Hypertension Flashcards
Which of the following best defines hypertension?
A. SBP: ≥140 or DBP: ≥90 mm Hg B. SBP: ≥140 and DBP: ≥90 mm Hg C. SBP: >140 or DBP: >90 mm Hg D. SBP: ≥140 and/or DBP: ≥90 mm Hg E. None of the options
A. SBP: ≥140 or DBP: ≥90 mm Hg
Which of the following is the primary ECF cation?
A. Potassium B. Sodium C. Calcium D. Chloride E. Phosphorus
B. Sodium
Which of the following is the primary intracellular cation?
A. Potassium B. Sodium C. Calcium D. Chloride E. Phosphorus
A. Potassium
Which of the following is/are the effect of sodium as primary determinant of ECF volume?
A. Increased intravascular volume B. Increased blood pressure C. Increased extravascular volume D. Decreased blood pressure E. Two of the options
E. Two of the options
Increased intravascular volume –> Increased BP
Which of the following leads to increased heart rate and contractility?
A. α1 B. α2 C. β1 D. β2 E. Any of the options
C. β1
α1 – vasoconstriction
α2 – inhibition of noradrenergic release
β1 – Increased heart rate and contractility
β2 – vasodilation
All of the following stimulation results to increased BP EXCEPT …
A. α1 B. α2 C. β1 D. β2 E. Any of the options
D. β2
β2 – vasodilation → decreased BP
Which of the following contributes highest to vasoconstriction?
A. Angiotensin I B. Angiotensin II C. Aldosterone D. Renin E. Any of the options
B. Angiotensin II
Angiotensin II – vasoconstriction
Aldosterone – sodium retention
Renin secretion – inhibited by increased NaCl transport
Which of the following are primary determinants of cardiac output?
A. TPR and SV B. HR and SV C. Preload and SV D. Preload and afterload E. None of the options
B. HR and SV
CO = HR x SV
Which of the following are important determinants of arterial pressure?
A. radius and compliance B. radius and resistance C. SBP and DBP D. TPR and SV E. Any of the options
A. radius and compliance
Decreased lumen size → increased resistance → decreased blood flow → increased blood pressure
Which of the following most likely results to hypertension?
A. Elastic arterioles B. Stiffened arterioles C. Semi-rigid arterioles D. Two of the options E. All of the options
B. Stiffened arterioles
Stiffened vasculature: less able to buffer alterations in blood flow → hypertension
Which of the is/are effects of generation of ROS from oxidative stress?
A. modify T cell function B. modify B cell function C. modify TNF α function D. modify cardiac muscle function E. Any of the options
A. modify T cell function
Inflammation and oxidative stress → generation of reactive oxygen species → modify T cell function → further enhance inflammation → endothelial dysfunction → hypertension
All of the following are important elements in patient history of hypertension EXCEPT
A. Lifestyle factors
B. Current and previous medications
C. Presence of vascular and abdominal bruits
D. Symptoms suggesting causes of hypertension
E. Duration of hypertension
C. Presence of vascular and abdominal bruits
Systolic pressure is recorded upon hearing what type of sound?
A. Tapping sound B. Soft swishing sound C. Crisp sound D. Blowing sound E. Silence
A. Tapping sound
Silence Systolic - Tapping sound Phase 2 - Soft swishing sound Phase 3 - Crisp sound Diastolic - Blowing sound Silence
Which of the following statements is/are true about jugular vein?
A. Found above the SCM
B. Main path for deoxygenated blood returning from the cranium back to the heart
C. Has no protection from bone or cartilage
D. Two of the options
E. All of the options
D. Two of the options
All of the following are appropriate steps in carotid pulse examination EXCEPT:
A. Raise the head to about 30 degrees.
B. Palpate both carotid arteries at the same time
C. Slowly increase pressure until maximal pulsation, then slowly decrease pressure until sensing the arterial pressure and contour.
D. Assess the amplitude, contour, variations, and timing of the pulse.
E. None of the options
B. Palpate both carotid arteries at the same time
Never palpate both carotid arteries at the same time. This may decrease blood flow and induce syncope.
Nicola, a 21-year old physician inspects the heart of her patient. Upon examination, she heard a soft decrescendo higher-pitched diastolic murmur. What does this indicate?
A. Normal; nothing to worry about B. Mitral stenosis C. Mitral regurgitation D. Aortic stenosis E. Aortic regurgitation
E. Aortic regurgitation
Mitral stenosis - low-pitched extra sounds such as an S3, “opening snap”
Systolic murmurs:
> Mitral regurgitation
> Aortic stenosis
Diastolic murmurs:
> Mitral stenosis
> Aortic regurgitation
In diagnosing a patient with hypertension, which of the following is/are applicable?
A. Make 3 BP readings; use the average of 2nd to 3rd reading
B. If <130/85 mmHg, re-measure after 3 years; 1 year in those with risk factors
C. If home BP is ≥135/85 mmHg or 24h ambulatory BP ≥130/80 mmHg, there is hypertension diagnosis
D. Two of the options
E. All of the options
E. All of the options
In the clinic, Nicola diagnosed her patient with grade 1 hypertension. Which of the following actions must she recommend to her patient?
A. Do Diet (e.g. reduce food intake rich in sodium)
B. Do Exercise (e.g. brisk walking for 30min/d)
C. Start Drug treatments (e.g. amlodipine)
D. Two of the options
E. All of the options
D. Two of the options
If grade 1 hypertension:
- Start lifestyle modifications
- Start drug treatments
If grade 2 hypertension:
- Start drug treatment
- Start lifestyle modifications
Which of the following tests are appropriate to test the endocrine system of the patient?
A. BUN, Crea, Albumin B. Potassium, Calcium, TSH C. Total cholesterol, HDL, LDL D. Hematocrit, ECG, 2D echo E. Any of the options
B. Potassium, Calcium, TSH
In hypertensive patients, how much salt intake is recommended per day?
A. <4g
B. <5g
C. <6g
D. <7g
C. <6g
Which of the following drugs inhibit Na/Cl pump in the DCT?
A. HCTZ B. Furosemide C. Spironolactone D. Eplerenone E. Amiloride
A. HCTZ - Thiazides
Thiazides - Na/Cl - DCT
Loop - Na/K/2Cl - Henle
K+ retaining - ENaC - Distal nephron
Aldosterone antagonists - renal CT
Which of the following diuretic drugs has the most efficacy?
A. HCTZ B. Furosemide C. Spironolactone D. Eplerenone E. Amiloride
B. Furosemide
Loop diuretics - most efficacious diuretics
Which of the following antihypertensive drugs also increase bradykinin levels?
A. Captopril B. Losartan C. Diazoxide D. Aliskerin E. Verapamil
A. Captopril
ACE inhibitors
Which of the following antihypertensive drugs inhibits renin secretion?
A. Captopril B. Losartan C. Diazoxide D. Aliskerin E. Verapamil
D. Aliskerin
Which of the following drugs is the first line for hypertensive emergencies?
A. Nitroprusside B. Nicardipine C. Labetalol D. Esmolol E. Hydralazine
A. Nitroprusside
Which of the following drugs is/are first line for hypertension?
A. CCB B. ACEI C. ARBs D. Thiazides E. Two of the options F. All of the options
F. All of the options
The three first-line drug classes for hypertension are (1) a CCB, (2) an ACEI or ARB, and (3) a thiazide-type diuretic
Which of the following calcium blockers is drug of choice for hypertension?
A. Nicardipine B. Lacidipine C. Amlodipine D. Nifedipine E. Felodipine
C. Amlodipine
We use amlodipine as the preferred CCB for most patients because it is long acting (once-daily dosing), is the best studied of the CCBs and performed well in multiple RCTs, and is now available in generic form.
Which of the following drugs is most cardioselective?
A. Atenolol
B. Metoprolol
C. Nebivolol
D. Betaxolol
C. Nebivolol
All of the following drugs are used for hypertension in pregnant EXCEPT:
A. Methyldopa B. Hydralazine C. Nifedipine D. Labetalopl E. Esmolol
E. Esmolol
“MINAHAL” = “MeNHL”
All of the following are adverse effects of thiazide diuretics EXCEPT:
A. Hyperglycemia B. Hyperlipidemia C. Hyperuricemia D. Hypercalcemia E. Hyperkalemia
E. Hyperkalemia
“Hyper GLUC”
