BCPS BCPS Cardiovascular & Specialty Pharmacotherapy

Question 1

Which antihypertensive drug class is the preferred first-line agent for hypertension in patients with chronic kidney disease (CKD) and proteinuria?

Accepted Answer

ACE inhibitors or ARBs

Answer

ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria, providing renoprotective benefits beyond blood pressure lowering in CKD.

Question 2

A patient with heart failure with reduced ejection fraction (HFrEF) is already on an ACE inhibitor, beta-blocker, and loop diuretic. Which additional agent has been shown to further reduce mortality?

Accepted Answer

Spironolactone

Answer

Mineralocorticoid receptor antagonists (MRAs) such as spironolactone have demonstrated significant mortality reduction in HFrEF patients in the RALES trial.

Question 3

Which anticoagulant requires monitoring with anti-Xa levels rather than aPTT when used therapeutically?

Accepted Answer

Low molecular weight heparin (LMWH)

Answer

LMWH (e.g., enoxaparin) does not reliably prolong aPTT and is monitored with anti-Xa levels when monitoring is needed (e.g., extremes of weight, renal impairment).

Question 4

A patient with atrial fibrillation (AF) and a CHA₂DS₂-VASc score of 3 requires anticoagulation. Which agent is preferred over warfarin per current guidelines?

Accepted Answer

Direct oral anticoagulants (DOACs) such as apixaban or rivaroxaban

Answer

DOACs are preferred over warfarin for stroke prevention in nonvalvular AF due to superior efficacy, safety, and the absence of routine INR monitoring.

Question 5

Which lipid-lowering agent is the drug of choice for lowering triglycerides and raising HDL cholesterol in a patient with isolated hypertriglyceridemia (TG 500-1000 mg/dL)?

Accepted Answer

Fibrates (e.g., fenofibrate)

Answer

Fibrates are the drug of choice for severe hypertriglyceridemia because they activate PPAR-alpha, markedly reducing triglyceride synthesis and increasing HDL.

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

BCPS BCPS Cardiovascular & Specialty Pharmacotherapy