BCPS BCPS Cardiovascular & Critical Care Pharmacotherapy 1

Question 1

A patient with heart failure with reduced ejection fraction (HFrEF, EF 30%) is already on carvedilol and lisinopril. Which additional agent has been shown to reduce mortality and hospitalizations in this population?

Accepted Answer

Sacubitril/valsartan (Entresto)

Answer

Sacubitril/valsartan (ARNI) demonstrated superior reduction in cardiovascular death and HF hospitalization compared to enalapril in the PARADIGM-HF trial and is recommended for HFrEF.

Question 2

A patient in the ICU develops atrial fibrillation with rapid ventricular response and is hemodynamically stable. Which agent is preferred for acute rate control?

Accepted Answer

Diltiazem IV

Answer

IV diltiazem (non-dihydropyridine CCB) is preferred for acute rate control in hemodynamically stable AF because of its rapid onset and titratable effect.

Question 3

Which vasopressor is considered first-line for septic shock per Surviving Sepsis Campaign guidelines?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock per Surviving Sepsis Campaign guidelines due to its strong alpha-1 activity with less tachycardia compared to dopamine.

Question 4

A patient with STEMI undergoes PCI and is started on dual antiplatelet therapy (DAPT) with aspirin and ticagrelor. Which monitoring parameter is specifically important for ticagrelor?

Accepted Answer

Dyspnea (often off-target adenosine effect) and bleeding

Answer

Ticagrelor causes dyspnea in up to 15% of patients (via adenosine pathway) and significantly increases bleeding risk, requiring monitoring of both.

Question 5

A patient is in hypertensive emergency with a blood pressure of 220/130 mmHg and new onset confusion. What is the correct initial blood pressure reduction target within the first hour?

Accepted Answer

Reduce mean arterial pressure (MAP) by no more than 25% in the first hour

Answer

Over-rapid BP reduction in hypertensive emergency can cause ischemia; guidelines recommend reducing MAP by no more than 25% in the first hour.

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

BCPS BCPS Cardiovascular & Critical Care Pharmacotherapy 1