Questions Flashcards
Case
A 45-year-old male patient with a 5-year history of hypertension presents for a checkup and review of blood work. Blood work is notable for fasting blood sugar 133 mg/dL. The physician decides to prescribe lisinopril. The patient calls the physician a week after being prescribed the medication and reports moderate tongue swelling.
Question
What is the most likely mechanism of the tongue swelling experienced by this patient?
Decreased catabolism of bradykinin
Sodium nitroprusside is administered intravenously in the cases of hypertensive emergency and causes prompt vasodilation. If given orally, the drug can cause death because of
Tissue anoxia
Case
A 33-year-old man presents with severe thirst and frequent urination; symptoms have been developing over the past month. He claims to consume more than 8 liters of fluids per day. Despite that, he is always thirsty.
Fasting blood glucose is 90 mg/dL. On brain MRI, the hyperintensity of the posterior pituitary is absent.
Question
What drug is likely used to treat this patient?
Desmopressin
Of the following, which class of diuretics would be the most effective diuretic in patients with acute renal failure?
K+ Sparing Diuretic
Thiazide Diuretic
Loop Diuretic
Osmotic Diuretic
Loop Diuretic
The function of the angiotensin family of peptides is to act as
Vasoconstrictors
Case
A 62-year-old female patient is being treated for chronic congestive heart failure; ejection fraction is 40%. She has been put on hydrochlorothiazide therapy. Serum electrolyte levels are being monitored and show a persistent hypokalemia.
Question Highlights
What is most appropriate to add to this patient’s therapeutic regimen?
Valsartan
Sacubitril-valsartan
Furosemide
Hydrochlorothiazide
Sacubitril-valsartan
Some diuretics antagonize the effects of aldosterone at the cortical collecting tubule and the late distal tubule. These drugs are most useful in the therapy of mineralocorticoid excess. Which of the following drugs causes direct pharmacological antagonism of mineralocorticoid receptors?
Triamterene
Spironolactone
Furosemide
Hydrochlorothiazide
Amiloride
Spironolactone
Historically ganglion blockers were the first drugs to be used for the treatment of hypertension. They are no longer used on account of the toxic effects associated with them. Which one of the following is a ganglion-blocking drug that is used even today to lower blood pressure?
Trimethaphan
A 60-year-old patient presents to the office with complaints of chest pain. During the conversation, the patient indicates that he is under a lot of stress at his job. His blood pressure is 175/102 mmHg, pulse is 84bpm. ECG showed slightly negative T-waves in II, III, and aVF. You decide to initiate the treatment with metoprolol-XL, 50mg a day instructing the patient not to stop the medication abruptly without doctor’s supervision. Out of the following, what describes the best reason behind your warning?
Undesirable negative inotropic action
Inefficient therapeutic response
Onset of heart failure
Precipitation of ischemic events
AV nodal depression
Increase of myocardial relaxation
Decrease of afterload
Precipitation of ischemic events
A 54-year-old female presents with complaints of shortness of breath and leg edema usually visible by the end of the day. She did not have those symptoms before. Auscultation displayed a prominent S3 gallop rhythm. If you were to initiate digitalis in this patient, what would be the most likely explanation for its beneficial therapeutic action?
Increased Cardiac Output
Case
A 65-year-old African American man presents in your office for a follow-up for hypertension. 3 months earlier, you prescribed furosemide. He checks his blood pressure daily and states that it is markedly lower since he has been on the medication, but it feels like his heart is skipping a beat once in a while.
Question
What deficiency is most likely?
Potassium
A 67-year-old female with the history of shortness of breath and leg edema is seeing you in the office for a follow-up visit. She is also taking enalapril and metoprolol. You decide to add digoxin to her treatment plan. Out of the following, what is the main adverse effect of treatment with digoxin?
Proarythmia
Case
A 25-year-old overweight African American man presents with concerns about his blood pressure. 3 months ago, he reports elevated blood pressure at a work health fair. He has checked his blood pressure in local grocery stores and he knows that the readings were “above normal.” He has a strong family history of hypertension. His blood pressure is 175/95 mm Hg in the left arm and 172/99 mm Hg in the right arm.
Question
What drug should be initiated along with appropriate lifestyle modifications?
1 Hydrochlorothiazide
2 Metoprolol
3 Enalapril
4 Losartan
5 Labetolol
Hydrochlorothiazide
A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance?
Incessant Cough
Comparison of prazosin with atenolol shows that
Both increase sympathetic outflow from the CNS
A 73-year-old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls?
Alpha1-selective receptor blockers
Which one of the following is characteristic of nifedipine treatment in patients with essential hypertension?
A
Competitively blocks angiotensin II at its receptor
B
Decreases calcium efflux from skeletal muscle
C
Decreases renin concentration in the blood
D
Decreases calcium influx into smooth muscle
E
Increases calcium excretion in the urine
Decreases calcium influx into smooth muscle
A patient with hypertension and angina is referred for treatment. Metoprolol and verapamil are among the drugs considered. Both metoprolol and verapamil are associated with which one of the following?A
Diarrhea
B
Hypoglycemia
C
Increased PR interval
D
Tachycardia
E
Thyrotoxicosis
Increased PR interval