S2_L5: Anti-Hypertensives Flashcards by Mind Med

TRUE OR FALSE: The liver produces renin that concerts angiotensin 1 to angiotensin 2. The adrenal cortex produces the angiotensin precursor.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

B. Both statements are false

Liver produces Angiotensinogen while renin is produced by the kidney to convert the inactive enzyme into angiotensin I.

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TRUE OR FALSE: In the kidneys, angiotensin II increases Na+/H+ exchange activity via vasodilation. In the posterior pituitary, it releases ADH, therefore conserving water.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

D. Only the 2nd statement is correct

Angiotensin II constricts the glomerular efferent
arterioles.

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TRUE OR FALSE: Angiotensin Converting Enzyme (ACE) are produced by the lung and kidney. It converts Angiotensin I to Angiotensin II

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

A. Both statements are true

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TRUE OR FALSE: Hypertensive patients on medical management do not require close monitoring during physical therapy sessions.

False

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TRUE OR FALSE: Patients managed with diuretics may manifest with weakness and frequency of urination which can affect physical therapy.

True

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TRUE OR FALSE: Transdermal nitroglycerine is used for the acute management of myocardial infarction.

False

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TRUE OR FALSE: Short term control of blood pressure involves baroreceptor reflexes coming from the arch of the aorta and the carotid bodies.

True

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TRUE OR FALSE: Beta blockers may limit the increase in heart rate during endurance exercise.

True

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TRUE OR FALSE: Angiotensin II is a potent arteriolar vasoconstrictor necessary during hypotensive episodes.

True

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TRUE OR FALSE: Non-selective beta blockers inhibit beta receptors in both the heart and lungs.

True

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TRUE OR FALSE: Calcium channel blockers act by causing peripheral vasodilation thereby decreasing intravascular pressure which can lead to reflex tachycardia.

True

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TRUE OR FALSE: During long term control of blood pressure, the hypothalamus releases aldosterone which conserves sodium and water.

False

It is the adrenal cortex that releases aldosterone

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TRUE OR FALSE: Alpha one blockers decrease the systemic vascular resistance by smooth muscle relaxation leading to vasoconstriction.

False

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TRUE OR FALSE: Beta blockers may not be the best choice for a hypertensive patient with asthma.

True

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stimulates heart activity
acts as a bronchodilator
acts on the lungs
acts on the heart
increases HR & BP

A. Beta-1
B. Beta-2

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Determine the effects of the following receptors when blocked.

hypotension
bradycardia
bronchoconstriction
asthmatic attack

A. Beta-1
B. Beta-2

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Choose as many letters indicated for the following.

Non-invasive
Invasive
Least Reliable
Gives the beat to beat variability
Standard monitoring of BP

A. aneroid/ analog sphygmomanometer
B. digital sphygmomanometer
C. arterial line

A & B
C
B
C
A

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Choose as many letters indicated for the following.

Operator dependent
May be used independently
Used for critically ill patient
Used in operation rooms
Has instances of malfunction

A. aneroid/ analog sphygmomanometer
B. digital sphygmomanometer
C. arterial line

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TRUE OR FALSE: Everytime the heart beats, a different blood pressure is generated.

True

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TRUE OR FALSE: Orthostatic Hypotension is an adverse effect of diuretics. Hypertension is an adverse effect of diuretics.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

C. Only the 1st statement is correct

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TRUE OR FALSE: Any changes in pressure detected by the chemoreceptors & baroreceptors will be sent to the cardioregulatory center & chemoreceptors in hypothalamus. This will send sympathetic / parasympathetic impulses to heart & blood vessels

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

B. Both statements are false

The acting structure is the medulla oblongata, which is the seat for RR, HR, & BP. This will be the one to send sympathetic and
parasympathetic impulses.

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TRUE OR FALSE: An increase in sodium will increase intravascular fluid. Low volume of blood will make your BP higher

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is correct
D. Only the 2nd statement is correct

C. Only the 1st statement is correct

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What is the effect of angiotensin II to the smooth muscles?

causes hypertension due to direct vasoconstriction

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What is the effect of angiotensin II to the hypothalamus?

activates thirst mechanism, resulting to ↑ intravascular fluids & volume →↑ BP

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What is the effect of angiotensin II to the adrenal cortex?

stimulates the secretion of Aldosterone, which is able to conserve Na and vasoconstrict

The following are adverse effects seen on intake of diuretics, EXCEPT: A. Fatigue B. Dizziness C. Weakness D. Electrolyte Imbalance E. Fluid depletion

B. Dizziness

Choose the following letters that corresponds to the adverse effects seen on intake of vasodilators: A. Bradycardia B. Reflex tachycardia C. Hypertension D. Orthostatic hypotension E. Dizziness

B, D, E

The following letters that corresponds to the adverse effects seen on vasodilators, EXCEPT: A. Weakness B. Nausea C. Fluid retention D. Hair growth E. None

E. None

The following letters corresponds to the adverse effects seen on converting enzyme inhibitors, EXCEPT: A. Allergic reactions B. GI discomfort C. Dizziness D. Orthostatic Hypotension E. Chest pains

D. Orthostatic Hypotension

TRUE OR FALSE: The anti-hypertensive property of diuretics come from their ability to excrete electrolytes and water.

True

TRUE OR FALSE: Angiotensin converting enzyme inhibitors promote a decrease in blood pressure by decreasing the levels of angiotensin II and angiotensin.

False

TRUE OR FALSE: Calcium channel blockers are known to cause dizziness, peripheral edema, and flushing which may affect physical therapy modalities.

True

This kinds of receptors are located in the carotid artery & the aorta. What is being described?

Mechanoreceptors/ Baroreceptors

This is referred to as having no direct identified reason for the HTN What is being described?

Essential Htn

This is the first manifestation of pts with kidney problems. What is being described?

Hypertension (htn)

The following are true of myocardial infarction, EXCEPT: A. affectation of the epicardial arteries B. due to blockage of artery C. due to vasoconstriction D. pain is felt due to hypoxemia E. None

D. pain is felt due to hypoxemia ***hypoxia

TRUE OR FALSE: The renin-angiotensin system increases blood pressure by increasing blood volume and systemic vascular resistance.

True

TRUE OR FALSE: Baroreceptors are mechanoreceptors

True

TRUE OR FALSE: Orthostatic hypotension is an adverse effect seen upon intake of angiotensin receptor blockers

True

What enzyme is inhibited in using a specific kind of anti-hypertensives?

ACE This prevents conversion of angiotensin I → II

Match the following anti-hypertensives to the adverse effects. Answers may or may not be limited to 1. 1. Lactation 2. Bronchoconstriction 3. Vertigo A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. E 2. A 3. E

Match the following anti-hypertensives to the adverse effects. Answers may or may not be limited to 1. 1. Orthostatic hypotension 2. Drowsiness 3. GI discomfort A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. A & B 2. C 3. D

Match the following anti-hypertensives to the adverse effects. 1. Dizziness 2. Urinary retention 3. Visual disturbance A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. C 2. D 3. D

Match the following anti-hypertensives to the adverse effects. Answers may or may not be limited to 1. 1. Sedation 2. Impaired concentration 3. Bradycardia A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. E 2. E 3. A

Match the following anti-hypertensives to the adverse effects. Answers may or may not be limited to 1. 1. Dry mouth 2. Depression 3. Reflex tachycardia A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. C, E 2. E 3. B

Match the following anti-hypertensives drug group 1. Targets brainstem 2. Targets autonomic ganglia 3. Targets heart and/or lungs A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. E 2. D 3. A

Match the following anti-hypertensives examples 1. Terazosin 2. Betaloc 3. Tenormin A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. B 2. A 3. A

Match the following anti-hypertensives examples. 1. Metoprolol 2. Trimethaphan 3. Reserpin A. beta blockers B. alpha blockers C. presynaptic adrenergic inhibitors D. ganglionic blockers E. centrally acting hypertensives

1. A 2. D 3. C

Enumerate the 6 kinds of anti-hypertensives

1. diuretics 2. sympatholytic 3. vasodilators 4. concerting enzyme inhibitors 5. calcium channel blockers 6. angiotensin receptor blockers

What receptor responds to changes in pH levels?

Chemoreceptors

What receptor responds to changes in volume & pressure?

Baroreceptors

What is the main function of anti-hypertensive drugs?

decrease BP

Hypertensive crisis happens as side effect of what drug group? Given atleast one example of the generic or brand name of the drug described.

centrally acting anti-hypertensives EXAMPLE: ● Methyldopa (Aldomet) ● Clonidine (Catapres) ● Guanabenz (Wytensin) ● Reserpine (Rauverid)

What 2 drug groups are used as a pharmacologic management of MI?

1. anti-platelets 2. nitrates

Nitrates become a potent vasodilator when it converts into what?

Nitric oxide

1. buccal mucosa 2. sublingual 3. transdermal A. nitrostat B. Nitroglycerin spray C. Nitroglycerin

1. B 2. A, B 3. C

What is the mainstay treatment for myocardial infarction?

aspirin

This is an anti-platelet agent that inhibits adenosine diphosphate. It acts to control the morphology of platelets (size, shape, number) & allows platelet aggregation. What is being described?

Clopidogrel

Sympathetic response to the heart and arteries is?

vasoconstriction & tachycardia

parasympathetic response to the heart and arteries is?

vasodilation & bradycardia

Identification: 1. The primary site of action of diuretics is? 2. The primary effect of action of diuretics is? 3. How is the primary effect achieved?

1. Sodium 2. Decreased blood volume 3. If sodium is removed, water is also removed. Pt will be able to urinate the excessive volume, leading to ↓ blood volume.

TRUE OR FALSE: Impulses from chemoreceptors and baroreceptors may also be sent to the adrenal glands

True

TRUE OR FALSE: Arterial Lines generates BP for each heartbeat & computes the Mean Arterial Pressure (MAP)

True

TRUE OR FALSE: Anti-diuretics are the first choice of drug for hypertension.

False This is not necessarily given first UNLESS the patient presents with bipedal edema or there is many fluids in lungs upon auscultation.

TRUE OR FALSE: All beta-blockers target beta-1 & beta-2 receptors.

False

What two drug group is usually the first line in prescribing anti-hypertensives?

Angiotensin receptor blockers & ACE inhibitors

Choose the letters that are risk factors for myocardial infarction: A. hypertension B. diabetes mellitus C. hyperlipidemia D. tobacco use E. edema F. valve regurgitation G. family history H. environmental factors I. female gender J. male gender

A-D, G, J

1. Antagonizes Aldosterone at cortical collecting tubules 2. Act on the Loop of Henle 3. Act on the distal convoluted tubules in the kidneys A. thiazide diuretics B. loop diuretics C. potassium sparing diuretics

1. C 2. B 3. A

1. Best choice of diuretics among the three 2. May lead to hypokalemia 3. May lead to muscle weakness A. thiazide diuretics B. loop diuretics C. potassium sparing diuretics D. A and B only

1. C 2. D 3. D

This is the hormone that is affected by potassium sparing diuretics. It is a vasoconstrictor and conserves water & electrolytes.

Aldosterone

Identification: 1. The primary site of action of sympatholytics are? 2. The primary effect of action of sympatholytics are? 3. How is the primary effect achieved?

1. heart & blood vessels 2. decreased sympathetic stimulation, decreased resistance and pooling of blood 3. Decreased sympathetic & resistance → vasodilation → bradycardia → leads to hypotension, dec BP

Which beta-blocker is contraindicated for asthmatic patients?

Propanolol

TRUE OR FALSE: Alpha receptors are distributed in the blood vessels. When blocked, it may lead to reflex tachycardia. A. Both statements are true B. Both statements are false C. Only the 1st statement is correct D. Only the 2nd statement is correct

A. Both statements are true

Centrally acting anti-hypertensives targets which brain structure?

brainstem

In the adrenergic synapse, what hormone is released?

norepinephrine this is controlled from the presynaptic membrane

Converting enzyme inhibitors act to control which organ?

Kidney

_____ channels are for muscle contraction & vasoconstriction

Calcium

Name 4 non-pharmacological management for hypertensive patients.

1. Lifestyle change 2. Well-balanced diet 3. Exercise 4. Less stress