Cardiology

Question 1

MOA of Thiazide Diuretics

Answer 1

Inhibit reabsorption of sodium and chloride ions in the distal tubules

Question 2

Contraindications to Thiazide Diuretics

Answer 2

Gout
Hypotension
Hypothermia
Renal failure
Lithium tx
Sensitivity to sulfa drugs

Question 3

MOA of loop diuretics

Answer 3

Inhibit the sodium- potassium-chloride pump of the kidney in the loop of Henle

Question 4

Contraindications to Loop Diuretics

Answer 4

Anuria (kidney failure)

Question 5

MOA of Aldosterone Receptor Antagonist Diuretics/Mineralocorticoid receptor antagonist/Antimineralcorticoids

Answer 5

Antagonizes the action of aldosterone. Increases elimination of water in the kidneys and conserves potassium

Question 6

Increases risk of hyperkalemia

Answer 6

ACEIs
ARBs
NSAIDs

Question 7

Side effect of Spironolactone

Answer 7

Gynecomastia

Usually reversible after DC

Question 8

Beneficial side effect of Thiazide Diuretics

Answer 8

Help bone loss by slowing down calcium loss (from the bone) and stimulating osteoclasts

Question 9

MOA of BB

Answer 9

Decreases vasomotor activity, decreases CO, and inhibits renin (kidney) and norepinephrine release

Question 10

CI of BB

Answer 10

Asthma, COPD, chronic bronchitis, emphysema

Second and third degree heart block (okay to use with first degree)

Question 11

Types of beta receptors

Answer 11

Beta 1: cardiac

Beta 2: lungs, vascular smooth muscle

Question 12

Cardioselective BB

Answer 12

Atenolol
Metoprolol
Bisoprolol

Question 13

MOA of CCB

Answer 13

Block voltage gated calcium channels in cardiac smooth muscle. Results in systemic vasodilation.

Question 14

SE of dihydropyridine CCBs

Answer 14

HA (d/t vasodilation)
Flushing
Ankle edema (vaso and benign) - dose dependent
Heart block (depressed cardiac muscle and AV node)
Reflex tachy

Question 15

CI to CCB

Answer 15

Sick sinus syndrome
Second and third degree heart block
Brady
HFrEF

Question 16

Dihydropyridine CCBs

Answer 16

-pine ending

Nifedipine
Amlodipine
Felodipine

Question 17

Non-dihydropyridine CCBs

Answer 17

Verapamil
Diltiazem

Question 18

MOA of ACEIs

Answer 18

Inhibit activity of angiotensin-converting enzyme, which decreases conversion of angiotensin I to II (more potent vasoconstrictor)

Question 19

MOA of ARBs

Answer 19

Block the effect of angiotensin II

Question 20

SE of ACEIs

Answer 20

Dry cough (more so w/ARBs)
Hyperkalemia
Angioedema (rare but life threatening)
Do not use in pregnancy

Question 21

ACEI examples

Answer 21

Usually “pril” ending

Ramiro
Benazepril
Enalapril
Fosinopril

Question 22

ARB examples

Answer 22

“Artan” ending

Losartan
Candesartan
Olmesartan
Ibesartan

Question 23

Guideline directed therapy for HFrEF

Answer 23

Diuretic
BB
ACEI/ARB
ARNI

Non-dihydropyridine CCBs are not recommended

Question 24

First line therapy for HTN

Answer 24

Diuretics
ACEIs
ARB
CCB

Question 25

Preferred HTN agents for African Americans

Answer 25

Thiazides CCBs

Question 26

Preferred HTN agent for CKD

Answer 26

ACEI/ARB

Question 27

SE of ARBs

Answer 27

Hyperkalemia Do not use in pregnancy

Question 28

SE of Alpha Blockers

Answer 28

Orthostatic hypotension

Question 29

SE of ARNIs

Answer 29

Sacubitril w/valsartan (Entresto) Hypotension, hyperkalemia, cough, angioedema

Question 30

SE of BB

Answer 30

Brady Fatigue Insomnia ED Brinchospasm

Question 31

SE of Loop Diuretics

Answer 31

Hypokalemja Hyponatremja Hyperuricemia Dehydration

Question 32

SE of Nondihydropyridine CCBs

Answer 32

Worsening CO Brady Constipation

Question 33

SE of Potassium sparing diuretics

Answer 33

Hyperkalemia Hyponatremia Dehydration

Question 34

SE of Thiazide Diuretics

Answer 34

Hypokalemia Hyponatremia Hyperuricemia Hypercalcemia Dehydration

Question 35

HTN med following MI

Answer 35

BB ACEI Aldosterone

Question 36

Asymptomatic MV prolapse interventions

Answer 36

No treatment Lifestyle changes: avoid caffeine, alcohol, cigarettes, aerobic exercise, reduce stress

Question 37

ABI for PAD

Question 38

Meds for PAD

Answer 38

Cilostazol (vasodilator) - phosphodiesrerase inhibitor Can be taken w/ASA and Clopidogrel Serum concentration can be increased if taken w/ grapefruit juice, diltiazem, and omeprazole

Question 39

Meds for PAD

Answer 39

Cilostazol - phosphodiesrerase inhibitor Can be taken w/ASA and Clopidogrel Serum concentration can be increased if taken w/ grapefruit juice, diltiazem, and omeprazole

Question 40

Pulsus Paradoxus

Answer 40

Fall of SBP of more than 10 mmHg during inspiratory phase - paradoxical pulse, important physical sign of cardiac tamponade Cause: Pulm (asthma, emphysema) or CI (pericarditis, cardiac effusion- decreases movement of the left ventricle)

Question 41

Cardiac Temponade

Answer 41

Fluid build up in the pericardial sac, compressing the heart

Question 42

Cardiac Temponade

Answer 42

Fluid build up in the pericardial sac, compressing the heart

Question 43

Foods High in K+

Answer 43

Avocados Sweet potatoes Coconut water Bananas Oranges Watermelon Cantaloupe Honeydew Apricots Grapefruit Leafy vegetables Edamame

Question 44

Rate Control Meds

Answer 44

BB (metoprolol) CCB (diltiazem) Digoxin

Question 45

Rhythm control meds

Answer 45

Amiodorone BBW - Pulm tox, hepatic injury, hyper/hypothyroidism, visual impairment, peripheral neuropathy, worsened arrhythmia

Question 46

Med that should not be prescribed w/sulfa allergy

Answer 46

Thiazide and loop diuretics

Question 47

ECG Showing Brady

Answer 47

> 5 large boxes

Question 48

ECG showing Tachy

Answer 48

< 3 large boxes