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Htn Flashcards

1
Q

Blood pressure may be elevated in the office but not at home ? Is called?

A

White coat hypertension

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2
Q

Essential (primary) HTN? With known cause or no unknow?

A

No specific cause.
Most cases with increase in PVR & CO

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3
Q

Secondary HTN - Specific cause such as?

A

Renal artery construction
Contraction of aorta
Cushing disease ( ^^ cortisol )
Primary aldosteronism ( a cancer do na water retention)
Pheochromocytoma ( tumor in adrenal gland so ^^ catecholamine secretion NE/ E and do contraction)

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4
Q

4 anatomical sites in the body regulare BP
Which one is incorrect?

a) heart
b) kidney
c) liver
d) capacitance vessels

A

C) liver

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5
Q

4 anatomical sites in the body regulare BP
Which one is incorrect?

a) heart
b) kidney
c) arteriole
d) intestine

A

d) intestine

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6
Q

Post-capillary venules is called also? Capacitance vessels or aorta

A

Capacitance vessels

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7
Q

Local release of vasoactive substances from vascular endothelium involved in in the regulation of vascular resistance are?

A

Endothelin 1 —> vasoconstriction

Nitric oxide —> vasodilation

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8
Q

Hydralazine is a vasodilatior - its MOA?

A

Dilates arterioles only (via NO)

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9
Q

Most of vasodilators cause orthostatic hypotension and sexual dysfunction? Yes - no?

A

No. Incorrect. They don’t

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10
Q

^^RAAS + reflex tachycardia when taking vasodilator like , hydralazine?

A

Yes

^^RAAS (Na/ water retention)
Treated by diuretic ( to deplete sodium and water)

Reflex tachycardia
Treated by b blockers

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11
Q

Hydralazine taken alone do?

A

Tachyphylaxis = acute (sudden) decrease in drug response

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12
Q

HTN and HF patients, who are african-american
Treated by? Hydralazine + nitrate. Or. Hydralazine +loop diuretic

A

Hydralazine + nitrate

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13
Q

Hydralazine - PK
Hydralazine is metabolized by? Alkylation or acidification or acetylation ?

A

acetylation

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14
Q

Does hydralazine to reflex tachycardia as a toxicity?

A

Yes

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15
Q

Hydralazine:Patient with ischemic hear disease (IHD) -> reflex tachycardia and sympathetic stimulation —> provoke ?

Angina ? Yes or no
Ischemic arrhythmias? Yes or no
Edema? Yes or no
Palpitation ? Yes or no

A

Angina ? Yes
Ischemic arrhythmias? Yes
Edema? No
Palpitation ? No

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16
Q

Lupus erythematosus is a toxicity of a drug called?
A. Minoxidil
B. Hydralazine
C. Nitroprusside
D. Fendolopam

A

B. Hydralazine ( release NO)

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17
Q

Minoxidil is taken Iv? Yes or no

Dilate arteriole and vein?

A

No
Its taken ( orally )

Ooonly arteriole Nooo vein

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18
Q

Minoxidil mechanism?
A. Release of nitric oxide
B. Activation of dopamine
C. Hyperpolarization of cell through opening of potassium channel
D. Reduction of calcium influx

A

D. Reduction of calcium influx

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19
Q

Fenoldopam mechanism?
A. Release of nitric oxide
B. Activation of dopamine
C. Hyperpolarization of cell through opening of potassium channel
D. Reduction of calcium influx

A

B. Activation of dopamine

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20
Q

Nitroprusside mechanism?

A

Release Nitric oxide

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21
Q

MD k+ ? Minoxidil. Diazoxide. Open k channel

A

Open k channel
Minoxidil
Diazoxide

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22
Q

Nifedipine mechanism?

Other drugs with the same mechanism?

A

Reduction of Ca influx

Other drugs: verapamil, diltiazem

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23
Q

Minoxidil used in combination with?

A

B blocker & loop diuretic

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24
Q

Toxicity of minoxidil when b blocker & diuretics are inadequate such as?

A

Tachycardia
Angina

**Edema
**Palpitation

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25
Q

Side effect unique for minoxidil is?
عرض جانبي مميز

A

Hypertrichosis

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26
Q

Hypertrichosis appear when taking?

A

Minoxidil

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27
Q

(?????) is a minoxidil used topically, it stimulate hair growth for baldness

A

Rogaine

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28
Q

Dilate both arterial and venous vessels?
Mechanism: release N.O.

A

Sodium nitroprusside

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29
Q

Activates guanylyl cyclase —> ^^ c GMP —> release N.O. —>relax smooth muscle

A

Sodium Nitroprusside

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30
Q

Nitroprusside is metabolized releasing ? Nitric oxide and?

A

Cyanide

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31
Q

In the presence of sulphur, cyanide converts to less toxic compound Thiocyanate via?

A

Mitochondrial enzyme rhodanese

32
Q

Sensitive to light. Must be made up fresh before administering?

A

Sodium Nitroprusside

33
Q

Toxicity of sodium Nitroprusside.
Acumulation of cyanide?
Hydroxocobalamin?
Methemoglobinemia?

34
Q

Diazoxide like midoxidil MD
Mechanism?

A

Potassium channel opening

35
Q

Diazoxide مميز بشي

Insulin

A

Inhibits insulin release form pancreas

36
Q

Drug Used for case “ insulinoma” ?

37
Q

Drug used to treat Hypoglycemia caused by hyperinsulinism secondary to insulinoma?

38
Q

Verapamil and diltiazem belongs to? Potassium opening - calcium channel blocker

Are they dihydropyridine or non-dihydropyridine?

A

calcium channel blocker

Non-dihydropyridine

39
Q

dihydropyridine and non-dihydropyridine are differently active in loweing blood pressure?

A

No. Incorrect

“Equally” active

40
Q

Sustained release calcium blocker with long half life for treatment of acute hypertension?

A

No

“Chronic” HTN

41
Q

Short acting nifedipine (ca blocker) increases risk of MI or mortality in patient with HTN.?

42
Q

Ca blockers taken IV only?

A. Clevidipine
B. Amylodipine
C. Felodipine
D. Nisoldipine
E. Nicardipine
F. More than one answer

A

F. More than one answer

( A. Clevidipine + E. Nicardipine )

43
Q

Niferdipine is long or short acting?

A

Short acting

44
Q

Niferdipine is a short acting drug
Taken Orally
Used for?

A

Emergency management of severe HTN

45
Q

Used in acute HTN occuring during surgery
Its IV drug

Clevidipine or nicardipine?

A

Clevidipine

46
Q

Parenteral drugs when oral treatment of HTN are not feasible. List them

A

Clevidipine
Nicardipine
Verapamil
Diltiazem

47
Q

Clevidipine is a slow onset drug used to treat chronic HTN during surgery? Correct - incorrect

A

incorrect

  • rapid onset
  • acute HTN
48
Q

S(-) non selective B blocking?

A. Carvedilol
B. Lebatalol
C. Nebivolol

A

A. Carvedilol

49
Q

S(-) R(+) isomers have equal B blocking in carvedilol? Yes or No

A

No
In alpha blockers

50
Q

(S,R) —> alpha
A. Carvedilol
B. Lebatalol
C. Nebivolol

A

B. Lebatalol

51
Q

(R,R) —> B blocking

A. Carvedilol
B. Lebatalol
C. Nebivolol

A

B. Lebatalol

52
Q

D- Nebivolol

Selective or non selective B block
Selevtive or non selective alpha

A

Selective or non selective B block

Beta
Beta
Beta

53
Q

L- Nebivolol do?

A

Vasodilation via endothelial release of NO

54
Q

Vasodilator via endothelial release of NO?

A. Nebivolol
B. Carvedilol
C. Levadolol
D. Labitalol

A

A. Nebivolll

55
Q

Nebivolol isomer that does vasodilation via NO release ? L-Nebivolol or D-Nebivolol

A

L-Nebivolol

56
Q

Diuretics lower blood pressure primarly by?

A

Depleting body sodium stores

So reducing BP by reducing B.V and CO

57
Q

In diuretics PVR may increase due to reflex tachycardia , after how long cardiac output returns toward normal ?

A

6- 8 weeks

58
Q

What type of diuretics is favourable in patients with HF?

Why?

A

Aldosterone antagonist ( spironolactone, eplerenone, finerenone)

They are cardio protective and prevent remodeling

59
Q

Diuretics side effects

Magnesium depletion ?
Increase serum lipid concentration?

60
Q

Diuretics side effects
Impair glucose tolerance, how?

A

High glucose level because insulin is resistant due to hypokalaemia that cause hyperpolarization of B cells and decrease insulin secretion

61
Q

Gynecomastia is a side effect of potassium sparing diuretics?
A. Eplerenone
B. Finerenone
C. Spironolactone

A

C. Spironolactone

62
Q

Minoxidil must not be in combination with loop diuretic & B blocker? Yer or no

A

No
Its a must. To prevent reflex-tachycardia
Its reflex is stronger than hydralazine

63
Q

Hypertrichosis is a side effect of ?
A. Hydralazine
B. Fenoldopam
C. Minoxidil
D. Nifedipine

A

C. Minoxidil

64
Q

Used as a stimulant to hair growth for correction of baldness?

A

Topical minoxidil ( e.g. Rogaine )

65
Q

Drug x is metabolised by uptake into RBCs and release NO and cyanide? Drug x is called?

A

Sodium nitroprusside

66
Q

Cyanide is converted into thiocyanate ( less toxic ) via?

A

Mitochondrial enzyme rhodanese

67
Q

Accumulation of cyanide leads to metabolic alkalosis? Yes or no?

A

No. Incorrect

Metabolic acidosis (True)

68
Q

Treatments of cyanide toxicity:
A) sodium thiosulfate
B) Hydroxycobolamin
C) A & B

69
Q

Drug x cause hyperpolarization in smooth muscle cells and pancreatic B cells:

A. Minoxidil
B. Diazoxide

A

B. Diazoxide

70
Q

Drug x has similar chemistry to thiazide diuretics by has nooooo diuretic activity?

A) fendolopam
B) minoxidil
C) Hydralazine
D) diazoxide

A

D) diazoxide

71
Q

Drug x is metabolized by conjugation
Increase IOP and should be avoided in patients with glaucoma
Used for hypertensive emergencies and post-operative hypertension

A

Fenoldopam

72
Q

Short acting CCB?
A. verapamil
B. Clevidipine
C. Nifedipine
D. Amlodipine

A

C. Nifedipine

73
Q

The only drug used as IV in CCBs?
A. Isradipinr
B. Amlodipine
C. Nifedipine
D. Clevidipine

A

D. Clevidipine

74
Q

Drug x has rapid onset and used for (acute) HTN occurring during surgery?

A. Nifedipine
B. Diltiazem
C. Verapamil
D. Clevidipine

A

D. Clevidipine (IV)

75
Q

Drug x is used (orally), short acting that’s used for emergency management of severe hypertension?

A. Clevidipine
B. Diltiazem
C. Nifedipine
D. Verapamil

A

C. Nifedipine

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