UWorld Pharmacology 2

Question 1

A patient started on lisinopril develops lip and tongue swelling without urticaria. What is the most likely mechanism?

Accepted Answer

Decreased bradykinin degradation

Answer

ACE also breaks down bradykinin, so inhibiting it lets bradykinin build up and cause angioedema.

Question 2

Which electrolyte abnormality most increases the risk of digoxin toxicity?

Accepted Answer

Hypokalemia

Answer

Low potassium increases digoxin binding to Na+/K+-ATPase, which makes toxicity more likely.

Question 3

A patient in hypertensive emergency on a prolonged high-dose infusion develops metabolic acidosis and confusion. Which drug is responsible?

Accepted Answer

Sodium nitroprusside

Answer

Nitroprusside releases cyanide as it is metabolized, and cyanide builds up with long or high-dose infusions.

Question 4

A patient on long-term therapy for atrial fibrillation develops progressive dyspnea and bilateral interstitial infiltrates. Which drug is most likely the cause?

Accepted Answer

Amiodarone

Answer

Amiodarone causes dose-related pulmonary fibrosis, so patients need baseline and follow-up pulmonary function testing.

Question 5

Which drug, added to hydralazine, lowers mortality in self-identified Black patients with HFrEF?

Accepted Answer

Isosorbide dinitrate

Answer

The A-HeFT trial showed a mortality benefit for hydralazine plus isosorbide dinitrate in this group.

UWorld Practice Test

UWorld Practice Test

UWorld Pharmacology 2