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?

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?

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

What is an example of a B blocker with A blocking Activity?

Atenolol

Metoprolol

Carvedilol

Bisoprolol

CORE Exam #1 Hypertension

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