shortness of breath which was often worse at night forcing him to “sit bolt upright”. He also noticed that his feet were getting swollen. Past history of the patient was unremarkable. Vital signs were: blood pressure 150/90, respiratory rate 17/min. On examination a mild pitting edema was seen on the legs. An ECG disclosed a second degree AV block. The physician diagnosed an initial cardiac failure and prescribed an appropriate therapy. Which of the following drugs would be contraindicated for this patient?
    • A. 

      Captopril

    • B. 

      Hydrochlorothiazide

    • C. 

      Digoxin

    • D. 

      Losartan

    • E. 

      Furosemide

    • F. 

      Spironolactone

  • 20. 
    A 62-year-old woman was admitted to the hospital complaining of nausea, mental confusion, dizziness and palpitations. The woman, suffering from hypertension and recurrent atrial fibrillation, had been receiving furosemide, captopril and digoxin for several months. One week ago she started erythromycin and ibuprofen for an acute upper respiratory tract infection. Which of the following events most likely caused the patient’s symptoms?
    • A. 

      Furosemide-induced hypokalemia

    • B. 

      Erythromycin-induced increase in digoxin oral bioavailability

    • C. 

      Furosemide-induced hypocalcemia

    • D. 

      Captopril-induced decrease in digoxin clearance

    • E. 

      Ibuprofen-induced decrease in digoxin clearance