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

Concurrent use of nitrates and PDE-5 inhibitors causes severe, potentially fatal hypotension due to synergistic vasodilation and is absolutely contraindicated.

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

Loop diuretics such as furosemide are the cornerstone of acute and chronic volume management in HF due to their potent diuretic effect even in reduced renal perfusion.

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

Amiodarone is a Class III antiarrhythmic with broad efficacy but serious organ toxicities (pulmonary fibrosis, thyroid dysfunction, hepatotoxicity) requiring regular monitoring.

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

SGLT2 inhibitors (dapagliflozin, empagliflozin) are now guideline-directed medical therapy for HFrEF, shown to reduce HF hospitalizations and cardiovascular death regardless of diabetes status.

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

A supratherapeutic aPTT requires holding the infusion temporarily and dose-reducing per the weight-based nomogram to minimize bleeding risk while maintaining anticoagulation.

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

BCPS BCPS Cardiovascular & Critical Care Pharmacotherapy 2