ADVANCED PHARMACOLOGY EXAM 2
REVIEW QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A 65-year-old patient with heart failure and a reduced ejection fraction is prescribed
Sacubitril/Valsartan. Which of the following is the primary mechanism of Sacubitril?
A. Inhibition of the renin-angiotensin-aldosterone system
B. Direct stimulation of beta-1 adrenergic receptors
C. Inhibition of neprilysin, leading to increased levels of natriuretic peptides
D. Blockade of calcium channels in the myocardium
Answer: C
Conceptual Explanation: Sacubitril is a neprilysin inhibitor. Neprilysin is the enzyme
responsible for the degradation of natriuretic peptides; inhibiting it increases these
peptides, promoting diuresis and vasodilation.
2. Which of the following laboratory parameters must be monitored closely when a patient is
initiated on Spironolactone for heart failure?
A. Serum Sodium and Liver Function Tests
B. Serum Potassium and Creatinine
,C. Hemoglobin A1c and Lipid Profile
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic. The most
significant risks are hyperkalemia and worsening renal function, requiring frequent
monitoring of serum potassium and creatinine.
3. A patient with Asthma is not well-controlled on a Low-Dose ICS. According to GINA
guidelines, what is the preferred next step in therapy?
A. Add a Long-Acting Muscarinic Antagonist (LAMA)
B. Switch to a High-Dose ICS monotherapy
C. Add a Long-Acting Beta-2 Agonist (LABA)
D. Initiate Oral Corticosteroids
Answer: C
Conceptual Explanation: For asthma not controlled on low-dose ICS, the preferred Step 3
treatment is the addition of a LABA to the ICS (ICS-LABA combination).
4. Which medication is contraindicated in a patient with a history of heart failure and a NYHA
Class III status due to the risk of fluid retention?
A. Metformin
B. Empagliflozin
, C. Pioglitazone
D. Sitagliptin
Answer: C
Conceptual Explanation: Thiazolidinediones (TZDs) like Pioglitazone cause fluid
retention and are contraindicated in patients with symptomatic heart failure.
5. A patient taking Warfarin presents with an INR of 7.5 and no active bleeding. What is the
most appropriate management strategy?
A. Administer 10mg Vitamin K intravenously
B. Administer Fresh Frozen Plasma (FFP)
C. Hold Warfarin and administer oral Vitamin K
D. Administer Protamine Sulfate
Answer: C
Conceptual Explanation: For patients with an INR between 4.5 and 10.0 and no bleeding,
the recommendation is to hold warfarin and potentially provide low-dose oral Vitamin K.
6. Which side effect is most uniquely associated with the use of SGLT2 inhibitors like
Canagliflozin?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
REVIEW QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A 65-year-old patient with heart failure and a reduced ejection fraction is prescribed
Sacubitril/Valsartan. Which of the following is the primary mechanism of Sacubitril?
A. Inhibition of the renin-angiotensin-aldosterone system
B. Direct stimulation of beta-1 adrenergic receptors
C. Inhibition of neprilysin, leading to increased levels of natriuretic peptides
D. Blockade of calcium channels in the myocardium
Answer: C
Conceptual Explanation: Sacubitril is a neprilysin inhibitor. Neprilysin is the enzyme
responsible for the degradation of natriuretic peptides; inhibiting it increases these
peptides, promoting diuresis and vasodilation.
2. Which of the following laboratory parameters must be monitored closely when a patient is
initiated on Spironolactone for heart failure?
A. Serum Sodium and Liver Function Tests
B. Serum Potassium and Creatinine
,C. Hemoglobin A1c and Lipid Profile
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic. The most
significant risks are hyperkalemia and worsening renal function, requiring frequent
monitoring of serum potassium and creatinine.
3. A patient with Asthma is not well-controlled on a Low-Dose ICS. According to GINA
guidelines, what is the preferred next step in therapy?
A. Add a Long-Acting Muscarinic Antagonist (LAMA)
B. Switch to a High-Dose ICS monotherapy
C. Add a Long-Acting Beta-2 Agonist (LABA)
D. Initiate Oral Corticosteroids
Answer: C
Conceptual Explanation: For asthma not controlled on low-dose ICS, the preferred Step 3
treatment is the addition of a LABA to the ICS (ICS-LABA combination).
4. Which medication is contraindicated in a patient with a history of heart failure and a NYHA
Class III status due to the risk of fluid retention?
A. Metformin
B. Empagliflozin
, C. Pioglitazone
D. Sitagliptin
Answer: C
Conceptual Explanation: Thiazolidinediones (TZDs) like Pioglitazone cause fluid
retention and are contraindicated in patients with symptomatic heart failure.
5. A patient taking Warfarin presents with an INR of 7.5 and no active bleeding. What is the
most appropriate management strategy?
A. Administer 10mg Vitamin K intravenously
B. Administer Fresh Frozen Plasma (FFP)
C. Hold Warfarin and administer oral Vitamin K
D. Administer Protamine Sulfate
Answer: C
Conceptual Explanation: For patients with an INR between 4.5 and 10.0 and no bleeding,
the recommendation is to hold warfarin and potentially provide low-dose oral Vitamin K.
6. Which side effect is most uniquely associated with the use of SGLT2 inhibitors like
Canagliflozin?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
