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Free Atrial Fibrillation Pharmacotherapy Quiz

by Eric Christianson | Nov 22, 2025 | 0 comments

1. 
Atrial Fibrillation Case Question 1

J.S. is a 72-year-old male who presents to the emergency department complaining of palpitations, lightheadedness, and mild shortness of breath for the past 24 hours. His past medical history includes hypertension, heart failure with preserved EF (HFpEF), type 2 diabetes, and hyperlipidemia. He drinks alcohol socially and admits to “a few extra drinks” at a wedding the night before.

Vital signs:

  • HR: 142 bpm, irregular

  • BP: 132/76 mmHg

  • RR: 18/min

  • O2 sat: 98% on room air

  • EKG: Atrial fibrillation with rapid ventricular rate (RVR)

Labs:

  • SCr: 1.4 mg/dL (CrCl ≈ 48 mL/min)

  • K: 3.3 mEq/L

  • Mg: 1.6 mg/dL

  • A1c: 7.1%

  • AST/ALT: WNL

The patient is hemodynamically stable. The cardiology team wants to control the rate and start stroke-prevention therapy. Which medication would be most appropriate to initiate?

2. 
Atrial Fibrillation Case Question 2

J.S. is a 72-year-old male who presents to the emergency department complaining of palpitations, lightheadedness, and mild shortness of breath for the past 24 hours. His past medical history includes hypertension, heart failure with preserved EF (HFpEF), type 2 diabetes, and hyperlipidemia. He drinks alcohol socially and admits to “a few extra drinks” at a wedding the night before.

Vital signs:

  • HR: 142 bpm, irregular

  • BP: 132/76 mmHg

  • RR: 18/min

  • O2 sat: 98% on room air

  • EKG: Atrial fibrillation with rapid ventricular rate (RVR)

Labs:

  • SCr: 1.4 mg/dL (CrCl ≈ 48 mL/min)

  • K: 3.3 mEq/L

  • Mg: 1.6 mg/dL

  • A1c: 7.1%

  • AST/ALT: WNL

The patient is hemodynamically stable. The cardiology team wants to control the rate and start stroke-prevention therapy.

What is the CHADS2Vasc Score?

3. 
Atrial Fibrillation Case Question 3

J.S. is a 72-year-old male who presents to the emergency department complaining of palpitations, lightheadedness, and mild shortness of breath for the past 24 hours. His past medical history includes hypertension, heart failure with preserved EF (HFpEF), type 2 diabetes, and hyperlipidemia. He drinks alcohol socially and admits to “a few extra drinks” at a wedding the night before.

Vital signs:

  • HR: 142 bpm, irregular

  • BP: 132/76 mmHg

  • RR: 18/min

  • O2 sat: 98% on room air

  • EKG: Atrial fibrillation with rapid ventricular rate (RVR)

Labs:

  • SCr: 1.4 mg/dL (CrCl ≈ 48 mL/min)

  • K: 3.3 mEq/L

  • Mg: 1.6 mg/dL

  • A1c: 7.1%

  • AST/ALT: WNL

The patient is hemodynamically stable. The cardiology team wants to control the rate and start stroke-prevention therapy.

What is the most appropriate oral anticoagulation therapy for this patient?

 

4. 
Atrial Fibrillation Case Question 4

J.S. is a 72-year-old male who presents to the emergency department complaining of palpitations, lightheadedness, and mild shortness of breath for the past 24 hours. His past medical history includes hypertension, heart failure with preserved EF (HFpEF), type 2 diabetes, and hyperlipidemia. He drinks alcohol socially and admits to “a few extra drinks” at a wedding the night before.

Vital signs:

  • HR: 142 bpm, irregular

  • BP: 132/76 mmHg

  • RR: 18/min

  • O2 sat: 98% on room air

  • EKG: Atrial fibrillation with rapid ventricular rate (RVR)

Labs:

  • SCr: 1.4 mg/dL (CrCl ≈ 48 mL/min)

  • K: 3.3 mEq/L

  • Mg: 1.6 mg/dL

  • A1c: 7.1%

  • AST/ALT: WNL

The patient is hemodynamically stable. The cardiology team wants to control the rate and start stroke-prevention therapy.

What electrolyte would be important to assess if digoxin is utilized?

5. 
Atrial Fibrillation Case Question 5

J.S. is a 72-year-old male who presents to the emergency department complaining of palpitations, lightheadedness, and mild shortness of breath for the past 24 hours. His past medical history includes hypertension, heart failure with preserved EF (HFpEF), type 2 diabetes, and hyperlipidemia. He drinks alcohol socially and admits to “a few extra drinks” at a wedding the night before.

Vital signs:

  • HR: 142 bpm, irregular

  • BP: 132/76 mmHg

  • RR: 18/min

  • O2 sat: 98% on room air

  • EKG: Atrial fibrillation with rapid ventricular rate (RVR)

Labs:

  • SCr: 1.4 mg/dL (CrCl ≈ 48 mL/min)

  • K: 3.3 mEq/L

  • Mg: 1.6 mg/dL

  • A1c: 7.1%

  • AST/ALT: WNL

The patient is hemodynamically stable. The cardiology team wants to control the rate and start stroke-prevention therapy.

Which of the following is a possible complication with the use of metoprolol?


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