Heart failure, valvular disease, arrhythmias, congenital defects, and the pharmacology that goes with them. This category has 101 original questions in the full StepExamPrep bank — here are 3 samples with complete explanations.
A patient on a statin continues to have elevated LDL despite maximal tolerated dose. Which of the following medication classes works by preventing intestinal cholesterol absorption?
Ezetimibe inhibits the intestinal Niemann-Pick C1-like 1 (NPC1L1) transporter, blocking dietary and biliary cholesterol absorption, providing an additional LDL-lowering effect when added to a statin.
A patient with chronic aortic regurgitation has a wide pulse pressure and bounding peripheral pulses. Which of the following best explains this pulse finding?
In aortic regurgitation, increased stroke volume (compensatory) raises systolic pressure, while diastolic pressure drops significantly due to rapid regurgitant flow (runoff) back into the left ventricle during diastole, together producing the characteristic wide pulse pressure and bounding "water-hammer" pulse.
A patient taking a class IA antiarrhythmic develops a prolonged QT interval and subsequently a polymorphic ventricular tachycardia. Which of the following is the most appropriate acute treatment?
This is torsades de pointes; IV magnesium sulfate is the first-line acute treatment regardless of serum magnesium level.
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