Test Questions

Advances in the Treatment of Chronic Stable Angina

Exam Questions

1. SP, a 63-year-old patient with known CAD, presents to the clinic complaining of daily symptoms of angina with exertion. SP is medically managed for secondary prevention of CAD on aspirin 81 mg daily, atenolol 100 mg daily, and atorvastatin 80 mg daily. Which of the following is the best option for the treatment of SP's acute episodes of angina?
    A. Sublingual nitroglycerin (NTG) 0.4 mg prn
    B. Isosorbide mononitrate 30 mg po daily
    C. Ranolazine 500 mg po bid
    D. Increase atenolol to 200 mg daily
2. KL is a 55-year-old male who presents to your clinic complaining of chest pain that developed about five blocks into his morning walk, which is not unusual for him. His pain is crushing in nature and usually subsides after about 10 minutes of rest. His past medical history includes hypertension, hyperlipidemia, BPH, and GERD. His current medications include hydrochlorothiazide 25 mg po daily, simvastatin 40 mg qhs, omeprazole OTC 1 tablet prn, and aspirin 81 mg po daily. Which condition(s) could be contributing to KL's symptoms?
    A. BPH
    B. GERD
    C. CAD
    D. Both B and C
3. How would you classify KL's chest pain?
    A. Stable angina
    B. Unstable angina
    C. Variant (Prinzmetal's) angina
    D. It's not true angina; it's GERD
4. Based on the CCS Angina Grading Scale, what class of severity is KL's chest pain?
    A. I
    B. II
    C. III
    D. None of the above
5. Which of the following would be the best initial drug therapy for management of KL's chest pain?
    A. Amlodipine 10 mg po daily, isosorbide mononitrate ER 30 mg po daily
    B. Metoprolol 50 mg po bid, sublingual NTG prn
    C. Pantoprazole 40 mg po bid
    D. Ranolazine 500 mg po bid, sublingual NTG prn
6. Which of the following represent equivalent doses?
    A. Isosorbide mononitrate 30 mg tid = isosorbide dinitrate 90 mg daily
    B. Isosorbide mononitrate 30 mg daily = isosorbide dinitrate 10 mg tid
    C. Isosorbide mononitrate 30 mg bid = isosorbide dinitrate 60 mg bid
    D. Isosorbide mononitrate 30 mg daily = isosorbide dinitrate 20 mg tid
7. Which regimen would provide an adequate nitrate-free interval?
    A. Isosorbide mononitrate 30 mg q12h
    B. Isosorbide dinitrate 10 mg q6h
    C. Isosorbide dinitrate 60 mg at 6 am, noon, and 4 pm
    D. None of the above
8. In which of the following situations would beta-blockers not be considered first-line therapy for CSA?
    A. Patient with a history of MI and revascularization
    B. Patients with severe asthma
    C. Elderly patient with hypertension and stable heart failure
    D. A patient with angina provoked by exercise that is relieved by rest and NTG
9. Which of the following is an absolute contraindication to therapy with beta-blockers?
    A. COPD
    B. Depression
    C. Diabetes
    D. Unstable heart failure
10. According to the 2002 ACC/AHA guidelines, CCBs would be considered first-line therapy in patients with which of the following?
    A. Hypertension and heart failure
    B. Persistent exertional angina despite maximum doses of propranolol
    C. Hypertension and sick sinus syndrome
    D. Both B and C
11. Which of the following describes a proposed mechanism of action for ranolazine?
    A. Shift in the production of ATP away from oxidation of fatty acids
    B. Systemic vasodilation leading to a decrease in preload
    C. Dilation of systemic and coronary arteries resulting in a decreased myocardial oxygen demand
    D. All of the above
12. Which of the following would be an appropriate first-line choice for a 62-year-old patient with newly diagnosed stable angina given the following: hypertension, mild peripheral edema, type 2 diabetes mellitus, BP 145/84, and pulse 69 bpm?
    A. Metoprolol tartrate 50 mg po bid
    B. Amlodipine 5 mg po daily
    C. Isosorbide mononitrate ER 30 mg po qam
    D. Metoprolol succinate 400 mg po qd
13. Which of the following is true regarding the use of CCBs in stable angina?
    A. All are FDA approved for the treatment of CSA
    B. Initial antianginal CCB therapy should include a short-acting dihydropyridine CCB
    C. Nifedipine IR can cause reflex tachycardia
    D. Verapamil and diltiazem are least likely to cause AV block and sinus dysfunction
14. Ranolazine therapy would not be appropriate for a patient receiving which of the following medications?
    A. Diltiazem
    B. Ketoconazole
    C. Haloperidol
    D. All of the above
15. Which of the following does not accurately describe a component of the pathophysiology of CSA?
    A. Regional myocardial ischemia arising from inadequate coronary perfusion
    B. Decreased perfusion of myocardial tissue as a result of bradycardia and increased myocardial oxygen requirements
    C. Supply-demand mismatch of oxygen requirements and stress or physical activity
    D. Plaque deposition external to the lumen, ultimately intruding and causing obstruction
16. Tachyphylaxis is most likely to occur with which of these regimens?
    A. Metoprolol tartrate 150 mg po bid
    B. Felodipine 5 mg po daily
    C. Isosorbide dinitrate 20 mg po q8h
    D. Ranolazine 750 mg po bid
17. In a patient presenting with new symptoms consistent with angina, what condition(s) should be included in the initial differential diagnosis?
    A. ST-elevation MI
    B. GERD
    C. Hypertension
    D. Both A and B
18. Nonpharmacologic management of angina includes:
    A. PCI
    B. TMR
    C. Exercise programs
    D. All of the above
19. EECP is:
    A. First-line therapy for stable angina
    B. An invasive and high-risk procedure
    C. A technique using balloon cuffs to compress the patient's extremities during diastole
    D. The treatment of choice for severe three-vessel coronary disease
20. Which of the following statements is true regarding PCI?
    A. It is a reasonable first-line therapy for chronic stable angina
    B. It does not reduce mortality when compared with aggressive medical management
    C. It is superior to CABG in patients with left main coronary disease
    D. Both A and B

Evaluation Questions

21. Met objective 1:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
22. Met objective 2:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
23. Met objective 3:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
24. Met objective 4:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
    F. N/A for Pharmacy Technicians
25. Related to your practice needs:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
26. Will help you improve patient care:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
27. Avoided commercial bias:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
28. How would you rate the overall quality of the material presented?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
29. How would you rate the overall user friendliness of the program?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
30. Comments on this program:
 
* Also applies to pharmacy technicians