Self Assesment Related to HTN 5.pdf

Assessment

1. SELF ASSESSMENT RELATED TO
HYPERTENSION
DR. MD. ABDUL MALEQUE
CLINICAL & INTERVENTIONAL CARDIOLOGIST
NICVD, DHAKA

2. Que 1)
Life style intervention for management of hypertension includes all except:
a)Regular aerobic activity 30 min /day
b)Salt intake to <6 gm/day
c)Attain and maintaining BMI >25k/m
2
d)Diets rich in fruits and vegetables and restricted content of saturated fats
e)Moderation of alcohol consumption

3. Que 2)
Hypertension management is helpful in the prevention of all except:
a)Coronary heart disease
b)Heart failure
c)Chronic kidney disease
d)Deep venous thrombosis
e)Cerebrovascular disease

4. Que 3)
Which are not first line drugs to treat primary hypertension:
a)ARB
b)CCB
c)ACEI
d)Beta Blocker
e)Thiazide type diuretics

5. Que 4)
Antihypertensive agent recommended for the protection of cardiovascular
diseases is:
a)Calcium channel blockers
b)Diuretics
c)ACE inhibitors
d)Alpha antagonists
e)Central sympatholytic

6. Que 5)
Angiotensin Receptor Blockers play Reno protective effect through all except:
a)Decreasing proteinuria
b)Decreasing intraglomerular pressure
c)Preventing endothelial dysfunction
d)Inhibiting conversion of angiotensin-I to angiotensin –II
e)Blocking the angiotensin mediated renal remodelling

7. Que 6)
Which of the following is the side effect of ACE inhibitors:
a)Hyperkalaemia
b)Hypercalcemia
c)Hyperglycaemia
d)Hypertension
e)Hypermagnesemia

8. Que 7)
Calcium channel blockers (Amlodipine) cause all except:
a)Pedal oedema
b)Flushing
c)Hyperkalaemia
d)Headache
e)Reflex tachycardia

9. Que 8)
Safest drug for hypertension in pregnancy are:
a)ACE inhibitors
b)Labetalol
c)Angiotensin receptor blockers
d)Diuretic
e)Methyldopa

10. Que 9)
The first line antihypertensive in diabetic patients is:
a)Diuretics
b)Angiotensin converting enzyme inhibitors
c)Beta blockers
d)Calcium channel blockers
e)Alpha blocker

11. Que 10)
Which of the following antihypertensive agent is contraindicated in
congestive cardiac failure:
a)ACE inhibitors
b)Angiotensin receptor blockers
c)Beta blockers
d)Diuretics
e)CCB

12. 11.
A 55-yr-old woman, who is devoted to singing, has hypertension which has been well controlled
with enalapril for the past month. She calls to report a new,intolerable side effect, and she
requests to be switched to a different drug. Which of the following adverse effects is most likely
to be intolerable to this patient?
A. Frequent urination
B. Dysgeusia
C. Dry cough
D. Headache

13. 12.
During her annual physical examination, a 45-yr-old patient with a history of asthma is found
to have an elevated blood pressure. Elevated pressures are confirmed on 2 additional readings
in the physician's office. In evaluating therapies for this patient, which class of antihypertensive
drugs is contraindicated?
A. Thiazide diuretics
B. Beta blockers
C. Angiotensin II blockers
D. Calcium channel blockers

14. 13.
At what age should you have your first screening for high blood pressure?
A.20
B.30
C.40
D.50

15. 14.
What features separate a hypertensive urgency from an emergency?
a. Percentile of blood pressure
b. Duration of elevation
c. Signs of end organ involvement
d. A & C
e. All of the above

16. 15.
You evaluate a woman with chronic hypertension whose blood pressure remains above target despite
a daily regimen of benazepril 20 mg, chlorthalidone 25 mg, and amlodipine 10 mg.
Your next step should be:
A.Add an agent from another class, such as hydralazine or clonidine.
B.Characterize the patient as having resistant hypertension and initiate therapy with 25 mg of
spironolactone (potassium levels permitting).
C. Add an ARB.
D.Switch from amlodipine to verapamil.

17. 16.
You are seeing a 60-year-old man for the first time. He has untreated hypertension (168/106 mm Hg
and blood pressure has been elevated on at least 3 occasions). There is currently no evidence of target
organ dysfunction (heart, neurological, or eyegrounds).
From a therapeutic perspective, what is the best initial approach?
A.Initiate treatment with 25 mg of hydrochlorothiazide.
B.Consider initiating treatment with a 2-agent combination pill.
C.Delay pharmacologic intervention and treat with salt restriction.

18. 17.
Which is incorrect statement incase of initial BP for management of hypertension?
Initial BP Follow-up
<130 & <85 Recheck in 1 year
130-139 & 85-89 Recheck within 3-6 month
140-159 and/or 90-99 Start treatment with low dose single drug
160-179 and/or 100-109 Evaluate within 1 month & treat if confirmed

≥180 and/or ≥ 110 Evaluate & initiate Rx immediately

19. •18.
A hypertensive 50 years old male presented to you with history of
syncope. On examination, Pulse-50 beat/min, BP 160/90 mmHg,
others non remarkable. Which drug will you prefer for management of
hypertension?
a)Amlodipine
b)RAAS inhibitor
c)Thiazide diuretics
d)No drug

20. •19.
A 40 years male, suffered from asthma, now presented to you with
complaints of excertional chest pain. On examination, his BP 160/90
mmHg & HR 110/min. Which will be the best choice to treat HTN for
this patients?
A.Bisoprolol
B.GTN
C.Diltiazem
D.Verapamil
E.ACEI/ARB

21. •20.
A 36 years married women presented with blurring of vision, abdominal pain
with 32 week of pregnancy having past H/O 2 abortions. O/E: BP-170/ 110
mmHg, Oedema- (++). Which drug will you avoid to treat the patient?
a)IV labetalol
b)Aspirin
c)High dose calcium
d)IV magnesium
e)IV diuretic

22. 21.
Which is the best drug used to treat a patient suffered from HOCM
having HTN?
A.ACEI/ARB
B.Nitrates
C.Diuretics
D.CCB- Amlodipine
E.Beta blocker

23. •22.
What factors will you consider before prescribing an antihypertensive drug?
a)Patient age
b)Drugs factor- side effects, cost, dosing frequency & availability of drug
c)Type & severity of HTN
d)Associated comorbidity & risk factors
e)Above all

24. •23.
A 55 years hypertensive male patient having well controlled BP, when
will you considered Aspirin along with antihypertensive drugs?
a)Having target organ damage
b)Having diabetes
c)10 years CVD risk of at least 20%
d)Above all

25. Answer
•1(c) 2(d) 3(d) 4(c) 5(d) 6(a)
•7(c) 8(b,e) 9(b) 10(e) 11(c) 12(b)
•13(b) 14(c) 15(b) 16(b) 17(c) 18(a)
•19(c) 20(e) 21(e) 22(e) 23(d) 24(a)
•25(f)

27. •24.
Which is the best combination drug to trat a patient having hypertension
suffered from Heart failure with H/O ischemic stroke?
a) ACEI & Diuretics
b) ACEI & Beta blocker
c) CCB & Diuretics
d) Beta blocker & Diuretics
e) Above all

28. •25.
When will you considered secondary cause of hypertension in a
hypertensive patient?
a)Younger patients <40 yrs with grade 2 HTN or onset of any grade of
HTN in childhood
b)Acute worsening HTN with previously documented normotension
c)Resistant HTN
d)Presence of extensive HMOD
e)Clinical or biochemical features suggestive of secondary cause
f)Above all