CORE Exam #1 Hypertension
What is the molecular target of Loop Diuretics?
Na+ / K+ / Cl2- co-transporter
Na+ / Cl2- co-transporter
Na+ channels
Na+ / K+ co-transporter
What is a side effect of Loop and Thiazide Diuretics?
Hyperkalemia
Hypokalemia
Gynecomastia
Angioedema
Which Aldosterone Antagonist Diuretic is known to have more side effects such as Gynecomastia?
Eplerenone
Spironolactone
Triamterene
Tolvaptan
What functional group of Thiazide Diuretics causing the side effect of Photosensitivity?
Green - sulfonamide group
Blue - e- withdrawing group
Brown - Ring-Sulfamoyl group
What portion of the kidneys do Vasopressin Receptor Agonists work?
Loop of henle
Distal tubule
Collecting duct
Proximal tubule
What is the most common side effect of an ACE Inhibitor?
Dry Cough
Hypotension
Renal Insufficiency
Bradycardia
Which ARB is not selective for the A1 receptor on vascular smooth muscle?
Losartan
Irbesartan
Valsartan
Telmisartan
Renin Inhibitors have fewer side affects than ACEI's and ARB's?
True
False
"First dose hypotension" is a common effect of which Sympatholytic agent?
A2 agonists
A1 blocker
B1 blocker
Non-Selective B blocker
Which drug does not have ISA (Intrinsic sympathomimetic activity)?
Carvedilol
Pindolol
Penbutolol
Acebutolol
Providing a drug with Cardio-selectivity would be a safer / beneficial for a patient with...
Peripheral Vascular Disease
Bradycardia
Asthma / COPD
Heart failure
A2 agonists are not a good drug choice for elderly patients because they can cause...
Sedation
Increased cardiac output
Fluid Retention
Weight Gain
Direct Vasodilators work by ...
Inhibiting K+ channels
Inhibiting NO
Inhibiting Ca2+ channels
Inhibiting Na+ channels
Which Calcium Channel Blocker effects both vascular smooth muscle and cardiac muscle?
Dihydropyridines
Non-dihydropyridines
Which of these does not activate the RAAS System?
Decrease in Na+ levels
Decrease in SNS activity
Diuretics
Blood volume concentration
Which RAAS System produces formation of both Ang II and Aldosterone?
Local RAAS
Endocrine RAAS
Which drug class would not have a strong effect on the RAAS System?
ARB
B-Blocker
ACEI
CCB
Which BP equation is corrcet?
BP= cardiac output x Peripheral Resistance
BP= cardiac output x strove volume
BP= cardiac output x heart rate
BP= peripheral resistance x stroke volume
Which of the following is NOT a contributor to Peripheral Resistance?
Vascular Constriction
Arteriole Tone
Vascular Hypertrophy
Venous Tone
Which of these BP's is considered Stage 1 hypertension?
>120/80
>120-129/80
>130-139/80-89
>140/80-90
Which of these is NOT a secondary cause of Hypertension?
Sleep Apnea
Reno-vascular Disease
Thyroid Disease
Diabetes
Decreased organ perfusion is a sign of ...
Hypotension
Hypertension
Edema
Heart Faluire
Which of these should be avoided before getting a BP measurement?
Having a cup of Coffee
Smoking
Sitting down for 5 minutes or more
Having an Alcoholic drink
Excersise
Having their arm supported
Placing their feet on the floor
What might give you a incorrect BP reading?
Patient is nervous to be at the Doctors Office
Atherosclerosis of Brachial Artery
Patient has never gotten their BP taken before
Patient has a large arm but you only have smaller cuff sizes
Patient is under 18 years of age
Patient is lifting up their own arm
What are ways to diagnose hypertension?
Get a list of medications and family history
BP in both arms
Take one BP measurement
Evaluate Comorbidity with Lab Tests
Ask patient if they have Hypertension
What are examples of Life Style Choices to reduce Hypertension?
Reduce pain reliever medications such as NSAIDS
Weight reduction
Increase sodium intake
DASH Diet
Exercise
Take medication as needed
Take your BP everyday
At what stage of hypertension would you treat with one medication and have a BP goal of >130/80
Normal
Elevated
Stage 1
Stage 2
Which Medication would be preferred for a pregnant patient?
Labetalol
Lostartan
Aliskiren
Lisinopril
Which drug class is not preferred for Diabetic patients?
Diuretics
ACEI/ARB
CCB
Renin Inhibitor
Why would you not use an ACEI and a ARB combination therapy?
They have a drug-drug interaction
They have a similar molecular target
They would give too many side effects
They could counteract each other and cause more hypertension
Fist Line Treatment for an elderly patient with hypertension would be?
Renin Inhibitor
Aldosterone Antagonist
Diuretic
ARB / ACEI
When is the best time to take combination drug therapy?
One in the am and one at noon
Both at the same time in the am
One in the am and one pm
Both at the same time in the pm
Which of these would be signs of resistant hypertension? (assume max dose on all meds)
BP above goal while on 3 meds
BP above goal while on 2 meds
BP at or below goal while on 4 meds
BP at or below goal while on 3 meds
Which of these would NOT promote adherence?
Patient Education
Clinical Empathy
Increase Daily Dosing
Using generic medications
BP of >180/120 with symptoms of headache and blurred vision would be considered?
Hypertensive Urgency
Hypertensive Emergency
Severe Hypertension
Resistant Hypertension
Which Diuretic has the greatest efficacy?
Loop
Thiazide
Osmotic
Potassium-sparing
Which Diuretic is known to help treat Hyponatremia or low blood sodium levels, especially in CHF patients?
Thiazide
Aldosterone Antagonists
Vasopressin Receptor Antagonists
Osmotic
What is the site of action of Osmotic Diuretics?
Proximal Tubule / Loop of henle
Distal tubule
Collecting Duct / Loop of henle
Loop of henle
What is the mechanism of an ACEI?
Block Ang II
Block renin production
Block Ang 1 --> Ang II
Block AT1 and AT2 receptors
Renin is a
Hormone
Protien
Enzyme
Neurotransmitter
What is an example of a B blocker with A blocking Activity?
Atenolol
Metoprolol
Carvedilol
Bisoprolol
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