Cardio Overview Quiz Flashcards
PMH: Your patient has stage 2 hypertension and is at risk for type 2 diabetes. At the follow up appointment you note that they have lost a small amount of weight, has an improved diet, and has begun to exercise on a regular basis. You noted a small decrease in blood pressure. After confirming your diagnosis you initiated treatment using the recommended dose of an ACE inhibitor. On the next follow up appointment you note that blood pressure was reduced by about 10 mmHg after 2 months of treatment. Based on your interview and the patients response you are confident that patient adherence to diet, exercise, and medication is high. Your patient is unaware of any side effects from the ACE inhibitor. However blood pressure remains elevated. You decide it is time to change therapy for hypertension. Your next should be to:
A) Continue diet, exercise, and ACE inhibitor therapy. Add a medication having a different mechanism of action and different side effects such as a thiazide diuretic
B) Keep raising the dose of ACE inhibitor until the patient reaches blood pressure goal
C) Stop the ACE inhibitor and initiate treatment with a calcium channel antagonist
D) Stop the ACE inhibitor and initiate treatment with the newest medication available
A
Match the drug class with the correct mechanism of action.
A) Thiazide type diuretics
B) Beta adrenergic antagonists
C) Angiotensin converting enzyme inhibitors
D) Calcium channel antagonists
1 - reduces the activity of renin system
2 - relaxes vascular smooth muscle and reduces total peripheral resistance
3 - reduces the activity of the sympathetic nervous system
4 - acts on the distal tubule to reduce sodium reabsorption
A) 4
B) 3
C) 1
D) 2
Match the pharmacologic class of medication the correct clinical benefit.
A) Thiazide diuretics
B) ACE inhibitors
C) Beta adrenergic antagonists
D) Calcium channel antagonists
1 - reduce mortality after MI and in HF. Prevent reflex tachycardia associated with use of vasodilators
2 - demonstrate improvements in mortality in most patients. Also useful to offset fluid retention caused by vasodilators
3 - particularly useful in patients with CKD, diabetes, HF and post MI
4 - use of short acting agents in this class is associated with increased risk of MI and increased risk of mortality
A) 2
B) 3
C) 1
D) 4
