BCACP – Cardiology Exam Solved 2023

MRA recommendation for CHF - ANSWER-1. symptomatic HFrEF /= 35% 2. Post-MI with /=40% and either HF symptoms or DM MRA CI - ANSWER-1. eGFR 30 2. SCr /=2.5 in male, /=2.0 in female 3. K 5.0 4. pt already on combination therapy with ACEI + ARB (d/t increase risk of hyperkalemia with MRA) Hydralazine/isosorbide recommended for which CHF patients? - ANSWER-1. AA patients with NYHA class III/IV taking ACEI/ARB , BB +/- MRA 2. any symptomatic HFrEF patients who are intolerant to ACEI/ARB Distal tubule diuretics - drugs and directions -place in therapy - ANSWER--Metolazone, Chlorthalidone -Given 30 min prior to loop diuretics to augment the effect CHF: digoxin toxicity - ANSWER-1. GI disturbances 2. Arrhythmia 3. CNS disturbances 4. Visual changes digoxin level goal CHF Afib both - ANSWER-0.5-0.9 ng/mL for CHF 1-2 ng/mL for Afib if both, use CHF goal (0.5-0.9) digoxin DDI - ANSWER-1. Amiodarone/Dronedarone 2. Verapamil 3. Quinidine 4. Erythromycin/Clarithromycin 5. Telaprevir, Saquinavir CHF: Ivabradine should be avoided in which patients? - ANSWER-1. AFib, 3rd degree heart block, pacemaker dependent 2. BP 90/50 or resting HR 60 bpm 3. acute CHF 4. severe hepatic impairment 5. strong CYP 3A4 inhibitors: dilt/vera, grpfrt juice 6. CYP 3A4 inducers: St John's wort, rifampin, barbiturates, phenytoin