Exam (elaborations)
2024 NAPLEX CARDIOLOGY REVIEW EXAM WITH CORRECT ANSWERS
- Course
- Institution
2024 NAPLEX CARDIOLOGY REVIEW EXAM WITH CORRECT ANSWERS
[Show more]
Content preview
2024 NAPLEX CARDIOLOGYREVIEW EXAM WITH CORRECT
ANSWERS
What is the definition of hypertension? - CORRECT-ANSWERSBP > 140/90
OR
Patient requires antihypertensive therapy
What is the specific MOA of spironolactone? - CORRECT-ANSWERSNON-
selective ARA = blocks aldosterone receptor, but also blocks androgen and
progesterone receptors, which is thus associated with endocrine side effects
What is the specific MOA of eplerenone? - CORRECT-ANSWERSSELECTIVE
ARA = binds the aldosterone receptor only (not associated with endocrine
side effects)
What are contraindications to use of the ARAs? - CORRECT-ANSWERS1) K > 5
mEq/L
2) SCr >2.5 mg/dL
3) CrCl < 30 mL/min
4) Concomitant ACE and ARB use (shouldn't happen)
What is a specific contraindication for eplerenone? - CORRECT-ANSWERSUse
of strong CYP3A4 inhibitors (Ritonavir, ketoconazole, itraconazole,
nefazodone, clarithromycin, etc.)
What is a common side effects for both ARAs? - CORRECT-
ANSWERSHyperkalemia
What side effects are specific to spironolactone? - CORRECT-ANSWERS1)
Gynecomastia
2) Breast tenderness
3) Menstrual changes
4) Hirsutism (can also be used to treat hirsutism)
What agents should you NOT use ARAs with? - CORRECT-ANSWERS1) ACEIs
or ARBs
2) NSAIDs
3) K supplements
Note: All increase hyperkalemia risk
,T/F: ARAs reduce mortality in heart failure patients. - CORRECT-
ANSWERSTrue!
What is epleronone's typical place in therapy? - CORRECT-ANSWERSUsed in
patients that develop bothersome endocrine side effects to spironolactone
What 3 ARBs are used in heart failure? - CORRECT-ANSWERS1) Candesartan
(Atacand)
2) Losartan (Cozaar)
3) Valsartan (Diovan)
Which 2 ARBs are actually approved for use in heart failure? - CORRECT-
ANSWERSCandesartan and Valsartan
T/F: ARBs should be considered equivalent to ACEIs in setting of heart failure.
- CORRECT-ANSWERSFalse. Should NOT be considered equivalent or superior
to ACEIs.
There are 2 vasodilators commonly used for heart failure. What are they? -
CORRECT-ANSWERS1) Hydralazine = only available generically (40-300
mg/day)
2) Isosorbide dinitrate = Isordil (30-120 mg/day)
What is the mechanistic difference between these two vasodilators? -
CORRECT-ANSWERSHydralazine = arterial vasodilator (decreased afterload)
Isordil = venous vasodilator (decreases preload)
T/F: There are no true contraindications to either of these vasodilators other
than drug allergies. - CORRECT-ANSWERSTrue.
What are side effects (think logically)? - CORRECT-ANSWERS1) Headache
2) Dizziness
3) Reflex tachycardia
4) Peripheral edema (hydralazine)
5) Lupus-like syndrome (hydralazine)
T/F: When used together, hydralazine and Isordil can decrease mortality in
heart failure. - CORRECT-ANSWERSTrue.
What happens when hydralazine is used alone in heart failure? - CORRECT-
ANSWERSIncreased mortality
When is the combination of these 2 vasodilators commonly used in heart
failure? - CORRECT-ANSWERSWhen ACE or ARB cannot be tolerated due to
renal insufficiency, hyperkalemia, and/or angioedema
,Is there a combo product with both vasodilators in it? - CORRECT-
ANSWERSYes. BiDil.
There are 3 intravenous vasodilators that can be used for heart failure. What
are they? - CORRECT-ANSWERS1) Nitroglycerin (NTG)
2) Nitroprusside
3) Nesiritide
What is the MOA of nitroglycerin? - CORRECT-ANSWERSIs a potent venous
vasodilator, and thereby decreases preload. Can also cause arterial
vasodilation, but only at high doses.
What are side effects of NTG? - CORRECT-ANSWERS1) Hypotension
2) Tachycardia
3) Headache
4) Tolerance
In what HF patients is NTG especially useful? - CORRECT-ANSWERSThose
with myocardial ischemia
How do you overcome tolerance to NTG? - CORRECT-ANSWERSIncrease
infusion rate
What is the MOA of nitroprusside? - CORRECT-ANSWERSArterial and venous
vasodilator, thereby decreasing BOTH preload and afterload
What are side effects of nitroprusside? - CORRECT-ANSWERS1) Hypotension
2) Cyanide/Thiocyanate toxicity
3) N/V
What makes risk of cyanide toxicity with nitroprusside greater? - CORRECT-
ANSWERSIf infusion lasts longer than 24 hours
In what patients should nitroprusside be avoided? - CORRECT-
ANSWERSThose with renal dysfunction (if they don't clear it appropriately,
the risk for cyanide toxicity climbs)
What is the MOA of nesiritide? - CORRECT-ANSWERSArterial and venous
vasodilator, which decreases BOTH preload and afterload
Note: is B-type natriuretic peptide (BNP)
What are side effects of nesiritide? - CORRECT-ANSWERS1) Hypotension
2) Headache
, What are titration instructions regarding nesiritide? - CORRECT-ANSWERSDo
not titrate more quickly than every 3 hours
There are 3 intravenous positive inotropes commonly used in heart failure.
What are they? - CORRECT-ANSWERS1) Dopamine
2) Dobutamine
3) Milrinone
Dopamine has a simple MOA, but it binds different receptors at different
doses. How so? - CORRECT-ANSWERS0.5-3 mcg/kg/min = agonizes dopamine
receptors and increases urine output
3-10 mcg/kg/min = agonizes beta-1 receptors and increases heart rate and
cardiac output
>10 mcg/kg/min = agonizes alpha-1 receptors and increases blood pressure
What are the side effects of dopamine? - CORRECT-ANSWERS1) Arrhythmias
2) Tachycardia
3) Myocardial ischemia
4) N/V
When should dopamine be avoided? - CORRECT-ANSWERSIn patients with
myocardial ischemia
What is the MOA of dobutamine? - CORRECT-ANSWERSBeta-1 and Beta-2
receptor agonist and weak alpha-1 receptor agonist, which leads to
increased CO and some vasodilation
What are side effects of dobutamine? - CORRECT-ANSWERS1) Arrhythmias
2) Tachycardia
3) Myocardial ischemia
4) Hypokalemia
5) Tremor
When should dobutamine be avoided? - CORRECT-ANSWERS1) In patients
with myocardial ischemia
2) In patients on chronic beta blocker therapy
3) Tolerance can develop
What is the MOA of milrinone? - CORRECT-ANSWERSPDE III inhibitor, which
leads to increased cardiac output and vasodilation
What is the cardiac output formula? - CORRECT-ANSWERSHR x SV
What are the side effects of milrinone? - CORRECT-ANSWERS1) Hypotension
2) Arryhthmias
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Elitaa. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $23.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79223 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now