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In this section, we are going to share some most important quizzes of the Cardiology exam. This question is very helpful for those students who want to prepare for the Cardiology exam.
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Q1:- A 65-year-old hypertensive non-diabetic has an eGFR <40. Screening tests showed microalbuminuria and a normal renal ultrasound. Which class of antihypertensive medication should you instigate? a) ACE inhibitor b) Beta-blocker c) Calcium-channel blocker d) Thiazide diuretic
Ans:1 [A]:- The control of blood pressure and blocking of the renin�angiotensin system are essential to preserve renal function. The African American Study of Kidney Disease (AASK) showed that ACE inhibitors were better at slowing eGFR decline than beta-blockers or calcium-channel blockers. This is true of diabetic and non-diabetic patients, especially if there is evidence of proteinuria. Optimal BP control is <130/80 mmHgor <125/75 mmHg in the instance of proteinuria. It is likely that the benefits of renin� angiotensin blockage are additional to the benefits derived from absolute blood pressure reduction.
Q2:- The side effects of the broad spectrum of calcium-channel blockers (CCBs) include the following, except: a) Peripheral oedema b) Gum hypertrophy c) Dyslipidaemia d) Negatively ionotropic
Ans 2:- [C]:- Peripheral oedema is caused by pre-capillary dilatation and, as with gum hypertrophy, occurs mostly in dihydropyridines. CCBs are negatively ionotropic and should be avoided in left ventricular dysfunction. Beta blockers rather than CCBs cause dyslipidaemia, reducing HDL and increasing triglycerides.
Q3:- The following is true of hypertension in the elderly, except: a) There is an age-associated increase in systolic blood pressure (SBP) b) There is decreased variability in blood pressure c) Beta-blocker use should be limited to specific indications d) There is good evidence for the treatment of hypertension in the very elderly (>80 years)
Ans :- [B]:- SBP increases with age whereas DBP plateaus at about age 60 resulting in an increased pulse pressure. The elderly have increased variability in their BP, and so several measurements should be made before diagnosis. Beta-blockers should be used in specific circumstances, such as with associated heart failure or CHD, as thiazide diuretics and ACE inhibitors have been shown to be more effective. The Hypertension in the Very Elderly Trial (HYVET) compared indapamide and perindopril treatment versus placebo for patients over the age of 80 with a SBP >160 mmHg. The treatment group had a significant reduction in stroke, mortality (stroke, cardiovascular, and all-cause), and heart failure.
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