- ß1-selective adrenergic receptor antagonists (blockers) are preferred over non-selective ß-adrenergic receptor blockers because [1]:
- Which of the following is the preferred agent for treatment of hypertension in a 55 year old white male with benign prostatic hyperplasia and mild Type II diabetes [2] ?
A. An ACE Inhibitor such as Enalapril or Lisinopril
B. A non-specific ß-blocker such as Propranolol or Naldolol
C. An alpha1-adrenergic antagonist such as Doxazosin or Terazosin
D. A ß1-selective adrenergic blocker such as Atenolol or Metoprolol
E. A calcium channel blocker such as amlodipine or Felodipine - A 48 year old man was hospitalized for surgical resection of diverticuli following several bouts of severe acute diverticulitis treated with ampicillin, gentamicin and metronidazole. His immediate post-operative course was complicated by aspiration, and a pneumonia developed on post-operative day 3 (hospital day 10). His renal function is stable with a creatinine of 1.1mg/dL. Gram stain of his sputum showed large numbers of neutrophils, gram negative rods, and scattered gram positive cocci in chains. The hospital has had a problem with gentamicin resistance amongst its gram negative rods. His peripheral leukocyte count is 15.5K/µL with 83% neutrophils and 8% band (immature) forms. Pending identification and sensitivities, his antibiotic regimen should be altered to include [3]:
A. Higher dose gentamicin and from ampicillin to ticarcillin-clavulanate (Timentin®)
B. Change from q8 hour to once-daily gentamicin and from ampicillin to ticarcillin-clavulanate
C. Change from gentamicin to tobramicin and from ampicillin to ticarcillin-clavulanate
D. Change from gentamicin to amikacin and from ampicillin to ticarcillin-clavulanate
E. No alteration of his antibiotic regimen is necessary - Which of the following statements concerning anti-platelet agents is TRUE [4] ?
A. Nonselective blockers do not reduce blood pressure as well as selective blockers
B. Nonselective blockers are more likely to cause peripheral vascular constriction and/orbronchospasm than are selective blockers
C. Nonselective blockers reduce gastric emptying more than selective blockers
D. Nonselective blockers increase urinary retention more than selective blockers
E. Nonselective blockers do not reduce the incidence of arrhythmias in ischemic settings aswell as selective blockers
I. Glycoprotein IIb/IIIa blockers are less effective platelet inhibitors than aspirin
| II. Aspirin and clopidogrel are synergistic in blocking platelet function |
| III. Aspirin is superior to clopidogrel for preventing recurrence of stroke after initial stroke |
| IV. Aspirin and glycoprotein IIb/IIIa inhibitors are synergistic in blocking platelet function |
V. Abciximab (ReoPro®) blocks only glycoprotein IIb/IIIa on the platelet membrane
A. I, II, and III are true concerning anti-platelet agents
B. I and III are true concerning anti-platelet agents
C. II and IV are true concerning anti-platelet agents
D. V alone is true concerning anti-platelet agents
E. All of the above statements are true concerning anti-platelet agents
- Which ONE of the following is indicated for the prevention of secondary stroke [5] ?
A. Subcutaneous heparin
B. Low molecular weight (LMH) heparin
C. Oral glycoprotein IIb/IIIa inhibitors
D. Clopidogrel (Plavix®)
E. Direct thrombin inhibitors - Which ONE of the following side effects is not associated with amiodarone [6] ?
A. Renal Insufficiency
B. Hepatitis
C. Thyroid Dysfunction
D. Pulmonary Fibrosis
E. PR interval prolongation - All Class III Anti-Arrhythmic Agents are associated with which ONE of the following [7] ?
A. Blockade of sodium channels
B. Blockade of potassium channels
C. Blockade of ß-adrenergic receptors
D. Blockade of nicotinic acetylcholine receptors
E. Blockade of sodium-potassium ATPase - Amphotericin B (standard formulation) is associated with all but ONE of the following side effects [8]:
A. Hypokalemia
B. Rigors
C. Nausea and/or vomiting
D. Hypermagnesemia
E. Thrombophlebitis - A 72 year old man recently visited the southwestern United States. He presents with cough, fever, weight loss, mild sputum production. He has atherosclerosis, history of myocardial infarction with post-MI arrhythmias, and renal insufficiency with a creatinine of 4.8mg/dL. He is diagnosed with histoplasmosis. The most appropriate anti-fungal treatment is [9]:
A. Fluconazole
B. Itraconazole
C. Terbinafine
D. Amphotericin B Liposomal Formulation
E. Amphotericin B acutely followed by itraconazole - A 52 year old man with 20 years of Type 2 diabetes mellitus undergoes pancreas and renal transplantation. His post-operative course is complicated by severe sinusitis with fever and rigors. Cultures reveal mucormyces. Local sinus surgery is performed, and Amphotericin B deoxycholate is administered with shakes, hypokalemia, and deterioration in renal function. The best course of action is [10]:
A. Continue amphotericin B and reduce cyclosporine levels
B. Replace amphotericin B with itraconazole
C. Replace amphotericin B with liposomal formulation of amphotericin B
D. Replace amphotericin B with fluconazole
E. Increase fluid intake to reduce nephrotoxicity
