DeepSeek Notes For Studying Conversion

A patient taking aripiprazole reports an intense feeling of inner restlessness and an inability to sit still. Which adverse effect is most likely?
A) Akinesia
B) Akathisia
C) Ataxia
D) Dyskinesia

Answer: B) Akathisia – Aripiprazole is a common cause of akathisia, characterized by subjective restlessness.

A patient with Parkinson’s disease presents with slow movement initiation and small, cramped handwriting. Which two symptoms are described?
A) Akinesia & Micrographia
B) Ataxia & Dyspepsia
C) Clonus & Paresthesia
D) Rigors & Otalgia

Answer: A) Akinesia & Micrographia – Both are key features of Parkinson’s (TRAP symptoms: Tremor, Rigidity, Akinesia/Bradykinesia, Postural instability).

A patient on lithium with a serum level of 2.0 mEq/L presents with slurred speech and unsteady gait. Which toxicity-related symptom is this?
A) Ataxia
B) Anhedonia
C) Apnea
D) Avolition

Answer: A) Ataxia – Lithium toxicity >1.5 mEq/L causes cerebellar dysfunction (ataxia, tremors).

A patient with schizophrenia speaks very little and shows no interest in social activities. Which two negative symptoms are described?
A) Alogia & Avolition
B) Anhedonia & Dyspnea
C) Atogia & Kernicterus
D) Prodrome & Paresthesia

Answer: A) Alogia & Avolition – Negative symptoms include reduced speech (alogia) and lack of motivation (avolition).

A patient reports losing interest in hobbies and feeling no joy in activities they once loved. Which symptom is most consistent with major depressive disorder?
A) Anhedonia
B) Orthopnea
C) Paronychia
D) Tachyphylaxis

Answer: A) Anhedonia – A core diagnostic criterion for depression.

A patient presents with a painless genital ulcer. Which infection and treatment are most likely?
A) Lyme disease – Doxycycline
B) Syphilis – Penicillin G (Bicillin L-A)
C) Candidemia – Micafungin
D) Ehrlichiosis – Levofloxacin

Answer: B) Syphilis – Penicillin G (Bicillin L-A) – Chancre is pathognomonic for primary syphilis.

A patient with HIV develops worsening TB symptoms after starting ART. Which condition is this?
A) IRIS (Immune Reconstitution Inflammatory Syndrome)
B) Guillain-Barré syndrome
C) Fanconi syndrome
D) Pseudomembranous colitis

Answer: A) IRIS – Paradoxical worsening of infections after immune recovery on ART.

A patient with a bull’s-eye rash and joint pain likely has which infection?
A) Lyme disease (Erythema migrans)
B) Mucormycosis
C) Pseudomembranous colitis
D) Pernicious anemia

Answer: A) Lyme disease – Erythema migrans is the hallmark rash.

A patient on topiramate for seizures reports reduced sweating and hyperthermia. Which adverse effect is this?
A) Oligohidrosis
B) Hypertrichosis
C) Livedo reticularis
D) Kernicterus

Answer: A) Oligohidrosis – Topiramate and zonisamide can impair sweating.

A patient on long-term nitroglycerin develops tolerance after repeated use. Which term describes this?
A) Tachyphylaxis
B) Ataxia
C) Steatosis
D) Virilization

Answer: A) Tachyphylaxis – Rapid tolerance to nitrates (e.g., nitroglycerin).

A patient on amphotericin B develops intense shaking chills during infusion. Which term describes this?
A) Rigors
B) Clonus
C) Akathisia
D) Paresthesia

Answer: A) Rigors – Common with amphotericin B infusions.

A splenectomy patient with pneumonia requires which antibiotic regimen?
A) Amoxicillin alone
B) Beta-lactam + Macrolide (or quinolone monotherapy)
C) Vancomycin + Piperacillin/tazobactam
D) Doxycycline + Clindamycin

Answer: B) Beta-lactam + Macrolide (or quinolone monotherapy) – Asplenia increases risk of encapsulated bacteria.

A patient with COPD exacerbation has purulent sputum. Which antibiotic is preferred?
A) Amoxicillin/clavulanate
B) Fluconazole
C) Terbinafine
D) Micafungin

Answer: A) Amoxicillin/clavulanate – First-line for purulent sputum in COPD.

A patient with thiamine deficiency and chronic alcoholism presents with confusion and ataxia. Which syndrome is this?
A) Wernicke’s encephalopathy
B) Fanconi syndrome
C) Fetal valproate syndrome
D) Korsakoff syndrome

Answer: A) Wernicke’s encephalopathy – Triad: confusion, ataxia, ophthalmoplegia (can progress to Korsakoff).

Which condition is a contraindication for ceftriaxone in neonates?
A) Kernicterus
B) Rickets
C) Myasthenia gravis
D) Heterozygous FH

Answer: A) Kernicterus – Ceftriaxone displaces bilirubin, risking kernicterus in neonates.

A patient on tenofovir DF develops glycosuria and hypophosphatemia. Which toxicity is this?
A) Fanconi syndrome
B) Pseudomembranous colitis
C) Guillain-Barré syndrome
D) IRIS

Answer: A) Fanconi syndrome – Proximal tubule dysfunction (seen with tenofovir DF).

A patient with Parkinson’s develops a lace-like skin discoloration. Which drug is the likely cause?
A) Amantadine
B) Carbidopa/levodopa
C) Aripiprazole
D) Topiramate

Answer: A) Amantadine – Causes livedo reticularis.

A patient taking aripiprazole reports an intense feeling of inner restlessness and an inability to sit still. Which adverse effect is this?
A) Akinesia
B) Akathisia
C) Ataxia
D) Dyskinesia

Answer: B) Akathisia

A patient with Parkinson’s disease has difficulty initiating movement and walks with slow, shuffling steps. Which symptom is described?
A) Akathisia
B) Akinesia
C) Clonus
D) Paresthesia

Answer: B) Akinesia

A patient with depression reports losing all enjoyment in hobbies they once loved. Which term best describes this symptom?
A) Anhedonia
B) Avolition
C) Dyspepsia
D) Orthopnea

Answer: A) Anhedonia

A patient reports excessive daytime fatigue and their partner observes pauses in breathing during sleep. Which condition is most likely?
A) Apnea
B) Dyspnea
C) Paroxysmal nocturnal dyspnea
D) Otalgia

Answer: A) Apnea

A splenectomy patient presents with community-acquired pneumonia. Which antibiotic regimen is most appropriate?
A) Amoxicillin alone
B) Beta-lactam + Macrolide
C) Vancomycin + Piperacillin/tazobactam
D) Fluconazole

Answer: B) Beta-lactam + Macrolide

A patient with lithium toxicity (2.2 mEq/L) presents with slurred speech and an unsteady gait. Which symptom is this?
A) Ataxia
B) Akathisia
C) Clonus
D) Kernicterus

Answer: A) Ataxia

A patient with schizophrenia speaks in very short sentences and rarely initiates conversation. Which negative symptom is this?
A) Alogia
B) Avolition
C) Anhedonia
D) Atogia

Answer: A) Alogia

A patient with schizophrenia shows no interest in socializing or self-care activities. Which term describes this lack of motivation?
A) Avolition
B) Anhedonia
C) Akathisia
D) Ataxia

Answer: A) Avolition

A patient on octreotide for variceal bleeding develops gallbladder complications. Which finding is most likely on ultrasound?
A) Biliary sludge
B) Cholelithiasis
C) Micrographia
D) Steatosis

Answer: A) Biliary sludge

A child with ear pain and fever has a bulging, red tympanic membrane. Which condition is most likely?
A) Acute otitis media
B) Otalgia
C) Otorrhea
D) Paronychia

Answer: A) Acute otitis media

A hospitalized patient with a central line develops a fungal bloodstream infection. Which drug is first-line?
A) Micafungin
B) Penicillin G
C) Doxycycline
D) Terbinafine

Answer: A) Micafungin

A patient has a painless genital ulcer. Which infection and treatment are most likely?
A) Syphilis – Penicillin G
B) Lyme disease – Doxycycline
C) Candidemia – Fluconazole
D) Ehrlichiosis – Levofloxacin

Answer: A) Syphilis – Penicillin G

A patient on an SSRI develops hyperreflexia and rhythmic muscle contractions after a dose increase. Which symptom suggests serotonin syndrome?
A) Clonus
B) Rigors
C) Paresthesia
D) Oligohidrosis

Answer: A) Clonus

A patient describes shortness of breath and chest tightness. Which term best fits?
A) Dyspnea
B) Orthopnea
C) Apnea
D) Paroxysmal nocturnal dyspnea

Answer: A) Dyspnea

A patient with a tick bite presents with fever and thrombocytopenia. Which treatment is most appropriate?
A) Doxycycline
B) Penicillin G
C) Micafungin
D) Amoxicillin/clavulanate

Answer: A) Doxycycline

A newborn exposed to carbamazepine in utero has facial dysmorphism and developmental delays. Which syndrome is this?
A) Fetal carbamazepine syndrome
B) Fetal valproate syndrome
C) Kernicterus
D) Wernicke’s syndrome

Answer: A) Fetal carbamazepine syndrome

A patient on octreotide develops gallstones. Which condition is this?
A) Cholelithiasis
B) Biliary sludge
C) Steatosis
D) Fanconi syndrome

Answer: A) Cholelithiasis

A patient taking a PDE-5 inhibitor reports upper abdominal burning after meals. Which term describes this?
A) Dyspepsia
B) Dyspnea
C) Otalgia
D) Paresthesia

Answer: A) Dyspepsia

A patient with a bull’s-eye rash and joint pain likely has which infection?
A) Lyme disease
B) Syphilis
C) Candidemia
D) Ehrlichiosis

Answer: A) Lyme disease

A patient on tenofovir DF develops renal tubular dysfunction with glycosuria. Which syndrome is this?
A) Fanconi syndrome
B) Wernicke’s syndrome
C) Guillain-Barré syndrome
D) IRIS

Answer: A) Fanconi syndrome

A newborn exposed to valproate in utero presents with neural tube defects and facial dysmorphism. Which syndrome is this?
A) Fetal valproate syndrome
B) Fetal carbamazepine syndrome
C) Kernicterus
D) Wernicke's syndrome

Answer: A) Fetal valproate syndrome

A patient develops ascending paralysis after a viral infection. Which autoimmune condition is this?
A) Guillain-Barré syndrome
B) Myasthenia gravis
C) Multiple sclerosis
D) Serotonin syndrome

Answer: A) Guillain-Barré syndrome

A patient has LDL >190 mg/dL and tendon xanthomas. Which genetic disorder and treatment combination is correct?
A) HeFH - Inclisiran + statin
B) Myasthenia gravis - Pyridostigmine
C) Fanconi syndrome - IV fluids
D) IRIS - Corticosteroids

Answer: A) HeFH - Inclisiran + statin

A patient on chronic prednisone develops adrenal insufficiency. Which term describes this complication?
A) HPA axis suppression
B) Tachyphylaxis
C) Virilization
D) Oligohidrosis

Answer: A) HPA axis suppression

A patient on minoxidil develops excessive hair growth in unwanted areas. Which term describes this?
A) Hypertrichosis
B) Alopecia
C) Livedo reticularis
D) Paronychia

Answer: A) Hypertrichosis

A patient taking antidepressants reports inability to maintain an erection. Which term describes this?
A) Impotence
B) Anhedonia
C) Avolition
D) Dyspepsia

Answer: A) Impotence

An HIV patient starting ART develops worsening TB symptoms. Which condition is this?
A) IRIS
B) Serotonin syndrome
C) Neuroleptic malignant syndrome
D) Tachyphylaxis

Answer: A) IRIS

Why is ceftriaxone contraindicated in neonates?
A) Risk of kernicterus (bilirubin displacement)
B) Risk of Fanconi syndrome
C) Risk of ototoxicity
D) Risk of QT prolongation

Answer: A) Risk of kernicterus

A chronic alcoholic presents with confabulation and memory loss. Which vitamin deficiency is implicated?
A) Thiamine (B1)
B) Vitamin B12
C) Vitamin D
D) Folate

Answer: A) Thiamine (B1)

A patient on amantadine develops a lace-like purple skin rash. Which adverse effect is this?
A) Livedo reticularis
B) Stevens-Johnson syndrome
C) Erythema multiforme
D) Hypertrichosis

Answer: A) Livedo reticularis

A newborn exposed to lithium in utero has cardiac abnormalities (e.g., Ebstein's anomaly). Which syndrome is this?
A) Fetal lithium syndrome
B) Fetal valproate syndrome
C) Fetal alcohol syndrome
D) DiGeorge syndrome

Answer: A) Fetal lithium syndrome

A Parkinson's patient's handwriting becomes progressively smaller. Which term describes this?
A) Micrographia
B) Bradykinesia
C) Akathisia
D) Ataxia

Answer: A) Micrographia

A diabetic patient with black necrotic nasal eschar likely has which fungal infection?
A) Mucormycosis
B) Candidemia
C) Aspergillosis
D) Histoplasmosis

Answer: A) Mucormycosis

A patient reports ptosis and muscle weakness worsening with activity. Which condition is this?
A) Myasthenia gravis
B) Guillain-Barré syndrome
C) Parkinson’s disease
D) Serotonin syndrome

Answer: A) Myasthenia gravis

A heart failure patient reports shortness of breath when lying flat. Which term describes this?
A) Orthopnea
B) Dyspnea
C) Apnea
D) Paroxysmal nocturnal dyspnea

Answer: A) Orthopnea

A child with acute otitis media presents with ear pain. Which term describes this symptom?
A) Otalgia
B) Otorrhea
C) Tinnitus
D) Vertigo

Answer: A) Otalgia

A patient with otitis media has fluid draining from the ear. Which term describes this?
A) Otorrhea
B) Otalgia
C) Tinnitus
D) Vertigo

Answer: A) Otorrhea

A patient on metformin reports "pins and needles" sensations in their hands. Which term describes this?
A) Paresthesia
B) Dysesthesia
C) Hyperesthesia
D) Akathisia

Answer: A) Paresthesia

A patient has a painful, red nail fold with pus. Which fungal treatment is most appropriate?
A) Terbinafine
B) Penicillin
C) Doxycycline
D) Metronidazole

Answer: A) Terbinafine

A heart failure patient wakes up gasping for air at night. Which term describes this?
A) Paroxysmal nocturnal dyspnea
B) Orthopnea
C) Apnea
D) Dyspnea

Answer: A) Paroxysmal nocturnal dyspnea

A patient with macrocytic anemia has anti-parietal cell antibodies. Which condition is this?
A) Pernicious anemia
B) Iron deficiency anemia
C) Fanconi anemia
D) Hemolytic anemia

Answer: A) Pernicious anemia

A patient has severe mood swings and irritability before menses. Which treatment is FDA-approved?
A) SSRI (e.g., fluoxetine)
B) NSAIDs
C) Oral contraceptives
D) Gabapentin

Answer: A) SSRI

A patient on clindamycin develops watery diarrhea with leukocytosis. Which condition is this?
A) Pseudomembranous colitis (C. difficile)
B) Ulcerative colitis
C) Crohn’s disease
D) Diverticulitis

A) Pseudomembranous colitis (C. difficile)

A patient reports tingling lips before cold sores appear. Which term describes this early symptom?
A) Prodrome
B) Paresthesia
C) Dysesthesia
D) Hyperesthesia

Answer: A) Prodrome

Bisphosphonates work by inhibiting which bone-related process?
A) Resorption by osteoclasts
B) Formation by osteoblasts
C) Mineralization
D) Remodeling

Answer: A) Resorption by osteoclasts

A child with bowed legs and delayed growth has low vitamin D. Which condition is this?
A) Rickets
B) Osteoporosis
C) Osteomalacia
D) Scurvy

Answer: A) Rickets

A patient develops shaking chills during an amphotericin B infusion. Which term describes this?
A) Rigors
B) Clonus
C) Akathisia
D) Tremor

Answer: A) Rigors

A patient taking benzodiazepines reports excessive daytime sleepiness. Which term describes this?
A) Somnolence
B) Insomnia
C) Narcolepsy
D) Cataplexy

Answer: A) Somnolence

Which bacteria cause both syphilis and Lyme disease?
A) Spirochetes
B) Streptococci
C) Staphylococci
D) Gram-negative rods

Answer: A) Spirochetes

Which term describes a drug that causes severe tissue damage if it extravasates (e.g., vancomycin)?
A) Vesicant
B) Irritant
C) Neurotoxin
D) Nephrotoxin

Answer: A) Vesicant

An inflammation of the lips that can cause dryness, redness, scaling, and cracking

Cheilitis

A patient on isotretinoin for acne develops dry, cracked lips. Which term describes this adverse effect?
A) Cheilitis
B) Glossitis
C) Stomatitis
D) Xerostomia

Answer: A) Cheilitis (Isotretinoin commonly causes cheilitis due to decreased sebum production.)

A swimmer presents with ear pain, itching, and purulent discharge. Which treatment is most appropriate?
A) Ciprofloxacin/dexamethasone otic drops
B) Oral amoxicillin
C) Terbinafine cream
D) Fluconazole tablets

Answer: A) Ciprofloxacin/dexamethasone otic drops (First-line for bacterial otitis externa.)

A patient with thickened, yellow toenails has a confirmed fungal infection. Which oral antifungal has the highest cure rate?
A) Terbinafine
B) Fluconazole
C) Itraconazole
D) Griseofulvin

Answer: A) Terbinafine (Preferred due to superior efficacy against dermatophytes.)

A diabetic patient with black necrotic nasal eschar and sinus involvement likely has which infection?
A) Mucormycosis
B) Aspergillosis
C) Candidiasis
D) Histoplasmosis

Answer: A) Mucormycosis (Rhino-orbital-cerebral mucormycosis is a medical emergency; treat with amphotericin B.)

A patient with diarrhea, dermatitis, and dementia has a niacin (B3) deficiency. Which term describes this condition?
A) Pellagra
B) Scurvy
C) Beriberi
D) Rickets

Answer: A) Pellagra (Classic triad: Diarrhea, Dermatitis, Dementia; treat with niacin.)

A patient with bleeding gums, easy bruising, and poor wound healing has a deficiency in which vitamin?
A) Vitamin C
B) Vitamin D
C) Vitamin B12
D) Vitamin K

Answer: A) Vitamin C (Scurvy is caused by vitamin C deficiency; common in malnutrition.)

A patient with night blindness and dry, foamy spots on the conjunctiva (Bitot's spots) has a deficiency in which vitamin?
A) Vitamin A
B) Vitamin E
C) Vitamin B1
D) Vitamin B6

Answer: A) Vitamin A (Xerophthalmia is a hallmark of vitamin A deficiency.)

A 65-year-old patient with type 2 diabetes has an eGFR of 28 mL/min. Which of the following is the most appropriate action regarding their metformin therapy?
A) Continue metformin at the current dose
B) Discontinue metformin
C) Reduce the dose by 50%
D) Switch to extended-release metformin

Answer: B) Discontinue metformin
Rationale: Metformin is contraindicated when eGFR is <30 mL/min due to the risk of lactic acidosis.

A patient with HIV has a CrCl of 25 mL/min. Which antiviral should be avoided?
A) Tenofovir alafenamide (TAF)
B) Dolutegravir
C) Raltegravir
D) Darunavir

Answer: A) Tenofovir alafenamide (TAF)
Rationale: TAF is contraindicated when CrCl is <30 mL/min.

A patient with invasive aspergillosis has a CrCl of 20 mL/min. Which antifungal should be avoided?
A) Fluconazole
B) Voriconazole
C) Caspofungin
D) Amphotericin B

Answer: B) Voriconazole
Rationale: Voriconazole is contraindicated when CrCl is <30 mL/min due to accumulation of the IV vehicle (sulfobutylether-β-cyclodextrin).

A 70-year-old patient with atrial fibrillation has a CrCl of 45 mL/min. Which anticoagulant is contraindicated?
A) Apixaban
B) Dabigatran
C) Rivaroxaban
D) Warfarin

Answer: B) Dabigatran
Rationale: Dabigatran is contraindicated when CrCl is <50 mL/min (or requires dose adjustment in some cases).

A patient with osteoarthritis has a CrCl of 40 mL/min. Which pain medication should be avoided?
A) Acetaminophen
B) Celecoxib
C) Ibuprofen
D) Tramadol

Answer: C) Ibuprofen
Rationale: NSAIDs are contraindicated when CrCl is <50 mL/min due to the risk of acute kidney injury.

A patient with a UTI has a CrCl of 55 mL/min. Which antibiotic should be avoided?
A) Nitrofurantoin
B) Ciprofloxacin
C) Amoxicillin-clavulanate
D) Fosfomycin

Answer: A) Nitrofurantoin
Rationale: Nitrofurantoin is contraindicated when CrCl is <60 mL/min due to ineffective urinary concentrations and increased toxicity risk.

A patient with type 2 diabetes has an eGFR of 58 mL/min. Which medication should be discontinued?
A) Metformin
B) Empagliflozin
C) Glipizide
D) Sitagliptin

Answer: B) Empagliflozin
Rationale: SGLT2 inhibitors (e.g., empagliflozin, canagliflozin) are contraindicated when eGFR is <60 mL/min due to reduced efficacy and increased adverse effects.

A patient with gastroparesis has a CrCl of 40 mL/min. What adjustment is needed for metoclopramide?
A) No change
B) Reduce dose by 25%
C) Reduce dose by 50%
D) Switch to ondansetron

Answer: C) Reduce dose by 50%
Rationale: Metoclopramide requires a 50% dose reduction when CrCl is <60 mL/min to reduce CNS side effects (e.g., extrapyramidal symptoms).

Which of the following drugs requires renal dose adjustment in chronic kidney disease (CKD)?

A) Moxifloxacin
B) Gentamicin
C) Ceftriaxone
D) Pantoprazole

Answer: B) Gentamicin
📌 Key Point: Aminoglycosides (gentamicin, tobramycin, amikacin) require renal adjustment due to nephrotoxicity risk.

A patient with CKD has a CrCl of 20 mL/min. Which drug should be dose-adjusted?

A) Apixaban
B) Warfarin
C) Aspirin
D) Clopidogrel

Answer: A) Apixaban
📌 Key Point: DOACs (apixaban, rivaroxaban, dabigatran) require renal adjustment, unlike warfarin.

Which antibiotic does NOT require renal dose adjustment?

A) Ciprofloxacin
B) Ceftriaxone
C) Vancomycin
D) Piperacillin-tazobactam

Answer: B) Ceftriaxone
📌 Key Point: Ceftriaxone is hepatically cleared and does not require renal adjustment.

Which anticoagulant requires renal monitoring and possible dose adjustment?

A) Dabigatran
B) Warfarin
C) Heparin
D) Fondaparinux

Answer: A) Dabigatran
📌 Key Point: Dabigatran is renally cleared (60-80%) and requires adjustment if CrCl <50 mL/min.

Which H2 blocker requires dose reduction in CKD?

A) Omeprazole
B) Famotidine
C) Calcium carbonate
D) Sucralfate

Answer: B) Famotidine
📌 Key Point: H2 blockers (famotidine, ranitidine) require renal adjustment (unlike PPIs).

Which antifungal requires renal dose adjustment?

A) Fluconazole
B) Voriconazole
C) Itraconazole
D) Posaconazole

Answer: A) Fluconazole
📌 Key Point: Fluconazole is renally cleared and requires adjustment if CrCl <50 mL/min.

Which drug requires close renal monitoring due to narrow therapeutic index?

A) Lithium
B) Sertraline
C) Bupropion
D) Escitalopram

Answer: A) Lithium
📌 Key Point: Lithium is renally cleared and requires frequent monitoring in CKD (risk of toxicity).

Which of the following requires renal adjustment but does NOT require hepatic adjustment?

A) Enoxaparin
B) Apixaban
C) Rivaroxaban
D) Warfarin

Answer: A) Enoxaparin
📌 Key Point: LMWHs (enoxaparin, dalteparin) require renal dose adjustment (CrCl <30 mL/min).

Which antiemetic requires dose reduction in CKD?

A) Ondansetron
B) Metoclopramide
C) Promethazine
D) Prochlorperazine

Answer: B) Metoclopramide
📌 Key Point: Metoclopramide accumulates in CKD, increasing the risk of extrapyramidal symptoms (EPS).

Which quinolone does NOT require renal adjustment?

A) Ciprofloxacin
B) Levofloxacin
C) Moxifloxacin
D) Norfloxacin

Answer: C) Moxifloxacin
📌 Key Point: Moxifloxacin is hepatically metabolized and does not require renal adjustment.

Which drug is contraindicated in severe renal impairment (CrCl <30 mL/min)?

A) Nitrofurantoin
B) Amoxicillin
C) Doxycycline
D) Azithromycin

Answer: A) Nitrofurantoin
📌 Key Point: Nitrofurantoin is ineffective and increases toxicity risk in CKD (CrCl <60 mL/min).

Which anticoagulant requires renal adjustment but is NOT a DOAC?

A) Enoxaparin
B) Apixaban
C) Rivaroxaban
D) Dabigatran

Answer: A) Enoxaparin
📌 Key Point: LMWHs (enoxaparin) require renal adjustment, unlike warfarin.

A 68-year-old patient with heart failure (HFrEF) is started on lisinopril. What is the target daily dose for HF management?
A) 5–10 mg
B) 20–40 mg
C) 50–100 mg
D) 80–160 mg

Answer: B) 20–40 mg daily
📌 Key Point: Lisinopril’s target HF dose is higher than its hypertension dose (20–40 mg vs. 10–40 mg).

A 72-year-old with CrCl 45 mL/min and atrial fibrillation is prescribed apixaban. What is the appropriate dose?
A) 2.5 mg BID
B) 5 mg BID
C) 10 mg BID
D) 20 mg daily

Answer: B) 5 mg BID
📌 Key Point: For nonvalvular AFib, apixaban is 5 mg BID (reduce to 2.5 mg BID if ≥2 of: age ≥80, weight ≤60 kg, Scr ≥1.5 mg/dL).

A patient with HFrEF weighs 90 kg. What is the target daily dose of carvedilol IR?
A) 6.25 mg BID
B) 12.5 mg BID
C) 25 mg BID
D) 50 mg BID

Answer: D) 50 mg BID
📌 Key Point: Carvedilol IR target dose is 25 mg BID (≤85 kg) or 50 mg BID (>85 kg).

A patient with a CrCl of 60 mL/min is prescribed dabigatran for DVT treatment. What is required before initiation?
A) 5–10 days of parenteral anticoagulation
B) No lead-in therapy needed
C) 21 days of rivaroxaban
D) Aspirin 81 mg daily

Answer: A) 5–10 days of parenteral anticoagulation
📌 Key Point: Dabigatran requires 5–10 days of heparin/LMWH before switching (unlike rivaroxaban/apixaban).

A patient taking digoxin 0.25 mg daily for HF is started on amiodarone. What adjustment is needed?
A) Increase dose to 0.5 mg daily
B) Reduce dose by 50%
C) No change
D) Switch to metoprolol

Answer: B) Reduce dose by 50%
📌 Key Point: Amiodarone/dronedarone inhibit P-gp, increasing digoxin levels.