CMC CMC Cardiac Pharmacology & Medications 1 — Questions and Answers
Question 1: Which drug class is first-line for reducing ventricular rate in atrial fibrillation?
- Beta-blockers (Correct answer)
- ACE inhibitors
- Loop diuretics
- Statins
Correct answer: Beta-blockers
Beta-blockers reduce ventricular rate by blocking sympathetic stimulation of the AV node.
Question 2: ACE inhibitors lower blood pressure primarily by blocking which enzyme?
- Renin
- Angiotensin-converting enzyme (Correct answer)
- Aldosterone synthase
- Phosphodiesterase
Correct answer: Angiotensin-converting enzyme
ACE inhibitors block angiotensin-converting enzyme, preventing formation of angiotensin II and lowering blood pressure.
Question 3: Which anticoagulant requires regular INR monitoring due to its narrow therapeutic window?
- Apixaban
- Rivaroxaban
- Warfarin (Correct answer)
- Dabigatran
Correct answer: Warfarin
Warfarin requires INR monitoring because of its variable metabolism and narrow therapeutic range.
Question 4: Digoxin is used in cardiac care primarily for which two conditions?
- Hypertension and angina
- Atrial fibrillation and heart failure (Correct answer)
- Pulmonary embolism and DVT
- Ventricular tachycardia and STEMI
Correct answer: Atrial fibrillation and heart failure
Digoxin controls ventricular rate in atrial fibrillation and increases contractility in heart failure via Na+/K+-ATPase inhibition.
Question 5: Statins reduce cardiovascular risk by inhibiting which enzyme in the cholesterol synthesis pathway?
- Lipoprotein lipase
- PCSK9
- HMG-CoA reductase (Correct answer)
- Cholesterol esterase
Correct answer: HMG-CoA reductase
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol biosynthesis, lowering LDL.
Question 6: Nitroglycerin relieves angina through which primary mechanism?
- Blocking beta receptors
- Blocking calcium channels
- Vasodilation via nitric oxide release (Correct answer)
- Inhibiting platelet aggregation
Correct answer: Vasodilation via nitric oxide release
Nitroglycerin releases nitric oxide, causing venodilation that reduces preload and decreases myocardial oxygen demand.
CMC CMC Cardiac Pharmacology & Medications 1
Which drug class is first-line for reducing ventricular rate in atrial fibrillation?