Description : Acute renal failure (ARF) may be caused by all of the following except (a) Acute tubular necrosis (ATN) due to drug therapy (e.g., aminoglycosides, contrast media) (b) Severe hypotension ... (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia
Last Answer : Ans: E
Description : When digoxin is used in a patient with congestive heart failure (CHF), it works by exerting a positive effect on (a) Stroke volume (b) Total peripheral resistance (c) Heart rate (d) Blood pressure (e) Venous return
Last Answer : Ans: A
Description : Situations that predispose a digitalistreated patient to toxicity include (a) Hypercalcemia (b) Hyperkalemia (c) Hypermagnesemia
Description : Which of the following situations constitutes an added risk of digoxin toxicity ? (a) Starting administration of captopril (b) Starting administration of quinidine (c) Hyperkalemia (d) Hypermagnesemia (e) Hypocalcemia
Last Answer : Ans: B
Description : A 55-year-old patient currently receiving other drugs for another condition is to be started on diuretic therapy for mild heart failure. Thiazides are known to reduce the excretion of (a) Diazepam (b) Fluoxetine (c) Imipramine (d) Lithium (e) Potassium
Last Answer : Ans: D
Description : For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects? (a) 2.0 mg/kg/min (b) 5–10 mg/kg/min (c) 10–20 mg/kg/min (d) 40 mg/kg/min (e) 40 mg/kg/min
Description : A patient of congestive heart failure was being treated with furosemide and digoxin. He developed urinary tract infection. Which of the following antimicrobials should be avoided: A. Ampicillin B. Gentamicin C. Norfloxacin D. Cotrimoxazole
Last Answer : B. Gentamicin
Description : When the post-cardiac surgery patient demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the patient's serum electrolytes anticipating which abnormality? a) Hyperkalemia ... likely be indicated by weakness, fatigue, and confusion without change in T wave formation
Last Answer : a) Hyperkalemia Hyperkalemia is indicated by mental confusion, restlessness, nausea, weakness, and dysrhythmias (tall, peaked T waves).
Description : Digoxin given for cardiac failure is extremely valuable in patients of (a) Thyrotoxicosis (b) Beriberi (c) Cor pulmonale (d) Atrial fibrillation
Description : Which of the following groups of symptoms is most often associated with a patient who has right-sided heart failure? (a) Nocturia, rales, paroxysmal nocturnal dyspnea (b) Paroxysmal ... distention (e) Paroxysmal nocturnal dyspnea, jugular venous distention, abdominal distention, shortness of breath
Description : The term ischemic heart disease (IHD) is used to designate all of the following conditions except (a) Angina pectoris (b) Sudden cardiac death (c) Congestive heart failur (CHF) (d) Arrhythmias
Last Answer : Ans: C
Description : In congestive heart failure patients: A. Volume of distribution of all drugs is increased B. Hepatic clearance of drugs is unaffected C. Orally administered diuretics may not be effective, but the same may work parenterally D. Inotropic action of digoxin is attenuated
Last Answer : C. Orally administered diuretics may not be effective, but the same may work parenterally
Description : A patient receiving a class I antiarrhythmic agent on a chronic basis complains of fatigue, low-grade fever, and joint pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely receiving (a) Lidocaine (b) Procainamide (c) Quinidine (d) Flecainide (e) Propranolol
Description : Which of the following has been shown to prolong life in patient with chronic congestive failure but has a negative inotropic effect on cardiac contractility? (a) Carvedilol (b) Digitoxin (c) Digoxin (d) Dobutamine (e) Enalapril
Description : Propranolol should not be prescribed for a patient of angina pectoris who is already receiving (a) Nifedipine (b) Felodipine (c) Verapamil (d) Isosorbide mononitrate
Description : A patient has been taking digoxin for several years for chronic heart failure is about to receive atropine for another condition. A common effect of digoxin (at therapeutic blood levels) that can ... Increased atrial contractility (c) Increased PR interval on the ECG (d) Headaches (e) Tachycardia
Description : The following drug is used for short-term control of emergency heart failure, but not for long-term treatment of congestive heart failure: A. Digoxin B. Ramipril C. Dobutamine D. Spironolactone
Last Answer : C. Dobutamine
Description : The dose of digoxin in congestive heart failure is adjusted by monitoring: A. Electrocardiogram B. Heart rate and symptoms of CHF C. Blood pressure D. Plasma digoxin levels
Last Answer : B. Heart rate and symptoms of CH
Description : The following drug has been demonstrated to retard progression of left ventricular dysfunction and prolong survival of congestive heart failure patients: A. Digoxin B. Furosemide C. Enalapril D. Amrinone
Last Answer : C. Enalapril
Description : The following drug increases cardiac output in congestive heart failure without having any direct myocardial action: A. Captopril B. Digoxin C. Amrinone D. Dobutamine
Last Answer : A. Captopril
Description : Which of the following cardiovascular agents is classified chemically as a glycoside? (a) Nifedipine (b) Digoxin (c) Flecainide (d) Cholestyramine (e) Warfarin
Description : Which one of the following drugs predictably prolongs the PR interval and increases cardiac contractility? (a) Digoxin (b) Lidocaine (c) Propranolol (d) Quinidine (e) Verapamil
Description : Which one of the following drugs increase digoxin plasma concentration by a pharmacokinetic mechanism? (a) Captopril (b) Hydrochorothiazide (c) Lidocaine (d) Quinidine (e) Sulfasalazine
Description : A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/ ... (a) Sublingual (b) Oral (c) Intravenous bolus injection (d) Slow intravenous infusion
Description : If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition? (a) Colestipol (b) Gemfibrozil (c) Lovastatin (d) Niacin (e) Simvastatin
Description : Infusion of potassium chloride is indicated in digitalis toxicity when the manifestation(s) is/are: A. Vomiting, hyperapnoea and visual disturbance B. Pulsus bigeminus with heart rate 110/min ... accidentally ingested 10 digoxin tablets D. 2:1 A-V block with occasional ventricular extrasystoles
Last Answer : B. Pulsus bigeminus with heart rate 110/min in a patient on maintenance digoxin therapy
Description : Whcih one of the following is not a symptom of cushing’s disease? (A) Hyperglycemia (B) Hypernatremia (C) Hirsutism (D) Hyperkalemia
Last Answer : Answer : D
Description : In hyperparathyroidism there is (A) Hypocalcemia (B) Hypophophatemia (C) Hypokalemia (D) Hyperkalemia
Last Answer : Answer : B
Description : Which of the following is the drug of choice for management of cardiac arrhythmias that occur in digitalis toxicity? (a) Amiodarone (b) Lidocaine (c) Propranolol (d) Sotalol (e) Prazosin
Description : Therapeutic dose of digoxin in a normal individual has the following effects, except (a) Increase in the speed of myocardial contractility (b) No significant change in cardiac output (c) Relaxation of peripheral vascular bed (d) Increase in the force of myocardial contractility
Description : Which of the following drugs is most likely to accentuate varient (Prinzmetal) angina ? (a) Digoxin (b) Furosemide (c) Enalapril (d) Amrinone
Description : The following drug is used to reduce the frequency of angina pectoris as well as to terminate an acute attack (a) Digoxin (b) Furosemide (c) Enalapril (d) Amrinone
Description : Which of the following drugs is preferred for termination of paroxysmal supraventricular tachycardia (a) Digoxin (b) Quinidine (c) Propranolol (d) Verapamil
Description : Which of the following observations in the patient who has undergone allograft for treatment of burn site must be reported to the physician immediately? a) Crackles in the lungs Crackles in the lungs ... pain at the recipient site is anticipated since the wound has been protected by the graft.
Last Answer : a) Crackles in the lungs Crackles in the lungs may indicate a fluid buildup indicative of congestive heart failure and pulmonary edema.
Description : Relatively higher dose of theophylline is required to attain therapeutics plasma concentration in (a) Smokers (b) Congestive heart failure patients (c) Those receiving erythromycin (d) Those receiving cimetidine
Description : Relatively higher dose of theophylline is required to attain therapeutic plasma concentration in: A. Smokers B. Congestive heart failure patients C. Those receiving erythromycin D. Those receiving cimetidine
Last Answer : A. Smokers
Description : Mary has a family history of heart disease and wonders if garlic would be beneficial to her. Which of the following statements is correct about garlic? (a) Enteric-coated tablets release their contents in ... (c) The safety of garlic in pregnancy is unknown (d) Garlic does not interact with warfarin
Description : Essential amino acids have been advocated as standard therapy for renal failure. Which of the following statements are true? A. Increased survival from acute renal failure has been reported ... BUN and creatinine to the same degree as solutions containing excessive nonessential amino acids.
Last Answer : Answer: BC DISCUSSION: Essential amino acids and hypertonic dextrose, as opposed to hypertonic dextrose alone, was reported by Abel and co-workers to be associated with a decreased mortality rate ... renal failure have not been carried out in sufficient numbers to yield answers to this question
Description : A patient on oral anticoagulant therapy is commenced on sulfamethoxazoletrimethoprim, double-strength twice daily. One may expect to see the international normalized ratio (a) Increase (b) Decrease (c) Remain unchanged
Description : Which of the following are not determinants of a postoperative cardiac complication? A. Myocardial infarct 4 months previously. B. Clinical evidence of congestive heart failure in a patient with 8.5 gm ... on electrocardiogram. D. A harsh aortic systolic murmur. E. Age over 70 years.
Last Answer : Answer: B DISCUSSION: Clinical evidence of congestive heart failure in a patient with 8.5 gm. per dl. hemoglobin concentration is a misleading sign. Evidence of congestive ... or ventricular contractions on the electrocardiogram are less strong determinants of a postoperative cardiac complication
Description : What are the causes of congestive heart failure in a patient?
Last Answer : Major causes of congested heart failure are smoking, environment, genetics, and lifestyle. Also lack of diet and exercise help contribute to heart problems.
Description : If a fibrinolytic drug is used for treatment of acute myocardial infarction, the adverse drug effect that is most likely to occur is (a) Acute renal failure (b) Development of antiplatelet antibodies (c) Encephalitis secondary to liver dysfunction (d) Hemorrhagic stroke (e) Neutropenia
Description : Regarding verapamil, which one of the following statements is false? (a) Angina pectoris is an important indication for the use of verapamil (b) Contraindicated in the asthmatic patient (c) ... phase of the action potential in AV nodal cells (e) Used in management of supraventricular tachycardias
Description : A 54-year-old woman with severe hypercholesterolemia is to be treated with a combination of niacin and atorvastatin. With this drug combination, it is important that the patient be monitored closely for signs of (a) Agranulocytosis (b) Gallstones (c) Lactic acidosis (d) Myopathy (e) Thyrotoxicosis
Description : A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to ... ) Grapefruit juice (d) Induction of drug metabolism (e) Over - the - counter decongestants
Description : After being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of (a) ... Alanine and aspartate aminotransferase (c) Platelets (d) Red blood cells (e) Uric acid
Description : Complications of over treatment with thyroxine include the following except: A. Auricular fibrillation B. Angina pectoris C. Congestive heart failure D. Acceleration of atherosclerosis
Last Answer : D. Acceleration of atherosclerosis
Description : 17.6 Complications of over treatment with thyroxine include the following except: A. Auricular fibrillation B. Angina pectoris C. Congestive heart failure D. Acceleration of atherosclerosis
Description : In patients receiving massive blood transfusion for acute blood loss, which of the following is/are correct? A. Packed red blood cells and crystalloid solution should be infused to restore oxygen ... should be administered with every 5 units of packed red blood cells to avoid hypocalcemia.
Last Answer : Answer: A DISCUSSION: Patients who are suffering from acute blood loss require crystalloid resuscitation as the initial maneuver to restore intravascular volume and re-establish vital signs. If 2 to 3 liters ... when the infusion of blood proceeds at a rate exceeding 1 to 2 units every 5 minutes