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1. The onset of PAH may be insidious and the presentation can be very nonspecific. Symptoms of PAH may include:

A. Tachycardia and chest pain B. Fluid retention and headache C. Dyspnea and fatigue D. Normal oxygen saturation and tachycardia

2. PT is a 52-year-old woman recently admitted to the hospital who is suspected of having PAH. From what you know about the comprehensive testing used to diagnose PAH, you explain that:

A. An echocardiogram is required to confirm the diagnosis B. A right heart catheterization is required to confirm the diagnosis C. Pulmonary function tests are required to confirm the diagnosis D. A ventilation-perfusion scan (V/Q scan) is required to confirm the diagnosis

3. The medical workup confirms the diagnosis of PAH and PT's symptoms are evident at rest. Your pharmacist colleague asks which WHO Functional Class best characterizes PT's symptom severity. You respond:

A. Functional class I B. Functional class II C. Functional class III D. Functional class IV

4. You and your pharmacist colleague discuss whether or not PT has risk factors associated with improved survival. You explain that:

A. 6MWD ≥ 300 meters is an indicator of improved survival B. WHO functional class I is an indicator of improved survival C. BNP > 80 pg/mL is an indicator of improved survival D. DLCO ≥ 50% is an indicator of improved survival

5. In addition to WHO Group 1 pulmonary arterial hypertension (PAH), which other WHO pulmonary hypertension (PH) group is riociguat approved for treatment?

A. Group 2 PH (left heart disease) B. Group 3 PH (lung disease) C. Group 4 PH (thromboembolic disease) D. Group 5 PH (multifactorial)

6. Which of the following agents for PAH requires documentation of REMS enrollment due to a risk for teratogenicity?

A. Epoprostenol B. Macitentan C. Sildenafil D. Selexipag

7. Which of the following is TRUE regarding use of calcium channel blockers (CCBs) in the management of PAH?

A. Very high doses are required B. About 70% of patients are responders C. Verapamil is the preferred agent D. CCBs should be started empirically in all patients with PAH

8. As a specialty pharmacist, you have been asked to educate the hospital pharmacy staff about the routes of administration of treprostinil. From what you know about treprostinil, you explain:

A. The subcutaneous (SQ) and intravenous (IV) formulations are NOT considered to be bioequivalent B. Inhaled treprostinil is typically used in functional class (FC) II patients C. The IV formulation must be diluted in normal saline, lactated ringer's solution, or Flolan® sterile diluent prior to infusion D. It is a prostacyclin analog for the treatment of PAH available in several formulations, including as a tablet for oral (PO) administration

9. A physician contacts you to discuss the use of phosphodiesterase type 5 inhibitors (PDE-5i) in patients with PAH. You are certain to educate him about the following contraindication to use:

A. Use in combination with riociguat due to unsafe blood pressure lowering B. Use in patients with sickle cell anemia due to increased clotting risk C. Use in combination with warfarin due to increased bleeding risk D. Use in combination with pioglitazone due to an increased risk of pulmonary edema

10. MN is a 40-year-old woman who had been experiencing progressively worsening dyspnea and exercise tolerance over the course of two years prior to her diagnosis of idiopathic PAH (FC III). She was then started and maintained on tadalafil, bosentan, oxygen, warfarin, and diuretics for five years. Recently, she had been experiencing a decline in her functional capacity and a repeat cardiac catheterization showed an increase in pulmonary arterial pressure (PAP) and decrease in cardiac index. Your specialty pharmacy is called up to provide guidance regarding combination therapy for PAH. Based on the medications she is taking, which of the following agents would you recommend for MN to improve outcomes?

A. Amlodipine B. Selexipag C. Riociguat D. Sildenafil

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. The onset of PAH may be insidious and the presentation can be very nonspecific. Symptoms of PAH may include:

2. PT is a 52-year-old woman recently admitted to the hospital who is suspected of having PAH. From what you know about the comprehensive testing used to diagnose PAH, you explain that:

3. The medical workup confirms the diagnosis of PAH and PT's symptoms are evident at rest. Your pharmacist colleague asks which WHO Functional Class best characterizes PT's symptom severity. You respond:

4. You and your pharmacist colleague discuss whether or not PT has risk factors associated with improved survival. You explain that:

5. In addition to WHO Group 1 pulmonary arterial hypertension (PAH), which other WHO pulmonary hypertension (PH) group is riociguat approved for treatment?

6. Which of the following agents for PAH requires documentation of REMS enrollment due to a risk for teratogenicity?

7. Which of the following is TRUE regarding use of calcium channel blockers (CCBs) in the management of PAH?

8. As a specialty pharmacist, you have been asked to educate the hospital pharmacy staff about the routes of administration of treprostinil. From what you know about treprostinil, you explain:

9. A physician contacts you to discuss the use of phosphodiesterase type 5 inhibitors (PDE-5i) in patients with PAH. You are certain to educate him about the following contraindication to use:

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. The onset of PAH may be insidious and the presentation can be very nonspecific. Symptoms of PAH may include:

2. PT is a 52-year-old woman recently admitted to the hospital who is suspected of having PAH. From what you know about the comprehensive testing used to diagnose PAH, you explain that:

3. The medical workup confirms the diagnosis of PAH and PT's symptoms are evident at rest. Your pharmacist colleague asks which WHO Functional Class best characterizes PT's symptom severity. You respond:

4. You and your pharmacist colleague discuss whether or not PT has risk factors associated with improved survival. You explain that:

5. In addition to WHO Group 1 pulmonary arterial hypertension (PAH), which other WHO pulmonary hypertension (PH) group is riociguat approved for treatment?

6. Which of the following agents for PAH requires documentation of REMS enrollment due to a risk for teratogenicity?

7. Which of the following is TRUE regarding use of calcium channel blockers (CCBs) in the management of PAH?

8. As a specialty pharmacist, you have been asked to educate the hospital pharmacy staff about the routes of administration of treprostinil. From what you know about treprostinil, you explain:

9. A physician contacts you to discuss the use of phosphodiesterase type 5 inhibitors (PDE-5i) in patients with PAH. You are certain to educate him about the following contraindication to use:

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