Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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Cardiovascular Prescribing Flashcards

7 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Cardiovascular Prescribing flashcards as text

  1. A 58-year-old man presents with NSTEMI and has no known drug allergies. Which antiplatelet regimen should be initiated immediately?

    Answer: Aspirin 300mg plus ticagrelor 180mg loading doses

    Dual antiplatelet therapy with aspirin 300mg plus ticagrelor 180mg (preferred over clopidogrel due to more consistent platelet inhibition) is the recommended regimen for NSTEMI.

  2. A patient on aspirin 75mg and ticagrelor 90mg BD (6 weeks post-MI with drug-eluting stent) requires emergency cholecystectomy. What is the best antiplatelet management approach?

    Answer: Stop ticagrelor 5 days before surgery and continue aspirin

    Ticagrelor should be stopped 5 days preoperatively to allow platelet function recovery, but aspirin is continued perioperatively to maintain residual thrombotic protection.

  3. A 65-year-old woman started on high-intensity statin therapy 4 weeks ago develops myalgia. Her CK is 720 U/L (ULN 200 U/L). What is the most appropriate action?

    Answer: Stop the statin temporarily, recheck CK, and consider an alternative once resolved

    CK elevation >3× ULN with symptoms warrants temporary statin cessation; after normalisation, a lower-intensity statin or rosuvastatin (lower myopathy risk) can be trialled.

  4. A 62-year-old man post-MI on atorvastatin 80mg daily needs treatment for a fungal nail infection. Which antifungal poses the greatest risk of statin-related myopathy?

    Answer: Itraconazole

    Itraconazole is a potent CYP3A4 inhibitor that markedly increases atorvastatin plasma levels, substantially raising the risk of myopathy and rhabdomyolysis.

  5. A 72-year-old man with stable angina complains of headaches after starting long-acting isosorbide mononitrate. What is the most likely mechanism?

    Answer: Cerebral vasodilation due to non-selective nitrate-mediated vasodilation

    Nitrates cause non-selective vasodilation including cerebral vessels, producing vasodilatory headaches that are the most common side effect and principal reason for early discontinuation.

  6. A 60-year-old woman with angina is prescribed GTN spray as needed. She asks how to use it correctly. Which instruction is correct?

    Answer: Use the spray, and if pain persists after 5 minutes use a second dose; call 999 if pain persists after a third dose 5 minutes later

    GTN spray should be used sublingually; if pain persists after 5 minutes a second dose can be used, and if unresolved after a third dose emergency services should be called as MI may be occurring.

  7. A 72-year-old post-CABG patient on isosorbide mononitrate presents to ED with severe hypotension. The nurse notes he recently took a medication for erectile dysfunction. Which interaction explains this?

    Answer: Sildenafil and isosorbide mononitrate causing synergistic cGMP-mediated vasodilation and profound hypotension

    PDE5 inhibitors like sildenafil are absolutely contraindicated with nitrates as both increase cGMP, causing profound additive vasodilation and potentially fatal hypotension.