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A 69-year-old man with persistent atrial fibrillation has been maintained on amiodarone for rhythm control for the past 18 months. He presents to clinic for follow-up and reports mild dyspnea on exertion but no chest pain or palpitations. He is otherwise stable on warfarin and carvedilol. Which organ systems require routine baseline and ongoing monitoring in patients treated chronically with amiodarone? 

A 58-year-old man had a heart attack (STEMI) treated with stent placement 3 months ago. He now has frequent premature ventricular contractions (PVCs) on Holter monitoring. He asks if there is a medicine to “stop the extra beats.” Which drug class improves survival in this setting? 

After 5 years on levodopa, a patient develops involuntary writhing movements. This is most likely: 

A 55-year-old man with long-standing hypertension and ischemic cardiomyopathy presents to your clinic with exertional dyspnea and palpitations. He has persistent atrial fibrillation. Current medications include carvedilol, lisinopril, spironolactone, and furosemide. Due to continued symptoms and inadequate rate control, digoxin is added.  What is the primary therapeutic role of digoxin in this clinical context? 

A patient with low literacy struggles with instructions. What is the best approach to providing this patient’s education? 

A 63-year-old woman on hydrochlorothiazide, citalopram, and omeprazole presents with dizziness and near fainting. ECG shows polymorphic ventricular tachycardia with prolonged QT (torsades de pointes). Which medication should be given immediately? 

A 52-year-old with alcohol dependence is prescribed naltrexone. How does naltrexone work? 

A 62-year-old with hypertension and CAD is started on propranolol. Shortly after, he reports new wheezing and SOB. What is the best explanation? 

An 11-year-old boy with ADHD is started on amphetamine-dextroamphetamine XR after inadequate response to behavioral therapy alone. His past medical history is unremarkable, and family history is negative for congenital heart disease or sudden cardiac death. At baseline, his BP is 100/62 mmHg and HR is 84 bpm. The NP counsels his parents on adverse effects that require ongoing monitoring. Which cardiovascular risk is most important to assess during follow-up visits? 

A 59-year-old man presents for follow-up 3 weeks after hospital discharge for an acute anterior STEMI treated with PCI and stent placement. He is asymptomatic today but asks what medications he “really needs to stay on long term to prevent another heart attack.” His current prescriptions include aspirin, ticagrelor, atorvastatin 80 mg, metoprolol succinate, and lisinopril. Which combination of therapies has been shown to improve survival and reduce reinfarction risk in patients with prior MI?