Cardiac Pharmacology Quiz
Questions: 16 · 10 minutes
1. A patient already taking a beta blocker is prescribed verapamil. Which additive pharmacologic effect is the main concern?
Marked reflex tachycardia from excessive vasodilation
Increased myocardial contractility and oxygen demand
Excessive bradycardia or AV block
Accelerated AV nodal conduction
2. A patient develops a persistent dry cough after starting an ACE inhibitor. Which class is commonly considered because it blocks the renin-angiotensin system without inhibiting bradykinin breakdown?
Direct thrombin inhibitors
Dihydropyridine calcium-channel blockers
Angiotensin II receptor blockers
Mineralocorticoid receptor antagonists
3. A patient taking spironolactone begins an ACE inhibitor. Which electrolyte disturbance warrants particular attention because both drugs can promote it?
Hypomagnesemia
Hypocalcemia
Hypernatremia
Hyperkalemia
4. Which medication is relatively selective for beta-1 adrenergic receptors at usual therapeutic doses?
Propranolol
Labetalol
Carvedilol
Metoprolol
5. A stable patient presents with a regular narrow-complex tachycardia caused by an AV node–dependent re-entry circuit. Which drug can briefly interrupt AV nodal conduction because of its very short duration of action?
Adenosine
Lidocaine
Atropine
Dobutamine
6. A patient is prescribed apixaban to reduce thromboembolic risk associated with atrial fibrillation. Which factor does apixaban directly inhibit?
Thrombin, or factor IIa
Factor Xa
Vitamin K epoxide reductase
Platelet cyclooxygenase-1
7. Although amiodarone affects several ion channels, which action is most associated with its classification as a class III antiarrhythmic?
Rapid sodium-channel blockade during phase 0
Potassium-channel blockade that prolongs repolarization
Selective beta-1 receptor stimulation
Activation of L-type calcium channels
8. How do ACE inhibitors primarily reduce angiotensin II activity?
They directly block angiotensin II at AT1 receptors.
They inhibit conversion of angiotensin I to angiotensin II.
They prevent renin release from the kidneys.
They inhibit aldosterone receptors in the distal nephron.
9. Warfarin decreases activation of several clotting factors by inhibiting which enzyme?
Cyclooxygenase-1
Vitamin K epoxide reductase
Plasminogen activator inhibitor-1
Phosphodiesterase type 5
10. A patient who uses sublingual nitroglycerin reports taking sildenafil recently. What is the principal pharmacologic concern with combining these drugs?
A profound fall in blood pressure from excessive cyclic GMP–mediated vasodilation
Severe hypertension from opposing effects on vascular tone
Reduced nitrate absorption caused by phosphodiesterase inhibition
Accelerated nitrate metabolism causing loss of antianginal activity
11. What is the primary enzyme inhibited by statins?
Lipoprotein lipase
Acyl-CoA cholesterol acyltransferase
Proprotein convertase subtilisin/kexin type 9
HMG-CoA reductase
12. Which molecular target is directly inhibited by digoxin?
The sodium-potassium ATPase
The sodium-chloride cotransporter
L-type calcium channels
The funny-current channel in the sinoatrial node
13. Which calcium-channel blocker primarily lowers blood pressure through arterial vasodilation and has less direct AV nodal suppression than verapamil?
Diltiazem
Adenosine
Ivabradine
Amlodipine
14. A patient has excessive anticoagulant effects from unfractionated heparin. Which agent directly neutralizes heparin?
Idarucizumab
Vitamin K
Protamine sulfate
Tranexamic acid
15. A patient taking digoxin starts high-dose furosemide and later develops nausea and an arrhythmia. Which furosemide-related change can increase susceptibility to digoxin toxicity?
Hypokalemia
Hypernatremia
Hypercalcemia
Hyperphosphatemia
16. In which nephron segment do loop diuretics such as furosemide exert their principal effect?
Proximal convoluted tubule
Thin descending limb of the loop of Henle
Thick ascending limb of the loop of Henle
Distal convoluted tubule