Quiz on angina pectoris

A 62-year-old male with stable angina is on aspirin, atorvastatin, and isosorbide mononitrate. He experiences exertional chest pain that lasts for 10-15 minutes and is only partially relieved by rest. He is hesitant to take sublingual nitroglycerin due to fear of side effects. His physician wants to add a medication to improve his symptom control. Which of the following is the most appropriate choice for PRN relief of his chest pain? *

A 58-year-old male with a history of myocardial infarction 2 years ago presents with recurrent exertional chest pain. He is already on aspirin, clopidogrel, atorvastatin, and metoprolol succinate 100 mg daily. His chest pain occurs with walking two blocks and resolves with 2 minutes of rest. The physician decides to add a medication for improved symptom control. Which of the following is the most appropriate choice? *

A 75-year-old female with stable angina is prescribed ranolazine 1000 mg BID for symptom control. She has a history of moderate renal impairment (creatinine clearance 40 mL/min). What is the most appropriate dose adjustment for ranolazine in this patient? *

A 68-year-old male with a history of diabetes and hypertension presents with new-onset, severe, crushing chest pain that started 2 hours ago and is ongoing. He has a history of stable angina treated with amlodipine 10 mg daily and aspirin 81 mg daily. His ECG shows ST-segment elevation in leads II, III, and aVF. He is diagnosed with an ST-elevation myocardial infarction (STEMI). Which of the following is the most critical immediate pharmacologic intervention? *

A 65-year-old male with a history of hypertension and hyperlipidemia presents to the emergency department with a 30-minute history of substernal chest pressure radiating to his left arm, accompanied by shortness of breath and diaphoresis. His vital signs are: BP 160/95 mmHg, HR 98 bpm, RR 20/min, SpO2 96% on room air. ECG shows ST-segment depression in leads V4-V6. He is diagnosed with unstable angina. Which of the following is the most appropriate initial pharmacologic management? *

A 55-year-old male with exertional angina is on a beta-blocker and aspirin. He continues to experience angina with moderate exertion. His physician is considering adding a calcium channel blocker. Which of the following calcium channel blockers would be most appropriate in this patient, given his history of angina? *

A 72-year-old female with stable angina presents with exertional chest pain that occurs with moderate exertion and is relieved by rest within 5 minutes. She is currently taking aspirin 81 mg daily and atorvastatin 20 mg daily. Her physician wants to add a medication for symptom control. Which of the following drug classes is most appropriate for long-term management of her exertional angina symptoms? *

A 70-year-old female with exertional angina is prescribed oral isosorbide mononitrate 30 mg daily for symptom relief. She reports good relief of her chest pain but is experiencing significant headaches with this medication. What is the most appropriate recommendation to her physician? *

A 50-year-old female with stable angina is prescribed oral diltiazem 120 mg BID. She reports significant constipation as a side effect. Which of the following is the most appropriate management strategy? *

Which of the following medications used in the pharmacotherapy of angina pectoris primarily works by increasing coronary blood flow through vasodilation and also reduces myocardial oxygen demand by decreasing preload and afterload? *

A 70-year-old male with exertional angina is started on beta-blocker therapy. He develops new-onset bronchospasm and wheezing. He has a history of mild asthma. Which of the following beta-blockers would be the most appropriate to use in this patient, considering his respiratory history? *

A 60-year-old male with chronic stable angina is on maximal medical therapy including a beta-blocker, aspirin, clopidogrel, and atorvastatin. He continues to have frequent anginal episodes requiring sublingual nitroglycerin multiple times a day. His ejection fraction is 50%. He is not a candidate for revascularization due to comorbidities. Which of the following is the most appropriate next step in management? *