NR667 - CEA Week 1-6
Comprehensive Review before
Chicago 2026 Test Questions With
Correct and Verified ANSWERs
Hypertension - ANSWER-Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment - ANSWER-Start with thiazide diuretic, ACE inhibitor,
ARB, or CCB.
Black population treatment - ANSWER-Start with thiazide diuretic or CCB.
DM or CKD treatment - ANSWER-Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment - ANSWER-Treat if BP ≥150/90 mmHg.
Age <60 years treatment - ANSWER-Treat if BP ≥140/90 mmHg.
Contractility - ANSWER-Force of cardiac muscle contraction.
Preload - ANSWER-Volume in ventricles at end-diastole (central venous volume).
Afterload - ANSWER-Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) - ANSWER-Calcification narrows aortic valve → outflow
obstruction.
Aortic Regurgitation (AR) - ANSWER-Incompetent aortic valve due to root dilation or
endocarditis.
Mitral Stenosis (MS) - ANSWER-Often post-rheumatic fever, calcification of mitral valve.
Mitral Regurgitation (MR) - ANSWER-Commonly due to MI, CHF-induced LV dilation,
papillary rupture, or endocarditis.
Direct Oral Anticoagulants (DOACs) - ANSWER-Do NOT require INR monitoring.
Factor Xa inhibitors - ANSWER-Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban
(Savaysa).
,Direct thrombin inhibitor - ANSWER-Dabigatran (Pradaxa).
Warfarin (Coumadin) - ANSWER-Onset: Delayed — requires bridging with LMWH or
heparin.
Bridging with Warfarin - ANSWER-Bridging is required until INR reaches ≥2.0 for at
least 24 hours.
Dopamine - ANSWER-Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine - ANSWER-Inotrope (↑ contractility).
Norepinephrine (Levophed) - ANSWER-Vasoconstrictor + mild inotrope.
Epinephrine - ANSWER-Mixed alpha & beta agonist.
Nitroglycerin - ANSWER-Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside - ANSWER-Potent arterial/venous vasodilator; risk of cyanide toxicity with
prolonged use.
Statins - ANSWER-HMG-CoA reductase inhibitors used as first-line therapy for lipid
management.
High-intensity statins - ANSWER-Atorvastatin 40-80 mg daily and Rosuvastatin 20-40
mg daily.
Indications for high-intensity statins - ANSWER-Clinical ASCVD (e.g., MI, stroke), LDL
≥190 mg/dL, Diabetes age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe - ANSWER-A secondary therapy for mild LDL-lowering, often required before
insurance approval of PCSK9 inhibitors.
PCSK9 inhibitors - ANSWER-Injectable monoclonal antibodies reserved for very high-
risk patients or statin-intolerant.
ASCVD - ANSWER-Atherosclerotic Cardiovascular Disease, includes MI, stroke,
angina, revascularization, and peripheral artery disease.
10-year risk categories - ANSWER-Low risk: <5%, Moderate risk: 5%-7.4%, High risk:
≥7.5%, Very high risk: ≥20% or known ASCVD.
Aortic Stenosis (AS) - ANSWER-Caused by calcification of the valve leading to outflow
obstruction, with a classic triad of angina, syncope, dyspnea.
, Aortic Regurgitation (AR) - ANSWER-Occurs when the valve fails to close, leading to
wide pulse pressure and bounding pulses.
Mitral Stenosis (MS) - ANSWER-Often caused by post-rheumatic fever, symptoms
include dyspnea, orthopnea, and atrial fibrillation.
Mitral Regurgitation (MR) - ANSWER-Caused by papillary muscle rupture, dilated LV, or
endocarditis, characterized by a holosystolic murmur.
HFrEF - ANSWER-Heart failure with reduced ejection fraction, defined as EF <40% and
associated with systolic dysfunction.
HFpEF - ANSWER-Heart failure with preserved ejection fraction, defined as EF ≥50%
and associated with diastolic dysfunction.
First-line medications for HFrEF - ANSWER-Include beta-blockers (Carvedilol,
metoprolol succinate, bisoprolol), ACE inhibitors or ARBs, loop diuretics, and
spironolactone.
Shock categories - ANSWER-Include hypovolemic, cardiogenic, distributive, and
obstructive types.
Hypovolemic shock - ANSWER-Caused by hemorrhage or dehydration, treated with
fluids and blood products.
Cardiogenic shock - ANSWER-Caused by MI or CHF, treated with inotropes
(dobutamine) and vasopressors.
Distributive shock - ANSWER-Caused by sepsis or anaphylaxis, treated with
vasopressors (norepinephrine) and fluids.
Obstructive shock - ANSWER-Caused by PE, tamponade, or tension pneumothorax,
treated by relieving the obstruction.
Norepinephrine (Levophed) - ANSWER-First-line treatment in septic shock.
Dobutamine - ANSWER-Used for low-output states in cardiogenic shock to improve
contractility.
Fluid optimization - ANSWER-Must occur before giving vasopressors; check CVP or
physical signs.
Vasodilator agents - ANSWER-Used for HTN emergencies or cardiac ischemia; avoid if
volume depleted.
NOACs - ANSWER-Do not require INR monitoring (e.g., apixaban, rivaroxaban).
Comprehensive Review before
Chicago 2026 Test Questions With
Correct and Verified ANSWERs
Hypertension - ANSWER-Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment - ANSWER-Start with thiazide diuretic, ACE inhibitor,
ARB, or CCB.
Black population treatment - ANSWER-Start with thiazide diuretic or CCB.
DM or CKD treatment - ANSWER-Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment - ANSWER-Treat if BP ≥150/90 mmHg.
Age <60 years treatment - ANSWER-Treat if BP ≥140/90 mmHg.
Contractility - ANSWER-Force of cardiac muscle contraction.
Preload - ANSWER-Volume in ventricles at end-diastole (central venous volume).
Afterload - ANSWER-Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) - ANSWER-Calcification narrows aortic valve → outflow
obstruction.
Aortic Regurgitation (AR) - ANSWER-Incompetent aortic valve due to root dilation or
endocarditis.
Mitral Stenosis (MS) - ANSWER-Often post-rheumatic fever, calcification of mitral valve.
Mitral Regurgitation (MR) - ANSWER-Commonly due to MI, CHF-induced LV dilation,
papillary rupture, or endocarditis.
Direct Oral Anticoagulants (DOACs) - ANSWER-Do NOT require INR monitoring.
Factor Xa inhibitors - ANSWER-Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban
(Savaysa).
,Direct thrombin inhibitor - ANSWER-Dabigatran (Pradaxa).
Warfarin (Coumadin) - ANSWER-Onset: Delayed — requires bridging with LMWH or
heparin.
Bridging with Warfarin - ANSWER-Bridging is required until INR reaches ≥2.0 for at
least 24 hours.
Dopamine - ANSWER-Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine - ANSWER-Inotrope (↑ contractility).
Norepinephrine (Levophed) - ANSWER-Vasoconstrictor + mild inotrope.
Epinephrine - ANSWER-Mixed alpha & beta agonist.
Nitroglycerin - ANSWER-Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside - ANSWER-Potent arterial/venous vasodilator; risk of cyanide toxicity with
prolonged use.
Statins - ANSWER-HMG-CoA reductase inhibitors used as first-line therapy for lipid
management.
High-intensity statins - ANSWER-Atorvastatin 40-80 mg daily and Rosuvastatin 20-40
mg daily.
Indications for high-intensity statins - ANSWER-Clinical ASCVD (e.g., MI, stroke), LDL
≥190 mg/dL, Diabetes age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe - ANSWER-A secondary therapy for mild LDL-lowering, often required before
insurance approval of PCSK9 inhibitors.
PCSK9 inhibitors - ANSWER-Injectable monoclonal antibodies reserved for very high-
risk patients or statin-intolerant.
ASCVD - ANSWER-Atherosclerotic Cardiovascular Disease, includes MI, stroke,
angina, revascularization, and peripheral artery disease.
10-year risk categories - ANSWER-Low risk: <5%, Moderate risk: 5%-7.4%, High risk:
≥7.5%, Very high risk: ≥20% or known ASCVD.
Aortic Stenosis (AS) - ANSWER-Caused by calcification of the valve leading to outflow
obstruction, with a classic triad of angina, syncope, dyspnea.
, Aortic Regurgitation (AR) - ANSWER-Occurs when the valve fails to close, leading to
wide pulse pressure and bounding pulses.
Mitral Stenosis (MS) - ANSWER-Often caused by post-rheumatic fever, symptoms
include dyspnea, orthopnea, and atrial fibrillation.
Mitral Regurgitation (MR) - ANSWER-Caused by papillary muscle rupture, dilated LV, or
endocarditis, characterized by a holosystolic murmur.
HFrEF - ANSWER-Heart failure with reduced ejection fraction, defined as EF <40% and
associated with systolic dysfunction.
HFpEF - ANSWER-Heart failure with preserved ejection fraction, defined as EF ≥50%
and associated with diastolic dysfunction.
First-line medications for HFrEF - ANSWER-Include beta-blockers (Carvedilol,
metoprolol succinate, bisoprolol), ACE inhibitors or ARBs, loop diuretics, and
spironolactone.
Shock categories - ANSWER-Include hypovolemic, cardiogenic, distributive, and
obstructive types.
Hypovolemic shock - ANSWER-Caused by hemorrhage or dehydration, treated with
fluids and blood products.
Cardiogenic shock - ANSWER-Caused by MI or CHF, treated with inotropes
(dobutamine) and vasopressors.
Distributive shock - ANSWER-Caused by sepsis or anaphylaxis, treated with
vasopressors (norepinephrine) and fluids.
Obstructive shock - ANSWER-Caused by PE, tamponade, or tension pneumothorax,
treated by relieving the obstruction.
Norepinephrine (Levophed) - ANSWER-First-line treatment in septic shock.
Dobutamine - ANSWER-Used for low-output states in cardiogenic shock to improve
contractility.
Fluid optimization - ANSWER-Must occur before giving vasopressors; check CVP or
physical signs.
Vasodilator agents - ANSWER-Used for HTN emergencies or cardiac ischemia; avoid if
volume depleted.
NOACs - ANSWER-Do not require INR monitoring (e.g., apixaban, rivaroxaban).
