Study Questions

1. A patient comes to your office with effort-induced angina and resting tachycardia. You choose the following drug to treat the patient because it slows heart rate by blocking L-type calcium channels in the SA node:

(A) Verapamil

(B) Propranolol

(C) Nitroglycerin

(D) Isosorbide dinitrate

(E) Metoprolol

2. Which of the following hemodynamic effects of ni-troglycerin are primarily responsible for the beneficial results observed in patients with secondary angina?

(A) Reduction in the force of myocardial contraction

(B) Reduction in systemic vascular resistance (af-terload)

(C) Increased heart rate

(D) Reduction in venous capacitance (preload)

(E) Increased blood flow to the subepicardium

3. A woman is prescribed a combination of drugs consisting of a nitroglycerin patch and a p-blocker, such as propranolol, to treat her attacks of secondary angina. Which effect of propranolol would counteract an adverse effect of nitroglycerin?

(A) A decrease in preload

(B) A decrease in afterload

(C) A decrease in heart rate

(D) An increase in myocardial contractile force

(E) A reduction in coronary vasospasm

4. A patient who has been taking propranolol for a long period for secondary angina comes to your office complaining of increased frequency of chest pains on exertion. You decide to stop the propra-nolol and give him diltiazem because you suspect he has a mixture of secondary and primary angina. Why would diltiazem be more likely to relieve the angina if your new diagnosis is accurate?

(A) Diltiazem produces a decrease in heart rate.

(B) Diltiazem dilates coronary blood vessels in spasm.

(C) Diltiazem produces AV blockade.

(D) Diltiazem reduces myocardial contractility.

(E) Diltiazem reduces afterload.

5. Metoprolol would produce which beneficial effect in a patient with secondary angina?

(A) A decrease in preload

(B) An increase in collateral blood flow

(C) An increase in afterload

(D) An increase in diastolic filling time

(E) An increase in blood flow through a concentric stenosis

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