D027 WGU pathopharm Exam with Questions
and Answers| Latest Update | Verified Answers
A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL
of 52, and triglycerides of 326. He has no history of atherosclerotic cardiovascular disease
(ASCVD) or diabetes. His blood pressure is 118/64. He has a pulse rate of 64, and he weighs
320 lb. He smokes one pack of cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?
Fenofibrate (Tricor) 145mg
Ibuprofen (Motrin) 200mg
Ezetimibe (Zetia) 10mg
Atorvastatin (Lipitor) 20mg - ✔✔d)Atorvastatin is more effective in reducing total
cholesterol having a greater impact on lowering LDL cholesterol. The American College of
Cardiology guidelines on blood cholesterol management emphasize that the greater the
reduction in the LDL-C on statin therapy, the greater the subsequent risk reduction.
A 73-year-old man with Systolic congestive heart failure (CHF) with reduced ejection fraction
(HFrEF) comes to a clinic complaining of shortness of breath. He is currently taking 6.25 mg
carvedilol (Coreg) twice a day and 50 mg losartan (Cozaar) and 20 mg furosemide (Lasix) daily.
His oxygen saturation is 95%, and he has a pulse of 64. His BP is 138/82, and his BNP is 1150.
Using the 2017 heart failure guidelines, which medication change should be recommended for
this patient?
Add nifedipine (Procardia)
Add amlodipine (Norvasc)
,Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
Stop ARB and add lisinopril (Zestril) - ✔✔c) In this case, the elevated BNP indicates
significant heart failure. Guidelines recommend replacing an ARB or ACE inhibitor with an ARNI
such as Entresto, especially in those with HFrEF
A 78-year-old man comes in with stable angina. He reports he has been having more angina
recently. He is currently taking the following medications: lisinopril (Zestril), atorvastatin
(Lipitor), aspirin, and nitrostat PRN for chest pain. He has a history of COPD with
bronchospasm. His blood pressure is 145/88, and he has a pulse of 74.
Which class of medications should be avoided for this patient?
Beta blockers
Calcium channel blockers
Diuretics
Long-acting nitrates - ✔✔beta blockers
The use of nonselective beta blockers is contraindicated in the management of patients with
a history of COPD or asthma because they impact both beta 1 and beta 2 receptors and
precipitate bronchospasms. Cardioselective beta blockers, while less likely to cause
bronchospasms, may still add to the risk of respiratory compromise.
Common H2 receptor antagonists - ✔✔cimetidine (Tagamet)
famotidine (Pepcid)
ranitidine (Zantac)
H2 receptor antagonists MOA - ✔✔Block histamine H2 receptor on the surface of
parietal cells (mainly in stomach) that leads to reduced acid production
Why are H2 receptor antagonists not being used often today? - ✔✔reports of cancer
causing ingredients, removed from the shelves
, MOA for proton pump inhibitors - ✔✔suppress acid secretion by inhibiting
hydrogen, potassium and ATPs (enzyme that makes gastric acid)
- suppressing acid production by suppressing ATPs
-longer acting, build up over time
Common PPI medications - ✔✔- Nexium
-Prevacid
- Protonix
-Prilosec
-SFX
Mucosal Agents MOA - ✔✔forms barrier over ulcer crater that protects against acid pepsin
What should you advise for a post PCI or MI patient who is currently taking Clopidogrel's and
wants to take PPI for GERD? - ✔✔Clopidogrel's anti-platelet therapy is inhibited by PPI
and should never be taken together. Should take H2 receptor antagonist or see GI specialist
to tx GERD
What natural supplement can cause liver toxicity and should be avoided by
breastfeeding moms? - ✔✔Cinnamon
What are some of the benefits of cinnamon - ✔✔improve health of the colon, Reduces
risk of colon CA, coagulant that helps to prevent bleeding, antimicrobial, antifungal,
antioxidant, antidiabetic, cholesterol/lipid lowering effects
What interactions may garlic have with certain medications? - ✔✔It can increase risk of
bleeding in patients taking antiplatelet drugs (aspirin) or anticoagulants (warfarin/heparin)
and Answers| Latest Update | Verified Answers
A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL
of 52, and triglycerides of 326. He has no history of atherosclerotic cardiovascular disease
(ASCVD) or diabetes. His blood pressure is 118/64. He has a pulse rate of 64, and he weighs
320 lb. He smokes one pack of cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?
Fenofibrate (Tricor) 145mg
Ibuprofen (Motrin) 200mg
Ezetimibe (Zetia) 10mg
Atorvastatin (Lipitor) 20mg - ✔✔d)Atorvastatin is more effective in reducing total
cholesterol having a greater impact on lowering LDL cholesterol. The American College of
Cardiology guidelines on blood cholesterol management emphasize that the greater the
reduction in the LDL-C on statin therapy, the greater the subsequent risk reduction.
A 73-year-old man with Systolic congestive heart failure (CHF) with reduced ejection fraction
(HFrEF) comes to a clinic complaining of shortness of breath. He is currently taking 6.25 mg
carvedilol (Coreg) twice a day and 50 mg losartan (Cozaar) and 20 mg furosemide (Lasix) daily.
His oxygen saturation is 95%, and he has a pulse of 64. His BP is 138/82, and his BNP is 1150.
Using the 2017 heart failure guidelines, which medication change should be recommended for
this patient?
Add nifedipine (Procardia)
Add amlodipine (Norvasc)
,Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
Stop ARB and add lisinopril (Zestril) - ✔✔c) In this case, the elevated BNP indicates
significant heart failure. Guidelines recommend replacing an ARB or ACE inhibitor with an ARNI
such as Entresto, especially in those with HFrEF
A 78-year-old man comes in with stable angina. He reports he has been having more angina
recently. He is currently taking the following medications: lisinopril (Zestril), atorvastatin
(Lipitor), aspirin, and nitrostat PRN for chest pain. He has a history of COPD with
bronchospasm. His blood pressure is 145/88, and he has a pulse of 74.
Which class of medications should be avoided for this patient?
Beta blockers
Calcium channel blockers
Diuretics
Long-acting nitrates - ✔✔beta blockers
The use of nonselective beta blockers is contraindicated in the management of patients with
a history of COPD or asthma because they impact both beta 1 and beta 2 receptors and
precipitate bronchospasms. Cardioselective beta blockers, while less likely to cause
bronchospasms, may still add to the risk of respiratory compromise.
Common H2 receptor antagonists - ✔✔cimetidine (Tagamet)
famotidine (Pepcid)
ranitidine (Zantac)
H2 receptor antagonists MOA - ✔✔Block histamine H2 receptor on the surface of
parietal cells (mainly in stomach) that leads to reduced acid production
Why are H2 receptor antagonists not being used often today? - ✔✔reports of cancer
causing ingredients, removed from the shelves
, MOA for proton pump inhibitors - ✔✔suppress acid secretion by inhibiting
hydrogen, potassium and ATPs (enzyme that makes gastric acid)
- suppressing acid production by suppressing ATPs
-longer acting, build up over time
Common PPI medications - ✔✔- Nexium
-Prevacid
- Protonix
-Prilosec
-SFX
Mucosal Agents MOA - ✔✔forms barrier over ulcer crater that protects against acid pepsin
What should you advise for a post PCI or MI patient who is currently taking Clopidogrel's and
wants to take PPI for GERD? - ✔✔Clopidogrel's anti-platelet therapy is inhibited by PPI
and should never be taken together. Should take H2 receptor antagonist or see GI specialist
to tx GERD
What natural supplement can cause liver toxicity and should be avoided by
breastfeeding moms? - ✔✔Cinnamon
What are some of the benefits of cinnamon - ✔✔improve health of the colon, Reduces
risk of colon CA, coagulant that helps to prevent bleeding, antimicrobial, antifungal,
antioxidant, antidiabetic, cholesterol/lipid lowering effects
What interactions may garlic have with certain medications? - ✔✔It can increase risk of
bleeding in patients taking antiplatelet drugs (aspirin) or anticoagulants (warfarin/heparin)
