CCS CCS Pharmacology & Cardiovascular Medications 2 — Questions and Answers
Question 1: ACE inhibitors are contraindicated in patients with which condition?
- Heart failure with reduced ejection fraction
- Hypertension
- Bilateral renal artery stenosis (Correct answer)
- Diabetic nephropathy
Correct answer: Bilateral renal artery stenosis
ACE inhibitors are contraindicated in bilateral renal artery stenosis because they can cause acute renal failure by reducing glomerular filtration pressure.
Question 2: Which diuretic is most effective for reducing fluid overload in acute decompensated heart failure?
- Hydrochlorothiazide
- Spironolactone
- Furosemide (Correct answer)
- Acetazolamide
Correct answer: Furosemide
Furosemide, a loop diuretic, is the most effective agent for rapid fluid removal in acute decompensated heart failure due to its potent natriuretic effect.
Question 3: Digoxin toxicity is potentiated by which electrolyte imbalance?
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypermagnesemia
Correct answer: Hypokalemia
Hypokalemia increases digoxin binding to Na+/K+ ATPase, potentiating toxicity and increasing the risk of life-threatening arrhythmias.
Question 4: Amiodarone is classified as a Class III antiarrhythmic because it primarily works by:
- Blocking sodium channels
- Blocking potassium channels to prolong repolarization (Correct answer)
- Blocking calcium channels
- Stimulating beta receptors
Correct answer: Blocking potassium channels to prolong repolarization
Amiodarone blocks potassium channels, prolonging the action potential duration and refractory period, which is the hallmark of Class III antiarrhythmic action.
Question 5: Which medication should be immediately available when administering adenosine for SVT conversion?
- Atropine (Correct answer)
- Epinephrine
- Aminophylline
- Lidocaine
Correct answer: Atropine
Atropine should be available when giving adenosine because it can cause prolonged asystole; atropine can be used to restore heart rate if needed.
Question 6: Statins reduce cardiovascular events primarily by which mechanism?
- Lowering blood pressure
- Inhibiting HMG-CoA reductase to reduce LDL cholesterol synthesis (Correct answer)
- Thinning the blood to prevent clots
- Dilating coronary arteries
Correct answer: Inhibiting HMG-CoA reductase to reduce LDL cholesterol synthesis
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis, reducing LDL cholesterol and slowing atherosclerotic plaque progression.
CCS CCS Pharmacology & Cardiovascular Medications 2
ACE inhibitors are contraindicated in patients with which condition?