NAPLEX Review - Cardiology Exam Questions and Answers Solved by Experts new update
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Course
NAPLEX
Institution
NAPLEX
What is the definition of hypertension? - ANSWER-BP > 140/90
OR
Patient requires antihypertensive therapy
Chronic uncontrolled HTN can lead to target organ damage. What organs or organ systems are typically affected? - ANSWER-1) Cardiac (MI, need for CABG, PCI, left ventricular hypertrophy...
NAPLEX Review - Cardiology Exam Questions
and Answers Solved by Experts new update
What is the definition of hypertension? - ANSWER-BP > 140/90
OR
Patient requires antihypertensive therapy
Chronic uncontrolled HTN can lead to target organ damage. What organs or organ
systems are typically affected? - ANSWER-1) Cardiac (MI, need for CABG, PCI, left
ventricular hypertrophy, CHF with reduced EF)
2) Cerebrovascular (stroke, TIA)
3) Renal (CKD)
4) Ophthalmologic (retinopathy, blindness)
5) Vascular (peripheral arterial disease)
What are blood pressure goals in patients with known history of coronary artery
disease? (10-year Framingham risk score >10%, stable/unstable angina, MI, or other
equivalent (PAD, AAA, etc.)) - ANSWER-<130/80 (AHA)
What are some reasonable lifestyle modifications to suggest for patients with HTN? -
ANSWER-1) Target BMI of 18.5-24.9 kg/m2
2) Increase fruit, veggies, low-fat dairy
3) Decrease saturated fat and total fat grams
4) Na intake should be less than 2.4 grams daily
5) Physical activity - 30 minutes most days of week
6) Limit alcohol and smoking
What are "safe" alcohol levels for men and women, respectively? - ANSWER-2 drinks
per day, 1 drink per day
What drugs should be considered as first line antihypertensive agents in non-black
patients? - ANSWER-1) Thiazide diuretic
2) ACEI
3) ARB
4) CCB
What drugs should be used first line for hypertension in black patients? - ANSWER-1)
Thiazide
and/or
2) CCB
What antihypertensives are first line in patients with CKD? (regardless of race or
diabetes status) - ANSWER-ACEI or ARB
,What class of drugs was once considered a first-line hypertension agent but is now only
used if certain comorbidities are present? - ANSWER-Beta-blockers
What antihypertensive agents are preferred in non-black patients with HFrEF? -
ANSWER-1) Diuretic
2) ACEI or ARB
3) Beta-blocker (carvedilol, metoprolol succinate, bisoprolol)
4) Aldosterone receptor antagonist (ARA)
What agents are useful in black patients with HFrEF? - ANSWER-1) Hydralazine
(arterial dilator)
2) Isosorbide dinitrate (vein-prominent dilation)
What anti-HTN agents in patients post-MI? - ANSWER-1) Beta-blocker
2) ACEI or ARB
What anti-HTN agents in patients with coronary disease risk? - ANSWER-1) ACEI or
ARB
2) Thiazide
3) CCB
T/F: Using concomitant ACEI and ARB therapy is sometimes indicated. - ANSWER-
False. Never do this.
When might two anti-HTN agents be initiated to start therapy? - ANSWER-BP >
160/100
SBP 20 above goal, DBP 10 above goal
What is the MOA of the thiazides? - ANSWER-Inhibit Na reabsorption in the distal
convoluted tubule (water follows salt!)
What is the primary contraindication to the thiazide diuretics? - ANSWER-Sulfa allergy
What are salient side effects to know for thiazide diuretics? - ANSWER-1) Electrolyte
deficiencies (Na, K, Mg)
2) Hypercalcemia
3) Hyperuricemia (gout risk)
4) Hyperglycemia
5) Photosensitivity (skin irritation)
What are some significant drug interactions to know regarding thiazides? - ANSWER-1)
Decrease effect of anti-diabetics
2) NSAIDs decrease effect
3) May increase lithium toxicity
, Thiazides are NOT effective when CrCl is less than 30 mL/min, except one agent.
Which one? - ANSWER-Metolazone
Note: if <30 mL/min, use loops
T/F: Thiazides do not have a ceiling effect, but loops diuretics do. - ANSWER-False.
Opposite. Loops do NOT have a ceiling effect.
When should loop diuretics be used for treatment of HTN? - ANSWER-1) If CrCl < 30
mL/min
2) Severe edema
3) HF (primary focus)
What is MOA of loops? - ANSWER-Inhibit Na reabsorption in the ascending limb of loop
of Henle ("EVERYTHING OUT")
What is the MOA of the potassium-sparing diuretics? - ANSWER-Inhibit Na
reabsorption in the collecting ducts
What are contraindications to use of potassium-sparing diuretics? - ANSWER-1)
Hyperkalemia
2) CKD
What is the primary side effect of potassium-sparing diuretics? - ANSWER-
Hyperkalemia (obvious)
What are some drug interactions to be aware of when using potassium-sparing
diuretics? - ANSWER-1) Use with K supplements
2) ACE/ARB concomitant
3) NSAIDs
All increase hyperkalemia risk
T/F: Potassium-sparing diuretics are rarely used at anti-HTN monotherapy. - ANSWER-
True. They are weak antihypertensives and are often used with thiazides to reduce K
loss.
There are some combo products available. What are they? -
ANSWER-Triamterene/HCTZ - Dyazide, Maxzide
Amiloride/HCTZ - only generic
What other class of agents works similarly to potassium-sparing diuretics? - ANSWER-
Aldosterone receptor antagonists
What is spironolactone/HCTZ called? - ANSWER-Aldactazide (intuitive)
What is the MOA of beta-blockers? - ANSWER-Block beta receptors, thereby reducing
cardiac output by negative inotropic (contractility) and negative chronotropic (heart rate)
effects
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