Drug Topics - January 14, 2008 - (Page 40) 40 DRUG TOPICS JANUARY 14, 2008 www.drugtopics.com TEST QUESTIONS 4. A patient with prehypertension has a BP reading of: a. SBP 120-139 mmHg or DBP 90-99 mmHg b. SBP 130-139 mmHg or DBP 80-89 mmHg c. SBP 120-139 mmHg or DBP 80-89 mmHg d. SBP 130-139 mmHg or DBP 90-99 mmHg 5. Complications of hypertension include all of the 13. In the RENAAL study: a. The losartan group showed a significant reduction of proteinuria over conventional therapy b. Patients with noninsulin diabetes were excluded c. Adverse effects were significantly higher in the losartan group than in the placebo group d. Doubling of SCr concentration was significantly higher in the losartan group than in the placebo group 14. IDNT found: a. No difference in proteinuria reduction between irbesartan and amlodipine b. Comparable relative risk reduction of ESRD between the irbesartan and amlodipine groups c. A significant decrease in proteinuria in the amlodipine group versus baseline d. Participants in the irbesartan group developed significantly more cardiovascular events than those in the amlodipine group 15. Thiazide diuretics: a. Reduce proteinuria independent of BP reduction b. Are most effective with a GFR <40 ml/min/1.73 m2 c. Reduce proteinuria as effectively as ACEIs d. Provide additive reductions to ACEI/ARB therapy on urinary albumin excretion 16. L.M. is a 75-year-old African-American male re- following except: a. Myocardial infarction b. Liver disease diagnosis c. Heart failure d. Cerebral hemorrhage 6. When evaluating a patient’s BP in the clinic, all of the following variables must be considered except: a. Consumption of caffeine b. Consumption of fruit c. Smoking cigarettes d. Exercise 7. Which is the most widely accepted method for as- sessing proteinuria? a. Albumin:creatinine ratio b. Random spot collection c. Overnight timed collection d. 24-hour collection 8. An albumin:creatinine ratio of 150 mg/gm would classify a patient as having: a. Normal albumin excretion b. Microalbuminuria c. Macroalbuminuria d. Overt proteinuria 9. Which of the following class of medications would not be recommended for hypertensive patients with proteinuria? a. ACEIs b. ARBs c. Direct vasodilators d. Beta-blockers 10. All of the following are compelling indications for turning for his follow-up visit. Last visit, losartan was titrated to the maximum dose of 100 mg/day for BP and proteinuria. L.M. is also taking aspirin, simvastatin, metformin, and hydrochlorothiazide. BP today is 146/80, pulse 74, and recent albumin:creatinine is 150 mg/dl. Which antihypertensives should the physician consider as thirdline agents? a. Loop diuretics b. Dihydropyridine calcium channel blockers c. Nondihydropyridine calcium channel blockers d. Alpha antagonists 17.The AASK trial: a. Looked at glucose control in African-Americans b. Showed that GFR decline was independent of proteinuria c. Found that amlodipine increased the urine:creatinine ratio d. Proved there was additional benefit in slowing progression of GFR decline in the lower BP group 18. In the GEMINI trial: a. Patients with diabetes were excluded b. Carvedilol significantly reduced the albumin:creatinine ratio compared with metoprolol and betablockers c. Patients with a baseline of 30 mg/gm or less of albuminuria had a lower progression to microalbuminuria in the metoprolol group d. Metoprolol significantly improved insulin sensitivity ACEIs except: a. Congestive heart failure b. Peripheral edema c. Cerebrovascular disease d. Status post-MI 11. ACEIs, such as lisinopril, fosinopril, and ramipril, are typically associated with: a. Hyperglycemia b. Dry cough c. Productive cough d. Rebound hypertension 12. Which agents are recommended as first-line agents for hypertension with diabetic nephropathy and/or non-diabetic kidney disease? a. Diuretics b. Beta-blockers c. ARBs and ACEIs d. Calcium-channel blockers http://www.drugtopics.com
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.