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 78-year-old woman with hypertension, AF, and type 2 diabetes on amlodipine, apixaban, and metformin develops gout. She is prescribed indometacin. What is the primary prescribing concern?

    Answer: NSAIDs combined with anticoagulants increase bleeding risk and can worsen renal function and blood pressure

    NSAIDs combined with anticoagulants significantly increase gastrointestinal bleeding risk; they also worsen hypertension and can precipitate acute kidney injury through prostaglandin inhibition.

  2. A 55-year-old man with asthma is newly diagnosed with hypertension. Which antihypertensive should be avoided?

    Answer: Propranolol

    Non-selective beta-blockers like propranolol block bronchial β₂ receptors, causing bronchoconstriction and potentially fatal bronchospasm in patients with asthma.

  3. A 28-week pregnant woman has a blood pressure of 158/98 mmHg. Which antihypertensive is most appropriate?

    Answer: Labetalol 100mg twice daily

    Labetalol is a first-line antihypertensive in pregnancy; ACE inhibitors and ARBs are absolutely contraindicated due to fetotoxicity and teratogenicity, especially in the second and third trimester.

  4. A 64-year-old man with gout and hypertension is prescribed bendroflumethiazide. Why is this choice problematic?

    Answer: Thiazides reduce renal uric acid excretion, potentially precipitating gout attacks

    Thiazide diuretics compete with uric acid for renal tubular secretion, reducing urate excretion and raising serum uric acid levels, which can precipitate or worsen gout.

  5. A 69-year-old man on lisinopril 20mg for hypertension develops a persistent dry cough with no other cause identified. He has no heart failure or proteinuric CKD. What is the most appropriate substitution?

    Answer: Losartan (an ARB)

    ACE inhibitor-induced cough is a class effect caused by bradykinin accumulation; switching to an ARB eliminates the cough as ARBs do not affect bradykinin metabolism.

  6. A 72-year-old woman with heart failure on digoxin 125 mcg daily presents with nausea, vomiting, and yellow-green visual halos. Her digoxin level is 3.1 ng/mL (therapeutic range 0.5–2.0 ng/mL). What is the most appropriate immediate management?

    Answer: Stop digoxin, correct hypokalaemia, and administer digoxin-specific antibody fragments (DigiFab) if severe toxicity present

    Symptomatic digoxin toxicity with supratherapeutic levels requires immediate cessation, electrolyte correction (especially potassium), and DigiFab in cases of severe or life-threatening toxicity.

  7. A 58-year-old man with stable angina and sinus tachycardia (resting HR 92 bpm) is being considered for ivabradine. Which investigation is essential before prescribing?

    Answer: Resting ECG to confirm sinus rhythm

    Ivabradine acts exclusively on the sinoatrial node's If current and is only effective in sinus rhythm; it is contraindicated in atrial fibrillation where it cannot lower ventricular rate.