BCACP Cardiovascular Disease Management 2

Question 1

A patient with heart failure with reduced ejection fraction (HFrEF) and CKD stage 3b (eGFR 32 mL/min) is started on sacubitril/valsartan. Which monitoring parameter is most critical in the first month?

Accepted Answer

Serum potassium and creatinine

Answer

Sacubitril/valsartan can cause hyperkalemia and worsen renal function, especially in patients with pre-existing CKD, requiring close monitoring of potassium and creatinine.

Question 2

A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 2 (female sex, hypertension) asks about stroke prevention. Which recommendation is most appropriate?

Accepted Answer

Anticoagulation therapy is recommended

Answer

A CHA₂DS₂-VASc score of 2 in a female patient (score accounting for female sex) with hypertension warrants oral anticoagulation therapy per current guidelines.

Question 3

Which beta-blocker has the strongest evidence for mortality reduction in patients with HFrEF and should be used preferentially?

Accepted Answer

Carvedilol, metoprolol succinate, or bisoprolol

Answer

Only carvedilol, metoprolol succinate (extended-release), and bisoprolol have demonstrated mortality benefit in large HFrEF trials and are guideline-recommended.

Question 4

A 68-year-old patient with ASCVD is intolerant to statins due to myalgia confirmed on rechallenge. What is the most appropriate next step for LDL-C lowering?

Accepted Answer

Ezetimibe plus a PCSK9 inhibitor

Answer

In true statin-intolerant patients with ASCVD, ezetimibe combined with a PCSK9 inhibitor provides substantial LDL-C lowering and cardiovascular risk reduction.

Question 5

A patient with stable angina and hypertension needs antianginal therapy. Which agent treats both conditions and has the most evidence for reducing angina episodes?

Accepted Answer

Amlodipine

Answer

Amlodipine, a long-acting dihydropyridine calcium channel blocker, effectively reduces blood pressure and angina episodes and has demonstrated cardiovascular outcome benefits.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Cardiovascular Disease Management 2