SGrade/USMLE Step 1/Cardiovascular & Renal Pharmacology
RAAS blockers, CCBs, nitrates, beta-blockers in HFrEF, Vaughan Williams classes, digoxin and adenosine, anticoagulant reversal, diuretic sites, and statins/PCSK9.
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A 48-year-old man with hypercholesterolemia is started on simvastatin. During a follow-up visit, he reports new onset muscle aches and weakness. Laboratory tests reveal an elevated creatinine kinase level.
Examiner's Design Intent
To assess the student's knowledge of the primary mechanism of action of a commonly prescribed drug (simvastatin) and their ability to associate this with a characteristic adverse effect.
A 60-year-old woman with chronic heart failure is on a regimen of furosemide and lisinopril. Her serum potassium level is consistently low. To counteract the potassium loss without altering her fluid balance significantly, her physician adds a new medication.
Examiner's Design Intent
To assess the student's ability to integrate knowledge of common cardiovascular medications (furosemide, lisinopril) with their known side effects (hypokalemia) and select an appropriate pharmacologic intervention to man…
A 55-year-old man with hypertension and a history of nephrolithiasis due to hypercalciuria is prescribed a new antihypertensive medication. After several weeks, his blood pressure is well-controlled, and he reports a decrease in the frequency of his kidney stone episodes.
Examiner's Design Intent
To assess the student's ability to integrate knowledge of antihypertensive mechanisms with their specific effects on renal physiology, particularly calcium handling, in the context of a common comorbidity (nephrolithiasi…
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