Therapeutics Exam 4
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- 1.Angina Pectoris can be precipitated by all of the following except:
- A.
Failing a therapeutics test because of a poorly graded question
- B.
Getting in a fight with your parents
- C.
Jogging
- D.
Laying on the couch after a meal
- E.
Walking to your car in a blizzard
- 2.Which are considered non-modifiable CHD risk factors:
- A.
Type 2 Diabetes
- B.
Being 70
- C.
Premature menopause
- D.
LDL of 120
- E.
HDL of 39
- F.
Your grandpa had a heart attack at 55
- G.
Your mother had coronary ischemia at 59
- 3.If Jimmy believes he is having his 2nd acute coronary event, but doesn't feel like he is in too much pain, it is OK for his wife to drive him to the ER because he doesn't have insurance.
- A.
True
- B.
False
- 4.The COURAGE trial showed that patients who have stable ischemic heart disease who receive PCI have a decreased incidence mortality in 4 years than patients who are med treated
- A.
True
- B.
False
- 5.ACE-I should be considered for patients with Stable Ischemic Heart Disease with these other co-morbid diseases, EXCEPT
- A.
Hyperlipidemia
- B.
Diabetes
- C.
HTN
- D.
CKD
- E.
LV systolic dysfunction
- 6.Beta blockers improve angina symptoms in patients with stable ischemic heart disease, but do not affect mortality.
- A.
True
- B.
False
- 7.If a patient has had a recent MI, their LDL goal is
- A.
- B.
- C.
- D.
- 8.Which are counseling points when dispensing SL NTG?
- A.
Keep with you at all times! May keep in a coat pocket, purse, fanny pack or shirt pocket.
- B.
Discard if tablets become "fuzzy" or until expiration date on bottle
- C.
Discard every 6 months
- D.
Place on the tongue every 5 minutes for 3 doses for refractory angina (as long as doctor is aware they are taking 3 doses before calling 911)
- E.
May cause an increase in heart rate
- F.
May be used as an analgesic
- G.
Take while sitting down
- 9.Short-acting Nifedipine can be used for ischemic heart disease.
- A.
True
- B.
False
- 10.Which CCB is the drug of choice for stable ischemic heart disease if the patient also has systolic heart failure?
- A.
Nifedipine
- B.
Cardizem
- C.
Diltiazem
- D.
Amlodipine
- 11.Which cardiac enzyme stays elevated for the longest period of time (on average)?
- A.
Troponin
- B.
Myoglobin
- C.
CK-MB
- D.
CK
- 12.In a patient who had a previous MI but was unaware of it, what will be different on their EKG?
- A.
ST depression
- B.
T wave inversion
- C.
Q wave
- D.
Nothing
- 13.When determining what type of acute coronary syndrome (ACS) a patient is experiencing, what are the 3 signs and symptoms that need to be evaluated? EKG, cardiac enzymes and:
- 14.Upon presenting to the ER for a NSTEMI, the patient should be given 81 mg ASA ASAP
- A.
True
- B.
False
- 15.The correct morphine dosing for UA/NSTEMI is:
- A.
2-4 mg/kg IV with increments of 2-8 mg/kg IV repeated at 5-15 min intervals
- B.
2-4 mg IV with increments of 2-8 mg IV repeated at 5-15 min intervals
- C.
1-2 mg/kg IV with increments of 2-10 mg/kg IV repeated at 5-15 min intervals
- D.
1-2 mg IV with increments of 4-8 mg IV repeated at 5-15 min intervals
- 16.The correct NTG IV dosing for a patient presenting with UA/NSTEMI is:
- A.
2-4 mg/min IV up to 100 mg/min IV until relief or limiting symptoms
- B.
5-10 mg/min IV up to 200 mg/min IV until relief or limiting symptoms
- C.
1-2 mcg/min IV up to 200 mcg/min IV until relief or limiting symptoms
- D.
5-10 mcg/min IV up to 200 mcg/min IV until relief or limiting symptoms
- 17.Clopidogrel has more rapid onset and more platelet inhibition than ticagrelor
- A.
True
- B.
False
- 18.If the patient is 76 years old and weights 130 pounds, she should be given the 5mg QD dose of Prasugrel
- A.
True
- B.
False
- 19.Fibrinolytic therapy should ALWAYS be initiated for a STEMI at a non-PCI-capable facility even if it has been 2 days since symptom onset
- A.
True
- B.
False
- 20.Triple therapy for refractory angina includes all of the following EXCEPT:
- A.
Long-acting nitrates
- B.
CCB
- C.
ACE-I
- D.
BB
- 21.Norepinephrine generally works by promoting sodium retention, increasing ventricular hypertrophy, increased cardiac fibrosisis and oxidative stress.
- A.
True
- B.
False
- 22.2/3 of heart failure hospitalizations are due to MIs.
- A.
True
- B.
False
- 23.Which are negative inotropic medications?
- A.
Doxorubicin
- B.
Some BBs
- C.
CCB
- D.
Terbinafine
- E.
Amphetamines
- F.
COX2 inhibitors
- G.
Antiarrhythmics
- H.
Imatinib
- 24.Which does not have a mortality benefit in systolic heart failure?
- A.
BB
- B.
ACE-I
- C.
Diuretics
- D.
Aldosterone Antagonists
- 25.Which drug CAN be used for systolic HF but absolutely should not be used in diastolic HF?
- A.
Digoxin
- B.
Metoprolol Tartrate
- C.
Metoprolol Succinate
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