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Category: Cardiology--->Pharmacology
Page: 10

Question 46# Print Question

C. P. is a 46-year-old white man admitted with worsening headache, and nausea and vomiting over 48 hours. The patient is status post single-lung transplant secondary to α1 -antitrypsin deficiency. His immunosuppression regimen includes cyclosporine, prednisone, and azathioprine. As a result of the cyclosporine, he has HTN and renal dysfunction (baseline serum creatinine, 1.9 mg/dL). His BP is controlled with clonidine 0.2 mg twice daily and metoprolol tartrate 25 mg twice daily. Two months ago, he was changed to metoprolol from amlodipine because of peripheral edema. The patient was in his usual state of health until approximately 1 week ago, when he experienced diarrhea, which has since resolved. On admission, his BP was 208/110 mmHg and his serum creatinine was 3.8 mg/dL. What is the most appropriate regimen to control this patient’s BP?

A. Change back to amlodipine 10 mg daily
B. Initiate nitroprusside drip and give IV fluids
C. Add captopril to the regimen and titrate to effect
D. Give sublingual nifedipine


Question 47# Print Question

R. W. is a 60-year-old woman with HF (left ventricular ejection fraction <30%) who has HTN with a BP of 152/90 mmHg. Her potassium is 4.0 mg/dL and serum creatinine is stable at 1.5 mg/dL. She is currently on digoxin and furosemide. Which regimen is most appropriate to initiate in this patient?

A. Hydralazine 25 mg four times daily
B. Metoprolol tartrate 12.5 mg twice daily
C. Valsartan 20 mg twice daily
D. Lisinopril 5 mg daily


Question 48# Print Question

A. V. is a 49-year-old woman with a history of HF presenting to the ED for the second time in a month with acutely decompensated HF. She has dyspnea at rest and 3+ edema in her lower extremities. Her serum creatinine is 1.8 mg/dL and BP is 90/60 mmHg. Her home regimen includes enalapril 20 mg twice daily, carvedilol 3.125 mg twice daily, and furosemide 40 mg PO daily. Which of the following is most appropriate for this patient?

A. Admit her to the hospital for IV furosemide therapy and hemodynamic monitoring
B. Admit her to the hospital for diuresis with nesiritide
C. Initiate an infusion of nesiritide in the ED and reassess in 4 hours
D. Schedule intermittent outpatient infusions of nesiritide


Question 49# Print Question

A patient with New York Heart Association class III HF was hospitalized 2 months ago for an exacerbation of his HF. The patient was discharged on lisinopril, furosemide, and digoxin. His lungs are clear and his vital signs are as follows: BP, 105/56 mmHg; heart rate, 84 bpm; and respiration rate, 18. Which regimen is most appropriate to initiate in this patient?

A. Atenolol 50 mg daily
B. Carvedilol 3.125 mg twice daily
C. Carvedilol 25 mg twice daily
D. Metoprolol tartrate 50 mg twice daily


Question 50# Print Question

Which β-blockers are recommended for use for patients with HF?

A. Metoprolol tartrate, pindolol, propranolol
B. Carvedilol, metoprolol succinate, bisoprolol
C. Metoprolol succinate, metoprolol tartrate, carvedilol
D. Metoprolol tartrate, carvedilol, bisoprolol




Category: Cardiology--->Pharmacology
Page: 10 of 11