CPTP 4.18-20

Question 1

drugs causing hypertension

Answer 1

phenylephrine (cold and flu), oesterogens, EPO

Question 2

NICE guidance for diagnosis of HT

Answer 2

If the clinic blood pressure is 140/90 mmHg or higher, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension

Question 3

Cause of dry cough ass with ACE-i

Answer 3

bradykinin

Question 4

heart failure drugs that improve survival

Answer 4

Beta blockers, ACE-I, K sparing diuretics

Question 5

drugs that just reduce sx in heart failure

Answer 5

cardiac glycosides, nitrates, opiates, diuretics

Question 6

indication for digoxin in HF

Answer 6

chronic HF, espec in AF

Question 7

drug used in cardiogenic shock

Answer 7

inotropes - dobutamine

Question 8

what is the white coat effect

Answer 8

discrepancy of more than 20/10 between clinical and average daytime ABPM bp

Question 9

ABPM targets

Answer 9

135/85 in under 80

Question 10

if >55 but CCB not suitable (for example because of oedema or intolerance, or if there is evidence of heart failure or a high risk of heart failure) what do you give

Answer 10

a thiazide-like diuretic

Question 11

step 2 in black/afro Caribbean patients

Answer 11

consider ARB instead of ACE-I (with CCB)

Question 12

diuretics contraindications

Answer 12

renal failure, gout, diabetes

Question 13

beta blockers contraindications

Answer 13

asthma, COPD, heart block, may not be suitable in heart failure

Question 14

ACE-I contraindications

Answer 14

pregnancy, hyperK, bilateral renal artery stenosis

Question 15

e.g. of a rate limiting CCB

Answer 15

diltiazem

Question 16

e.g. of a non rate limiting CCB

Answer 16

nifedipine

Question 17

alpha blocker indications

Answer 17

prostatism

Question 18

alpha blocker contraindications

Answer 18

postural hypotension, elderly, urinary incontinence

Question 19

AntiHT in pregnancy

Answer 19

methyldopa, nifedipine, labetolol (alpha beta blocker)

Question 20

AntiHT contraindicated in pregnancy

Answer 20

beta blockers (growth retardation), ACE-I (congenital malformations), Thiazides (oligohydramnios)

Question 21

statin guidelines For patients with >10% 10yr CVD risk

Answer 21

Atorvastatin 20 mg

Question 22

1st line in acute heart failure

Answer 22

sit patient up, high flow o2, iv access, furosemide