Hypertension

Question 1

What is the mechnism of ACE inhibitors?

give examples of ACEis

Answer 1

The inhibit the conversion of Angiotesin 1 –> angiotensin II

ramipril

Benazepril (Lotensin)

Captopril.

Enalapril (Vasotec)

Question 2

What is the MoA of thiazide-like diuretics

examples

examples of thiazide diuretics

Answer 2

They inhibit sodium resorption at the beginning of the distal convoluted tubule

chlorothiazide, HCTZ, methychlothiazide

indapamide, CTDN, and metolazone

Question 3

What is the first line treatment for hypertension in caucasian patients under 55?

Answer 3

ACE i

Question 4

which one of the following blood pressure measurements would be diagnostic for stage 1 hypertension?

1. A clinic blood pressure above or equal to 120/80mmHg and ambulatory blood pressure measurement average above or equal to 120/75mmHg
2. A clinic blood pressure above or equal to 160/100mmHg and ambulatory blood pressure measurement average above or equal to 150/95mmHg
3. A clinic blood pressure above or equal to 140/90mmHg and ambulatory blood pressure measurement average above or equal to 135/95mmHg

Answer 4

diagnostic for stage 1 hypertension

Clinical BP >/= to 140/90 mmHg and ambulatory BP measurement average above or equal to 135/95 mmHg

Question 5

Beta blockers are contraindicated in patients with which one of the following conditions?

Sick sinus syndrome

Korsakoff

ZE syndrome

Answer 5

Sick sinus

Question 6

Which one of the following medicines are known to cause a dry cough as a common side effect?

Ramipril

Amlodipine

Candesartan

Answer 6

ramipril

Question 7

at which blood pressure would you consider drug therapy

Answer 7

180/120 - consider starting drug treatment

Question 8

classification ranges for hypertension diagnosis

Answer 8

Stage 1- 140/90 -> 159/99

Stage 2- 150-100 -> 180/20

Stage 3 severe hypertension-> SBP > 180 or DBP> 120

Question 9

causes of hypertension

Answer 9

primary- no identifiable cause

secondary hypertension-

Renal

• Chronic pyelonephritis
• Diabetic nephropathy
• Glomerulonephritis
• Polycystic kidney disease
• Obstructive uropathy
• Renal cell carcinoma

Vascular

• Coarctation of the aorta
• Renal artery stenosis

Endocrine

• Primary hyperaldosteronism
• Pheochromocytoma
• Cushing’s syndrome
• Acromegaly
• Hypothyroidism

Drugs

• Alcohol
• Ciclosporin
• Cocaine and other
substances of abuse
• Combined oral contraceptive
• Corticosteroids
• Erythropoietin
• Leflunomide
• Liquorice
• Nonsteroidal anti-
inflammatory drugs
• Sympathomimetics
• Venlafaxine

Question 10

Hypertension with T2DM which drug should you use?

Answer 10

ACEi or ARB –>same + CCB or thiazide-like diuretic –> all 3 –>specialist help + spirinalactone