NR 667 CHAMBERLAIN CEA
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS FULLY VERIFIED
CORRECT ANSWERS
●● 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.
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS FULLY VERIFIED
CORRECT ANSWERS
●● 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.
