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 : The basis for use of β-adrenergic blockers in congestive heart failure (CHF) is: A. They exert positive inotropic effect in CHF B. They counteract deleterious effect of sympathetic overactivity on the myocardium C. They exert antiischaemic effect on the heart D. They prevent cardiac arrhythmias
Last Answer : B. They counteract deleterious effect of sympathetic overactivity on the myocardium
Description : The basis for use of β -adrenergic blockers in congestive heart failure (CHF) is: A. They exert positive inotropic effect in CHF B. They counteract deleterious effect of sympathetic overactivity on the myocardium C. They exert antiischaemic effect on the heart D. They prevent cardiac arrhythmias
Description : In a patient receiving digoxin for congestive heart failure, condition that may facilitate the appearance of toxicity include (a) Hyperkalemia (b) Hypernatremia (c) Hypocalcemia (d) Hypomagnesemia (e) All of the above
Last Answer : Ans: D
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 : Choose the drug which is used as a short-term inotropic in severe congestive heart failure and has selective adrenergic β1 agonistic activity but no dopaminergic agonistic activity: A. Dopamine B. Dobutamine C. Amrinone D. Salmeterol
Last Answer : B. Dobutamine
Description : Choose the drug which is used as a short-term inotropic in severe congestive heart failure and has selective adrenergic β 1 agonistic activity but no dopaminergic agonistic activity: A. Dopamine B. Dobutamine C. Amrinone D. Salmeterol
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 : 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 : Because of proven beneficial effects on “cardiac remodeling”, these agents are now indicated as first line therapy in CHF patients. Which of the following is representative of this group of drugs? (a) Hydrochlorothiazide (b) Enalapril (c) Furosemide (d) Carvedilol (e) Bumetanide
Last Answer : Ans: B
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 : 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
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 : 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 : 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 : 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 : A patient of CHF was treated with furosemide and digoxin. He became symptom-free and is stable for the last 3 months with resting heart rate 68/min in sinus rhythm but left ventricular ... medication as before C. Continue the diuretic but stop digoxin D. Continue digoxin but stop the diuretic
Last Answer : A. Stop above medication and start an ACE inhibitor
Description : Treating Congestive Heart Failure?
Last Answer : If you have been diagnosed with congestive heart failure, treating this can weaken the symptoms related to condition and help your heart function more efficiently as well. Some physicians focus on ... combined with gaining weight, may mean that their heart condition is not being controlled properly.
Description : Maximal medical therapy for treating angina pectoris is represented by which of the following choices? (a) Diltiazem, verapamil, nitroglycerin (b) Atenolol, isoproterenol, diltiazem (c) Verapamil, nifedipine, propranolol (d) Isosorbide, atenolol, diltiazem (e) Nitroglycerin, isosorbide, atenolol
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 : 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 : 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 : 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 : 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 : Aspirin in small doses (50 to 150 mg per day) (a) Is of benefit in patients of unstable angina (b) Has thrombolytic action (c) PREFerentially inhibits prostacyclin synthetase enzyme (d) MAY Alleviate need for Verapamil in variant angina
Description : Which vasodilator is most suitable for a patient of CHF who is symptomatic even at rest and has a central venous pressure of 25 mm Hg and cardiac index 1.8 L/min/m2 : A. Glyceryl trinitrate B. Enalapril C. Hydralazine D. Nifedipine
Last Answer : B. Enalapril
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 : 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 : 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 : 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 : A patient to be commenced on oral anticoagulant therapy for DVT would be treated with (a) Oral anticoagulant therapy with warfarin for a goal intenational normalized ration (INR) of 2-3 (b) Oral anticoagulant therapy ... of 2.5-3.5 (c) Oral anticoagulant therapy with aspirin for a goal INR of 2-3
Description : Digoxin given for cardiac failure is extremely valuable in patients of (a) Thyrotoxicosis (b) Beriberi (c) Cor pulmonale (d) Atrial fibrillation
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 suffers from spisodic pain diffusely localized over the chest and upper abdomen, which is relieved by sublingual glyceryl trinitrate. He could be suffering from (a) Angina pectoris (b) Biliary colic (c) Esophageal spasm (d) All of the above
Description : Quinidine can cause paradoxical tachycardia in a patient of (a) Stick sinus syndrome (b) Auricular extrasystoles (c) Auricular fibrillation (d) Ventricular extrasystoles
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 : Situations that predispose a digitalistreated patient to toxicity include (a) Hypercalcemia (b) Hyperkalemia (c) Hypermagnesemia
Description : Strong anticholinergic effects limit the antiarrhythmic use of (a) Quinidine (b) Procainamide (c) Tocainide (d) Flecainide (e) Disopyramide
Description : All of the following statements about hemorrhagic shock are true except: A. Following hemorrhagic shock, there is an initial interstitial fluid volume contraction. B. Dopamine, or a similar inotropic ... shock, a narrowed pulse pressure is commonly seen before a fall in systolic blood pressure.
Last Answer : Answer: BC DISCUSSION: Hemorrhagic shock is associated with a contraction of the interstitial fluid compartment because of precapillary vasoconstriction and reabsorption of interstitial fluid ... definitive evidence that such solutions are better than standard crystalloid solutions is lacking
Description : The action of quinidine differs from that of digitalis in (a) Decreasing irritability of cardiac muscle (b) Preventing passage of impulses to the ventricle (c) Increasing irritability of heart muscle (d) Reducing conductivity (e) None of the above
Description : A treatment of angina that consistently decreases the heart rate and can prevent vasospastic angina attacks is (a) Isosorbide dinitrate (b) NIFedipine (c) Nitroglycerin (d) Propranolol (e) Verapamil
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 : Though nitrates and calcium channel blockers are both vasodilators, they are used concurrently in angina pectoris because (a) They antagonize each other's side effects (b) Nitrates primarily reduce preload while calcium ... load (c) Nitrates increase coronary flow while calcium (d) Both (b) and (c)
Description : Major beneficial effect of nitrates in classical angina is due to (a) Dilation of veins more than arteries (b) Increase in total coronary blood flow (c) An increase in the end diastolic size of the heart (d) An increase in the heart rate
Description : Procainamide differs from quinidine in the following respect (a) It does not cause paradoxical tachycardia (b) It has no alfa adrenergic blocking activity (c) It has little antivagal action (d) Both (b ... a) Pacemaker function (b) Resting potential (c) Action potential duration (d) All of the above
Description : Which of the following vasoactive drugs used in treating shock results in reduced preload and afterload, reducing oxygen demand of the heart? a) Nitroprusside (Nipride) A disadvantage ... increases cardiac output. d) Methoxamine (Vasoxyl) Methoxamine increases blood pressure by vasoconstriction.
Last Answer : a) Nitroprusside (Nipride) A disadvantage of nitroprusside is that it causes hypotension.
Description : A patient on the dental chair has cardiac arrest. What is INCORRECT, A. Observing the vital signs and check that the air way is clear is at high importance B. Expired air has 15% O2 only, ... D. Intermittent positive pressure is better than mouth to mouth when it has been given at the same rate.
Last Answer : C. Intermittent positive pressure at the rate of 40/min will reduce the chances of cerebral hypoxia