Dyslipidemia
According to the 2026 Dyslipidemia guidelines, in secondary prevention, a goal of LDL-C < ______ mg/dL is recommended for those at very high risk of ASCVD events.
55 mg/dL (smaller number of patients with ASCVD not at very high risk have an LDL-C goal of at least < 70 mg/dL)
MG had two blood pressure readings obtained on separate occasions: 132/68 mmHg and 128/84 mmHg. Based on these values, what stage of hypertension would she be classified as having according to the 2025 AHA/ACC Guideline for High Blood Pressure?
Stage 1 Hypertension
GB presents to the clinic with new onset symptoms of shortness of breath (relieved when using a pillow to sit up in bed), fatigue, and lower leg swelling. His LVEF is found to be 36%. What heart failure classification would GB have?
HFrEF (heart failure with reduced ejection fraction)
According to the 2023 ACC/AHA Guideline for Atrial Fibrillation, what Vaughan Williams class does flecainide belong to?
Class 1c
According to the 2026 AHA/ASA Guidelines for Stroke, rapid thrombolytic treatment is recommended in eligible patients, regardless of NIHSS score, within what treatment window without advanced imaging selection?
0 to 4.5 hours
The 2018 Dyslipidemia guidelines recommended using the PCE risk calculator to determine ASCVD risk. This has now been updated to which risk calculator in the 2026 Dyslipidemia guidelines?
PREVENT-ASCVD calculator
According to the 2025 AHA/ACC Guideline for High Blood Pressure, what are the four first-line antihypertensive drug classes recommended for the management of hypertension?
Thiazide diuretics, dihydropyridine CCBs, ACE inhibitors, and ARBs
According to the 2022 AHA/ACC Guidelines for Heart Failure, what are the four classes of medications included in GDMT?
Beta-blockers, SGLT2 inhibitors, MRAs, and ARNi/ACEi/or ARBs
According to the 2023 ACC/AHA Guideline for Atrial Fibrillation, what are the two main first-line classes of medication that can be used for rate control? Give an example of a medication within each drug class.
Beta-blockers (metoprolol, etc.) or non-DHP CCBs (verapamil, diltiazem)
According to the package insert for atorvastatin, what 5 risk factors increase the likelihood that a patient would experience myopathy while taking this medication?
Age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs (including lipid-lowering therapies), and higher atorvastatin calcium dosage.
According to the package insert for hydrochlorothiazide, its use would be contraindicated in a patient with hypersensitivity to which drugs?
Sulfonamide-derived drugs
According to the package insert, what is a common warning/precaution seen with the use of spironolactone (more often seen in men) that warrants a change in therapy to eplerenone?
Gynecomastia
According to the package insert for amiodarone, what are the three toxicities that amiodarone has a boxed warning for?
Pulmonary toxicity, Hepatic toxicity, and Cardiac toxicity
According to the package insert for alteplase, one clinical trial found that doses greater than 0.9 mg/kg may be associated with an increased incidence of what?
Intracranial hemorrhage
HN comes into your clinic. You run labs and her LDL-C level comes back at 130 mg/dL. She is currently on the highest dose of a high-intensity statin. What is an additional treatment option you could add on to her current therapy to further reduce LDL-C?
A PCSK9 inhibitor (evolocumab (Repatha), alirocumab (Praluent), inclisiran (Leqvio)) OR bempedoic acid OR ezetimibe
MM is a 28-year-old female with a past medical history of hypertension who presents for her annual examination. Her blood pressure today in clinic is 133/83 mmHg, and she reports adherence to her current antihypertensive therapy, lisinopril. Laboratory results obtained yesterday are as follows: sodium 139 mEq/L, potassium 4.1 mEq/L, serum creatinine 0.8 mg/dL, BUN 12 mg/dL, glucose 92 mg/dL, and hCG +. What are the most appropriate next steps in management?
Discontinue lisinopril, initiate either labetalol or nifedipine ER
BT is a 30-year-old male with a history of heart failure who presents to the hospital for heart failure exacerbation. While inpatient, his fluid overload is treated with furosemide 20 mg IV daily. The hospitalist wants to discharge him on PO furosemide, but at the equivalent dose of what he has been receiving in the hospital. What dose of PO furosemide should you send the patient home on?
Furosemide 40 mg PO
GA is a 76-year-old female who presents to clinic for management of newly diagnosed atrial fibrillation. Her past medical history includes hypertension, type 2 diabetes mellitus, and a prior ischemic stroke three years ago. What is this patient’s CHA₂DS₂-VASc score, and does she require anticoagulation? If so, what drug class would you recommend?
Her CHA₂DS₂-VASc score is 7. She does require anticoagulation (score ≥ 3). The first-line drug class recommended for anticoagulation in atrial fibrillation is DOACs.
CR presents to the emergency department with stroke-like symptoms. She is found to be experiencing an acute ischemic stroke and is eligible for thrombolytic treatment. The PA and pharmacist are working together to determine if they should use tenecteplase or alteplase. What might be an advantage of using tenecteplase over alteplase in regard to administration regimens?
Tenecteplase is a one-time dose (0.25 mg/kg, max: 25 mg) as a single bolus over 5 seconds and alteplase is dosed as an IV bolus over 1 minute (10% of 0.9 mg/kg) followed by a continuous infusion over 60 minutes (90% of 0.9 mg/kg)
NS is a 45 year-old male who comes into your clinic. He has a 10-year estimated risk for ASCVD of 5% and an LDL-C level of 122 mg/dL. What intensity of statin would be recommended for primary prevention in order for him to achieve ≥ 30 to 49% LDL-C reduction and to reduce ASCVD risk? (INCLUDE THE NAME OF THE STATIN, THE INTENSITY, AND THE DOSE)
Moderate intensity: Atorvastatin 10 mg or 20 mg, Rosuvastatin 5 mg or 10 mg, Fluvastatin XL 80 mg, Fluvastatin 40 mg BID, Lovastatin 40 mg or 80 mg, Pitavastatin 1 mg or 2 mg or 4 mg, Pravastatin 40 mg or 80 mg, or Simvastatin 20 mg or 40 mg
FF is a 51-year-old AA female with two blood pressure readings obtained on separate occasions of: 142/93 mmHg and 144/91 mmHg. Based on these values, FF would be classified as having stage 2 hypertension. Her most recent labs were all within normal limits except her K+ was 5.2. She has no known drug allergies. Which antihypertensive medication(s) should be initiated for FF to improve blood pressure control?
CCB – dihydropyridine (amlodipine, felodipine, isradipine, nicardipine SR, nicardipine LA, or nisoldipine) + Thiazide diuretic (chlorthalidone, hydrochlorothiazide, or indapamide)
BC is a 62-year-old female (weight 151 lbs.) who presents to the clinic for her routine cardiology follow-up. Her PMH includes HFrEF with a LVEF of 30%, hypertension, and type 2 diabetes. Her labs today are as follows: sodium 136 mEq/L, potassium 4.7 mEq/L, eGFR 73 mL/min/1.73 m², glucose 111 mg/dL, HR 64 bpm, and BP 116/83 mmHg. Her current medications are as follows: metformin 1,000 mg BID, lisinopril 10 mg daily, carvedilol 12.5 mg BID, and furosemide 20 mg daily PRN. What is one potential gap that can be identified in her current therapy to maximize GDMT?
Switch ACEi to ARNi if tolerated, add SGLT2i, add spironolactone (beta-blocker already at max dose for weight (≤85 kg, 25 mg daily))
GS is a 55-year-old male with a history of HFrEF, atrial fibrillation, dyslipidemia, and CKD stage 3. He presents to your emergency department with symptoms of blurred vision, seeing greenish-yellow halos, and is currently experiencing palpitations. His current medications include metoprolol succinate 50 mg daily, spironolactone 25 mg daily, lisinopril 10 mg daily, dapagliflozin 10 mg daily, digoxin 0.25 mg daily, and atorvastatin 40 mg daily. You run labs and initial tests, and the results come back as follows: K+ 5.6, Mg 1.7, Ca++ 10.9, digoxin level 2.4, HR 54 bpm, and BP 128/70 mmHg. Based on the GS’s current symptoms and lab results, what do you think the primary problem is, and which medication would you give to treat it?
Digoxin toxicity; give DigiFab