PEBC (Cardiovascular and CNS) Sample Questions
Categories: PEBC Canada
Ques. MP is a 72 years old patient diagnosed for systolic congestive heart failure after his LVEF is ≤ 40%. MPs blood pressure reading is 130/85. Doctors categorized MP symptoms according to NYHA class 2. Doctor considering prescribing Ramipril 5 mg as initial therapy to CHF? What are the therapeutic benefits of ACEi treatment for patients of CHF?
A) Reduce mortality
B) Reduce readmission in hospital for heart failure
C) Improve symptoms and improve ejection fraction
D Decrease the rate of reinfarction in patients with coronary artery disease
E) all of the above
Answer: (e)
Ques. MP returns to the pharmacy with a new prescription of metoprolol 50 mg bid, because he says his heart failure symptoms have not improved. His doctor said his LVEF <30%. What is the therapeutic benefit of beta blockers therapy in CHF?
A) Reduce mortality
B) Reduce readmission in hospital for heart failure
C) Improve symptoms and improve ejection fraction
D Decrease the rate of reinfarction in patients with coronary artery disease
E) all of the above
Answer: (e)
Ques. Patients using beta blockers (metoprolol, carvedilol and bisoprolol) in congestive heart failure, have the risk of treatment such as fluid retention, worsening of heart failure, fatigue, bradycardia, heart blockade, and hypotension. Thus which of the following are monitored in congestive heart failure patients using beta blockers?
A) Changes in fatigue and dyspnea symptoms
B) Fluid accumulation by taking weight
C) Heart rate
D) Blood pressure
E) All of the above
Answer: (e)
Ques. After initiating metoprolol therapy, MP visits his physician with increased pedal edema and shortness of breath. Doctor considering treating fluid retention and dyspnea. What are the best treatment options?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Verapamil
E) Hydralazine and isosorbide dinintrate
Answer: (a)
Ques. What is the therapeutic benefit of adding diuretics to congestive heart failure patients?
A) Improve CHF symptoms such as pedal edema and dyspnea
B) Decrease mortality
C) Decrease rehospitalization
D) Decrease CHF progression
E) All of the above
Answer: (a)
Ques. MPs congestive heart failure continued to deteriorate on optimal doses of ramipril and metoprolol. Doctor prescribed candesartan 32 mg daily. What is the pharmacist's concern?
A) Side effect of hypotension, ↑ SrCr and hyperkalemia (K>5)
B) Combination of ACEi plus ARBs
C) Increased risk of fluid retention
D) Increased aldosterone concentration
E) Risk of renal failure
Answer: (a)
Ques. MPs prescribed digoxin 0.125 mg daily to improve quality of life and symptoms and exercise tolerance. What is the reason low dose of digoxin was prescribed?
A) age
B) low ejection fraction
C) hyperkalemia
D) to avoid drug interactions
E) to avoid digitalis toxicity
Answer: (a)
Ques. MPs doctor prescribed spironolactone 12.5 mg daily to treat severe symptoms of congestive heart failure and reduced ejection fraction. What is the greatest risk of hyperkalemia?
A) Patients with renal dysfunction CrCl < 30 ml/min and elevated serum potassium K+>5
B) Patients with renal dysfunction CrCl < 30 ml/min and age
C) Patients with renal dysfunction CrCl < 30 ml/min and using NSAIDs
D) Patients with renal dysfunction CrCl < 30 ml/min and using ACEi
E) Patients with renal dysfunction CrCl < 30 ml/min and using ARBs
Answer: (a)