BCPS BCPS Cardiovascular & Critical Care Pharmacotherapy 2

Question 1

A patient with chronic stable angina is prescribed sublingual nitroglycerin for acute episodes. Which counseling point is most critical to prevent a potentially life-threatening interaction?

Accepted Answer

Do not use within 24–48 hours of phosphodiesterase-5 (PDE-5) inhibitors such as sildenafil

Answer

Avoid taking with food

Answer

Store at room temperature and avoid refrigeration

Answer

Limit use to no more than 10 doses per day

Question 2

A patient with systolic HF (EF 25%) develops symptomatic hypotension and fluid overload. Which diuretic is the preferred first-line agent for volume management?

Accepted Answer

Furosemide (loop diuretic)

Answer

Hydrochlorothiazide

Answer

Spironolactone

Answer

Acetazolamide

Question 3

Which antiarrhythmic drug is classified as a Class III agent and is used for both atrial and ventricular arrhythmias but requires monitoring for pulmonary, thyroid, and hepatic toxicity?

Accepted Answer

Amiodarone

Answer

Lidocaine

Answer

Metoprolol

Answer

Flecainide

Question 4

A patient with type 2 diabetes and chronic heart failure with reduced ejection fraction is started on an SGLT2 inhibitor. Beyond glycemic control, what is the primary cardiovascular benefit in HFrEF?

Accepted Answer

Reduction in HF hospitalizations and cardiovascular death

Answer

Reduction in systemic blood pressure only

Answer

Prevention of atrial fibrillation only

Answer

Improvement in ejection fraction without mortality benefit

Question 5

In a patient receiving a continuous IV heparin infusion for DVT, the aPTT comes back supratherapeutic at 180 seconds (therapeutic range 60–100 seconds). What is the appropriate pharmacist action?

Accepted Answer

Hold the infusion temporarily and reduce the rate per the institution's weight-based nomogram

Answer

Continue the current rate as therapeutic aPTTs vary widely

Answer

Stop heparin permanently and switch to warfarin immediately

Answer

Administer protamine sulfate to reverse heparin effect

Question 6

Which endpoint is used to define successful resuscitation from septic shock in the initial 3-hour bundle per Surviving Sepsis Campaign guidelines?

Accepted Answer

Mean arterial pressure (MAP) ≥65 mmHg

Answer

Heart rate below 90 bpm

Answer

Systolic blood pressure above 120 mmHg

Answer

Central venous pressure (CVP) of 8–12 mmHg