Cardiovascular

Question 1

Which medications inhibit effectiveness of direct oral anticoagulants and should not be used with them?

Answer 1

Phenytoin, phenobarbital, carbamazepine, St. John’s wort, levetiracetam, rifampin

Question 2

Which agents can be used for rhythm control in patients with coronary artery disease (4)?

Answer 2

Dofetilide
Dronedarone
Sotalol
(Amiodarone)

Question 3

Which agents can be used for rhythm control in patients with heart failure?

Answer 3

Dofetilide
Amiodarone

Question 4

Which rhythm control meds must be initiated in hospital due to the need for continuous EKG monitoring?

Answer 4

Sotalol, dofetilide

Question 5

Which anticoagulant should not be used in a patient with creatinine clearance of 95 mL/min or greater?

Answer 5

Edoxaban

Question 6

Medication causes of hypertension

Answer 6

Corticosteroids
Cyclosporine and tacrolimus
Erythropoetin stimulating agents
NSAIDs
Sympathomimetics

Question 7

Stage one hypertension, definition

Answer 7

130 - 139/80 -90 mmHg

Question 8

Stage two hypertension, definition

Answer 8

> = 140/90 mmHg

Question 9

Drugs with negative inotropic effects

Answer 9

Anti-arrhythmics
Beta-blockers
Non-DHP CCBs
Itraconazole

Question 10

Cardiotoxins

Answer 10

alcohol
Chemo (anthracyclines, cyclophosphamide, paclitaxel)
Amphetamines

Question 11

Medications which can trigger heart failure flare due to sodium and water retention

Answer 11

Androgens and estrogens
COX-2 inhibitors
Glucocorticoids
NSAIDs
Salicylates
Thiazolidinediones

Question 12

What dose of ethacrynic acid should be used in a patient switching from torsemide 20 mg daily

Answer 12

Ethacrynic acid 50 mg daily

Question 13

What is the most accurate test for primary aldosteronism? (And positive cut off)

Answer 13

Aldosterone:renin activity ratio (30 ng/dL)

Question 14

Calculating LDL –C

Answer 14

TC - (TG/5) - HDL-C

Question 15

At What level of triglycerides would measurement of apoB be considered?

Answer 15

Triglycerides >= 200 mg/dL

Question 16

What apoB level Constitutes a risk enhancing factor?

Answer 16

> 130 mg/dL

Question 17

What are the indications for measurement of lipoprotein a?

Answer 17

Family history of premature ASCVD, or personal history of ASCVD not explained by major risk factors

Question 18

What level of Lp(a) is a risk-enhancing factor?

Answer 18

Lp(a) > = 50 mg/dL

Question 19

What is the reduction in ASCVD risk provided by 38.7 mg/dL LDL – C reduction?

Answer 19

21%

Question 20

LDL – C reduction expected by from high intensity statin therapy

Answer 20

> = 50%

Question 21

Which statins are considered high intensity, at what dose?

Answer 21

Atorvastatin 80 mg, rosuvastatin 20 mg

Question 22

What extent of LDL – C lowering does ezetimibe provide?

Answer 22

13-20%

Question 23

When should addition of a PCSK9 inhibitor be considered?

Answer 23

Patient on maximally tolerated LDL lowering therapy with LDL– C 70 mg/dL or higher

Question 24

HAS-BLED

Answer 24

HTN
Abnormal renal (dialysis, transplant or SCr > 2.6)
Abnormal liver (cirrhosis, Bili > 2 x ULN, AT/ALT/ALP > 3 x ULN)
Stroke
Bleeding
Labile INRs (< 60 Time in range)
Elderly (>65 yrs)
Drugs (ASA or NAIDs) or alcohol

Question 25

CHA₂DS₂-VASc

Answer 25

**C**ongestive heart failure or LV dysfunction **H**ypertension **A**ge (>75 yrs) **D**iabetes melitus **S**troke or TIA or thromboembolism **V**ascular disease (prior MI, PAD, or aortic plaque) **A**ge 65-74 yrs **S**ex **C**ategory (female gender)

Question 26

What is the recommended Fluid restriction for heart failure?

Answer 26

48-56 ounces/day

Question 27

Ivabradine criteria for use

Answer 27

-Symptomatic HFrEF (=<35%) -Receiving GDMT, including a beta blocker at max tolerated dose -In sinus rhythm -Heart rate >= 70 bpm

Question 28

What is the goal of dyslipidemia treatment in primary prevention with a statin (in patient 50-75 yrs)?

Answer 28

Reduce LDL cholesterol by over 50% of baseline AND Target an LDL cholesterol less than 70 mg/dL

Question 29

What is the target treatment with high intensity statin for people (50-75 yrs) with diabetes and atherosclerotic cardiovascular disease?

Answer 29

LDL cholesterol reduction of >= 50% AND LDL cholesterol =< 55 mg/dL

Question 30

What is the recommended intensity of therapy initiation in patients over 75 years of age?

Answer 30

Moderate intensity

Question 31

What is the expected benefit of adding an SGLT2 inhibitor in person with type 2 diabetes and established preserved ejection fraction heart failure? (HFpEF)

Answer 31

Improve symptoms, physical limitations, and quality of life

Question 32

What medication should be added to improve cardiovascular outcome, and reduce the risk of chronic kidney disease progression for patients with type 2 Diabetes and chronic kidney disease with albuminuria already receiving an ACEi or ARB?

Answer 32

Finerinone

Question 33

What are the criteria for addition of an SGLT2 inhibitor in a patient with type 2 diabetes and chronic kidney disease?

Answer 33

GFR >= 20 mL/min/1.73 m² AND Urinary albumin >= 200 mg/g creatinine