1. Which of the following pulmonary arterial hypertension medications is correctly matched with its class?

2. According to the Fifth World Symposium on Pulmonary Hypertension treatment guidelines, which of the following treatments could be considered for management of a patient with World Health Organization functional class II symptoms?

3. The next 5 questions refer to the following Case Vignette:
A 67-year-old female with a history of scleroderma and gastroesophageal reflux disease presents to the hospital for evaluation of progressive shortness of breath and fatigue. Her current medications include prednisone 2.5 mg daily, omeprazole 20 mg daily, and nifedipine 90 mg extended-release daily. A diagnosis of pulmonary arterial hypertension (PAH) is confirmed by right heart catheterization. Her symptoms are most consistent with World Health Organization (WHO) functional class (FC) II.

Which treatment regimen outlined below would be considered a reasonable initial recommendation for this patient?

4. Which of the following treatment recommendations could also be considered for initial management in this patient?

5. Which of the following is a typical adverse effect associated with the phosphodiesterase type 5 inhibitor class of medications?

6. Drug interactions that could be anticipated with the endothelin receptor antagonist class of medications include which of the following?

7. Case Vignette Update:
Over the next few months, the patient’s symptoms progress to shortness of breath and fatigue when at rest, despite the initial PAH treatment. A recent echocardiogram shows severe right ventricular dysfunction and a repeat right heart catheterization reveals worsening hemodynamics. Her symptoms are most consistent with WHO FC IV.

Which treatment recommendation would now be the most appropriate for this patient?

8. The next 2 questions refer to the following Case Vignette:
TJ is a 60-year-old man with idiopathic pulmonary arterial hypertension (PAH) who is admitted to the hospital for transition from inhaled to intravenous treprostinil due to progressive shortness of breath, decline in 6-minute walk distance, and worsening right ventricular function on echocardiography. The patient has received an insurance authorization.

Which of the following would be most relevant to ensuring appropriate transitions of care?

9. Upon initiation of intravenous treprostinil, TJ develops significant gastrointestinal adverse effects, including frequent diarrhea. Which of the following approaches would be best to manage this drug-related problem?

10. Which of the following targeted pulmonary arterial hypertension medications has a Risk Evaluation and Mitigation Strategies program?

Evaluation Questions

11. How confident are you in your decision about treatment for your female patient above?

12. How confident are you in your decision about treatment for your patient TJ above?

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