271 HCVD

Question 1

A 62/M presents with severe headache, nausea, projective vomiting, and altered mental status. BP 250/120 mmHg. What IV drug will you give?

Answer 1

Nicardipine

Question 2

A 24M complaints of throbbing temporal headache slightly relieved with acetaminophen. With lower extremity cramps and weakness. PE: right arm 180/115 mmHg, left arm 188/113 mmHg. Right thigh 100/80 mmHg. Left thigh 102/58 mmHg. +ateriorvenius nicking on fundoscopy. +continuous murmur heard over left scapula. No abdominal bruits. Reduced pulses on extremities. What is your diagnosis?

Answer 2

Coarctation of the aorta

Question 3

A 56/M with DM, HPN, BMI >26 presents with myalgia. LDL more than 130 mg/dl on atorvastatin 40 mg OD. AST and ALT are more than 3x elevated. What will you advise this patient?

Answer 3

Discontinue statin. Start on other non statin. Re-check AST and ALT after 2 weeks

Question 4

Which receptors are responsible for the rebound hypertension that occurs with abrupt cessation of clonidine?
A. alpha receptors
B. beta receptors
C. baroreceptors
D. angiotensin 1 receptors

Answer 4

A. alpha receptors

Question 5

True or false. Average systolic blood pressure is higher for men than for women during early adulthood.

Answer 5

True. Among age 60 years and older, systolic blood pressure of women are higher than of those of men

Question 6

strong independent risk factors for hypertension

Answer 6

obesity and weight gain

Question 7

True or false. Prevalence of hypertension is related to dietary NaCl intake

Answer 7

True.

Question 8

True or false. Low intake of calcium and potassium also may contribute to the risk of hypertension

Answer 8

True.

Question 9

True or false. Urine sodium to potassium ratio is a stronger correlate of blood pressure than sodium and potassium alone

Answer 9

True.

Question 10

Two determinants of arterial pressure

Answer 10

cardiac output and peripheral resistance

Question 11

how is cardiac output determined

Answer 11

stroke volume and heart rate

Question 12

True or false. Effect of sodium on blood pressure is related to the provision of sodium with chloride

Answer 12

True.

Question 13

an antihypertensive agent that is centrally acting alpha 2 agonist that inhibits sympathetic outflow

Answer 13

clonidine

Question 14

Can occur with abrupt cessation of clonidine therapy

Answer 14

rebound hypertension

Question 15

sensory nerve endings in the carotid sinuses and aortic arch that modulate blood pressure

Answer 15

stretch sensitive sensory nerve endings in the carotid sinuses and aortic arch

Question 16

primary mechanism for rapid buffering of acute fluctuations of arterial pressure that may occur during postural changes

Answer 16

baroreceptors

Question 17

rate limiting step in the cathecolamine synthesis

Answer 17

tyrosine hydroxylase

Question 18

where is renin mostly synthesized

Answer 18

renal afferrent renal arteriole

Question 19

Three primary stimuli for renin secretion

Answer 19

decrease NaCl transport in the distal portion of the TAL of Henle, decrease pressure or stretch within the renal afferent arteriole, sympathetic nervous system stimulation of renin secreting cells via the beta 1 adrenoreceptors

Question 20

potent pressor substance

Answer 20

angiotensin II