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What are the three major mechanisms of arrhythmias?

Increased automaticity, afterdepolarizations (EAD/DAD), and reentry.

What is the most common mechanism of tachyarrhythmias?

Reentry.

What is EAD associated with?

Phase 2–3, prolonged QT, torsades de pointes.

What is DAD associated with?

Phase 4, intracellular Ca²⁺ overload, digoxin toxicity.

What are the Vaughan Williams antiarrhythmic classes?

Class I Na⁺ blockers, Class II β-blockers, Class III K⁺ blockers, Class IV Ca²⁺ blockers.

Which antiarrhythmic causes cinchonism?

Quinidine.

Which antiarrhythmic causes drug-induced lupus?

Procainamide.

Which antiarrhythmic causes anticholinergic effects?

Disopyramide.

Which antiarrhythmic is also a local anesthetic?

Lidocaine.

Which antiarrhythmic is used in digoxin-induced ventricular arrhythmias?

Lidocaine.

Which antiarrhythmics should be avoided in structural heart disease?

Flecainide and Propafenone.

What are the hallmark toxicities of amiodarone?

Pulmonary fibrosis, thyroid dysfunction, hepatotoxicity, corneal deposits.

Which antiarrhythmic has a half-life less than 10 seconds?

Adenosine.

What is the drug of choice for torsades de pointes?

IV Magnesium sulfate.

What ECG change is characteristic of β-blockers?

Increased PR interval.

What ECG change is characteristic of Class III antiarrhythmics?

Increased QT interval.

What is anemia?

Decreased Hb, hematocrit, or RBC mass causing reduced oxygen-carrying capacity.

What are the three major causes of anemia?

Decreased RBC production, increased RBC destruction, blood loss.

What type of anemia is iron deficiency anemia?

Microcytic hypochromic anemia.

What is the best indicator of iron stores?

Ferritin.

What is the iron profile in iron deficiency anemia?

↓ Ferritin, ↑ TIBC, ↓ Serum iron.

What is the iron profile in anemia of inflammation?

↑/Normal Ferritin, ↓/Normal TIBC.

What is the major regulator of iron metabolism?

Hepcidin.

Where is hepcidin produced?

Liver.

What does hepcidin do?

Binds ferroportin and decreases iron absorption/release.

What differentiates B12 deficiency from folate deficiency?

B12 deficiency causes neurologic symptoms.

What happens to MMA and homocysteine in B12 deficiency?

Both increase.

What happens to MMA in folate deficiency?

Normal.

What causes pernicious anemia?

Intrinsic factor deficiency.

Where is vitamin B12 absorbed?

Terminal ileum.

What is the major indication for ESA therapy?

Anemia of chronic kidney disease.

Which drugs are ESAs?

Epoetin alfa, Darbepoetin alfa.

What are the major adverse effects of ESA therapy?

Hypertension and thrombosis.

Which growth factor stimulates neutrophil production?

G-CSF.

Which drugs are G-CSF analogs?

Filgrastim, Pegfilgrastim.

What is the most common adverse effect of filgrastim?

Bone pain.

Which drugs are TPO receptor agonists?

Romiplostim, Eltrombopag.

What is the major indication of Romiplostim/Eltrombopag?

Chronic ITP.

What vitamin treats sideroblastic anemia?

Pyridoxine (Vitamin B6).

What is the hallmark feature of asthma?

Reversible airway obstruction.

What spirometry finding supports asthma diagnosis?

FEV1 increase ≥12% and ≥200 mL.

What is the diagnostic criterion for COPD?

Post-bronchodilator FEV1/FVC <0.7.

What is the most effective controller medication in asthma?

Inhaled corticosteroids (ICS).

What is the most common adverse effect of ICS?

Oral candidiasis.

Why should patients rinse their mouth after ICS use?

To prevent oral candidiasis.

Which drugs are SABA?

Salbutamol, Terbutaline.

Which drugs are LABA?

Salmeterol, Formoterol.

Which LABA can be used as both controller and reliever?

Formoterol.

Which ultra-LABA is mainly used in COPD?

Indacaterol.

What are the major adverse effects of β₂ agonists?

Tremor, tachycardia, hypokalemia.

Which drug is a SAMA?

Ipratropium.

Which drug is a LAMA?

Tiotropium.

What is the mechanism of theophylline?

Nonselective PDE inhibition and adenosine antagonism.

What is the major disadvantage of theophylline?

Narrow therapeutic index.

Which leukotriene receptor antagonist is commonly used in asthma?

Montelukast.

Which biologic is an anti-IgE antibody?

Omalizumab.

Which biologics target IL-5 signaling?

Mepolizumab, Benralizumab.

What is the preferred COPD combination in Group B/E?

LABA + LAMA.

Which lipoprotein is known as bad cholesterol?

LDL.

Which lipoprotein is responsible for reverse cholesterol transport?

HDL.

What is the most important apoprotein for LDL uptake?

ApoB.

Which enzyme is inhibited by statins?

HMG-CoA reductase.

Which drug class is most effective at lowering LDL?

Statins.

Which statins are the most potent?

Rosuvastatin, Atorvastatin.

What are the major adverse effects of statins?

Myopathy, rhabdomyolysis, hepatotoxicity.

Which laboratory finding requires discontinuation of statins?

CK >10× upper limit of normal.

Which drug class activates PPAR-α?

Fibrates.

Which drug class is most effective at lowering triglycerides?

Fibrates.

Which drug raises HDL the most?

Niacin.

What is the hallmark adverse effect of niacin?

Flushing.

How can niacin-induced flushing be prevented?

Aspirin.

What is the mechanism of ezetimibe?

NPC1L1 inhibition, blocks intestinal cholesterol absorption.

Which drugs are PCSK9 inhibitors?

Alirocumab, Evolocumab.

What is the mechanism of PCSK9 inhibitors?

Prevent LDL receptor degradation → ↓ LDL.

What are the four major classes of antithrombotic drugs?

Anticoagulants, Antiplatelets, Thrombolytics, Antithrombolytics.

What is the difference between thrombus and embolus?

Thrombus adheres to vessel wall; embolus circulates freely.

What is the difference between arterial and venous thrombi?

Arterial = platelet-rich white thrombus; Venous = fibrin/RBC-rich red thrombus.

What are the steps of primary hemostasis?

Vasoconstriction, platelet adhesion, activation, aggregation.

What are the steps of secondary hemostasis?

Coagulation cascade, thrombin generation, fibrin formation.

Which antiplatelet drug irreversibly inhibits COX-1?

Aspirin.

Which P2Y12 inhibitor is most commonly used with aspirin?

Clopidogrel.

What is the antidote of heparin?

Protamine sulfate.

What is the antidote of warfarin?

Vitamin K.

What are the three major types of angina?

Stable, unstable, variant (Prinzmetal).

Which type of angina is caused by coronary vasospasm?

Prinzmetal angina.

What is the main goal of antianginal therapy?

Restore myocardial oxygen supply-demand balance.

What determines myocardial oxygen demand?

Heart rate, contractility, wall tension.

Which antianginal drug is used for acute angina attacks?

Nitroglycerin.

What are the hallmark adverse effects of nitrates?

Headache, hypotension, reflex tachycardia.

Which antianginal drug class decreases heart rate and oxygen demand?

β-blockers.

Which calcium channel blockers are commonly used in angina?

Verapamil, Diltiazem, Amlodipine.