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All the following features favor ventricular tachycardia as the cause of broad-complex
tachycardia, EXCEPT:
A.
QRS duration with right bundle branch block morphology (RBBB) is greater than 140
ms, and greater than 160 ms with left LBBB morphology
B.
LAD with RBBB morphology, extreme LAD (northwest axis) with LBBB morphology
C.
AV dissociation
D.
Response to carotid sinus massage
E.
Concordance of the QRS pattern in all precordial leads (i.e., all positive or all negative
deflections)
ANSWER: D
Which of the following will most likely respond to verapamil?
A.
RVOT tachycardia
B.
Idiopathic LV tachycardia
C.
Bundle branch re-entry tachycardia
D.
ARVD ventricular tachycardia
E.
All of the above
ANSWER: B
The most common type of arrhythmia in WPW syndrome is....
A.
Ventricular tachycardia
B.
Ventricular fibrillation
C.
Ventricular premature complexes
D.
Atrial ectopics
E.
AV re-entry tachycardia
ANSWER: E
When TTE is technically difficult, MRI is needed to exclude cardiac abnormalities. Which is the
preferred initial treatment strategy for rate control in AF patients?
A.
Digoxin
B.
Beta-blockers or rate limiting CCB
C.
Combination therapy of beta-blockers and rate-limiting CCB’s
D.
Amiodarone
E.
Combination therapy of digoxin and beta-blockers
ANSWER: B
Which option is better in regard to cardioversion?
A.
Synchronised DC shock to restore sinus rhythm
B.
Amiodarone in all patients to restore sinus rhythm
C.
Flecainide in patients with IHD to maintain sinus rhythm
D.
Digoxin to restore sinus rhythm
E.
Propaphenone to restore sinus rhythm in HCMP patients
ANSWER: A
Regarding antithrombotic treatment in AF:
A.
Patients with asymptomatic AF have less risk of embolism than symptomatic patients
B.
Patients with atrial flutter do not need antithrombotic treatment due to the low risk of
embolism of this arrhythmia
C.
Warfarin is the best option in patients with high risk of thromboembolism
D.
Aspirin has a similar effect in stroke reduction to placebo
E.
Paroxysmal AF has the lowest risk of embolism
ANSWER: C
8.
Sudden cardiac death in patients >35 years old is most commonly associated with:
A.
Hypertrophic cardiomyopathy
B.
Coronary artery disease
C.
Congenital long QT syndrome
D.
Long QT syndrome secondary to various medications
E.
arrhythymogenic RV cardiomyopathy
ANSWER: B
Congenital long QT syndrome can lead to
A.
Complete heart block
B.
Polymorphic ventricular tachycardia
C.
Acute myocardial infarction
D.
Recurrent supraventricular tachycardia
E.
All of the above
ANSWER: B
Bundle branch re-entry ventricular tachycardia is most commonly associated with:
A.
Enhanced automaticity in the right bundle
B.
Enhanced automaticity in the left bundle
C.
Supranormal conduction in the His bundle
D.
Abnormally slow conduction in the His bundle
E.
All of the above
ANSWER: D
11.
All of the following are ECG manifestations of Wolff-Parkinson-White syndrome
EXCEPT
A.
Narrow QRS
B.
Initial slurred QRS upstroke
C.
Short PQ interval
D.
Normal QT interval
E.
All of the above
ANSWER: A
The initial manifestations of WPW syndrome may include which of the following?
A.
Atrial fibrillation
B.
AV re-entry tachycardia
C.
Ventricular fibrillation
D.
Wide-QRS tachycardia
E.
All of the above
ANSWER: E
The presence of an r prime in V1 during narrow-QRS tachycardia is suggestive of...
A.
AV re-entry
B.
AV node re-entry
C.
Rate-dependent BBB
D.
Atrial tachycardia
E.
Atrial fibrillation
ANSWER: B
Ventricular ectopic beats (VEBs) occurring in apparently normal hearts are:
A.
Associated with a bad prognosis
B.
Never frequent or complex
C.
Less frequent with increasing age
D.
May be associated with symptoms of “missed beats”
E.
Always symptomatic
ANSWER: D
In patients with ventricular ectopic beats:
A.
Caffeine restriction always reduces symptoms
B.
High caffeine intake should always be discouraged in symptomatic patients
C.
There is good evidence that reducing caffeine intake reduces ectopics
D.
Hypertension has no association with frequency of ectopic beats
E.
LVH is not associated with increased frequency of ectopics
ANSWER: B
Regarding ventricular ectopics and exercise:
A.
Ectopics are usually benign if they are supressed on exercise
B.
Exercise-induced VEBs are not associated with adverse prognosis
C.
RVOT ectopics are usually supressed on exercise
D.
Ectopics induced on recovery after exercise are benign
E.
All of the above
ANSWER: A
An idiopathic left ventricular tachycardia (VT) shows the following...
A.
Typical LBBB morphology
B.
LAD and RBBB morphology
C.
Associated with a high risk of sudden cardiac death and almost always requires ICD
therapy
D.
Never responds to verapamil
E.
All of the above
ANSWER: B
Beta blockers are accepted treatment to prevent VT in:
A.
Brugada syndrome, RVOT-VT, short QT syndrome and long QT syndrome
B.
Brugada syndrome, RVOT-VT and long QT syndrome
C.
RVOT-VT and long QT syndrome
D.
Short QT syndrome and long QT syndrome
E.
Brugada syndrome and short QT syndrome
ANSWER: C
When present, each of the following heart sounds occurs shortly after S2 EXCEPT:
A.
Opening snap
B.
Third heart sound
C.
Ejection clic
D.
Tumor plop
E.
Pericardial knock
ANSWER: C
Each of the following statements regarding splitting of the second heart sound is true EXCEPT:
A.
Severe pulmonic valvular stenosis is associated with a softened P2
B.
Delayed closure of the pulmonic valve with inspiration contributes to physiologic
splitting of S2
C.
Fixed splitting of S2 is the auscultatory hallmark of an ostium secundum atrial septal
defect
D.
Paradoxical splitting of S2 is expected in patients with a right ventricular electronically
paced rhythm
E.
Right bundle branch block is associated with paradoxical splitting of S2
ANSWER: E
The timing of an "innocent" murmur is usually:
A.
Early systolic
B.
Presystolic
C.
Midsystolic
D.
Holosystolic
E.
Early diastolic
ANSWER: C
Which of the following pairs of medical conditions and antihypertensive medications would be
incorrect to use in a patient with essential hypertension?
A.
Beta-blocker and a history of myocardial infarction
B.
Alpha-blocker and prostatic hypertrophy
C.
Thiazide diuretic and gout
D.
Amlodipine and heart failure
E.
ACE-inhibitor and diabetes mellitus
ANSWER: C
Thiazide diuretics can contribute to each of the following metabolic effects EXCEPT:
A.
Hypomagnesemia
B.
Hypouricemia
C.
Hypercalcemia
D.
Hypercholesterolemia
E.
Hyponatremia
ANSWER: B
Which of the following statements regarding prevention of stroke is correct?
A.
Treatment of systolic hypertension does not decrease the risk of stroke in patients older
than age 60
B.
Hypertension should not be a target of secondary prevention after an ischemic stroke
because elevated BP is desirable to maintain adequate cerebral perfusion
C.
Treatment with HMG-CoA reductase inhibitors reduces the risk of recurrent stroke
D.
The combination of aspirin and clopidogrel is superior to aspirin alone for prevention of
recurrent stroke
E.
None of the above
ANSWER: C
You see a diabetic patient presents with BP readings that are 155/95 or higher. All of the
following statements about the treatment of this patient's hypertension are correct EXCEPT:
A.
Pharmacologic blocade of the renin-angiotensin system reduces the risk of both
microvascular and macrovascular events
B.
Aggressive BP control reduces cardiovascular events more in diabetics than in
nondiabetics
C.
Calcium channel blockers show no benefit in reducing cardiovascular events
D.
The goal BP for this patient is <130/80 mmHg
E.
All the above statements are correct
ANSWER: C
Which of the following antihypertensive agents is a known cause of autoimmune hemolytic
anemia?
A.
Metoprolol
B.
Methyldopa
C.
Captopril
D.
Losartan
E.
Monoxidine
ANSWER: B
All of the following characteristics are typical of hypertensive crisis EXCEPT:
A.
Diastolic BP >120 mmHg
B.
Retinal hemorrhages
C.
Constriction of cerebral arterioles with decreased vascular permeability
D.
Proteinuria
E.
Microangiopathic hemolytic anemia
ANSWER: C
Which of the following pairs of medical conditions and antihypertensive medications would be
INCORRECT to use in a patient with essential hypertension?
A.
Beta-blocker and a history of myocardial infarction
B.
Alpha-blocker and prostatic hypertrophy
C.
Thiazide diuretic and gout
D.
Amlodipine and heart failure
E.
ACE-inhibitor and diabetes mellitus
ANSWER: C
Which of the following statements regarding antihypertensive agents and atrial fibrillation (AF)
is TRUE?
A.
Losartan has been shown to decrease new-onset AF more effectively than atenolol
B.
Valsartan has been shown to decrease new-onset AF more effectively than amlodipine
C.
Atenolol has been shown to decrease new-onset AF more effectively than captopril
D.
Nifedipine has been shown to decrease new-onset AF more effectively than diltiazem
E.
All of the above are false
ANSWER: A
Which lifestyle change has been shown to produce the biggest reduction in systolic blood
pressure?
A.
10-kg weight loss
B.
Dietary sodium reduction
C.
Moderation of alcohol consumption
D.
Change to a vegetarian diet
E.
Magnesium supplement
ANSWER: A
35.
Which of these statements is true regarding renin-angiotensin system-blocking agents?
A.
Less effective when combined with a diuretic than when used alone
B.
More effective in patients of African descent than in white patients
C.
Preserve kidney function in addition to lowering blood pressure
D.
Are the first-line antihypertensive medications in pregnancy
E.
All of the above
ANSWER: C
36.
Which of the following antihypertensive agents is INCORRECTLY matched with the
indication for therapy?
A.
ACE inhibitor – diabetic nephropathy
B.
Beta-blocker – coronary artery disease
C.
Calcium channel blocker – angina pectoris
D.
Hydrochlorthiazide – diabetes mellitus
E.
Loop diuretic – heart failure
ANSWER: D
Which of the following statements about microalbuminuria is TRUE?
A.
To be of clinixal value, microalbuminuria must be measured in a timed 12- to 24-hour
sample
B.
Microalbuminuria is a cardiovascular risk factor that is independent of traditional
Framingham risk factors
C.
Microalbuminuria is a predictor of risk only in patients with diabetes
D.
Microalbuminuria is present when the “spot” urine albumin-to-creatinine ration is >500
mg/g
E.
All of the above statements are correct
ANSWER: B
Renin-dependent hypertension includes:
A.
Primary hyperaldosteronism
B.
Essential hypertension
C.
Renovascular hypertension
D.
Pheochromocytoma
E.
Cushing syndrome
ANSWER: C
A young hypertensive patient has serum potassium 2.8 mEq/l and increased aldosterone level
with decreased plasma renin activity. The likely diagnosis is....
A.
Renal artery stenosis
B.
Ectopic ACTH syndrome
C.
Conn syndrome
D.
Liddle syndrome
E.
Cushing syndrome
ANSWER: C
The proportion of essential (primary) hypertension among all hypertension causes is as high as
A.
25-30%
B.
40-45%
C.
60-65%
D.
70-75%
E.
90-95%
ANSWER: E
All of the following are risk factors for hypertension, EXCEPT
A.
Increased body weight
B.
Family history of hypertension
C.
Excessive intake of sodium
D.
Regular use of one glass of wine per day
E.
Cigarette smoking
ANSWER: D
Optimal blood pressure (BP) is defined as a BP level of
A.
<120/80 mmHg
B.
<130/80 mmHg
C.
<140/90 mmHg
D.
<160/100 mmHg
E.
<125/80 mmHg
ANSWER: A
Which parameter of arterial blood pressure (BP) yields the best prognostic information in
patients at risk for cardiovascular disease?
A.
Systolic BP
B.
Diastolic BP
C.
Mean arterial BP
D.
Pulse pressure
E.
None
ANSWER: D
Which BP profile below identifies the patient with the highest risk for development of
cardiovascular complications?
A.
160/90 mmHg
B.
160/65 mmHg
C.
140/100 mmHg
D.
130/90 mmHg
E.
120/70 mmHg
ANSWER: B
Physicians should diagnose isolated office hypertension (so-called “white-coat hypertension”)
whenever office BP is ?140/90 mmHg at several visits, while 24-h ambulatory BP is
A.
<160/100 mmHg
B.
<140/90 mmHg
C.
<130/85 mmHg
D.
<125/80 mmHg
E.
<120/70 mmHg
ANSWER: C
Target organs in hypertension include all of the following EXCEPT
A.
Brain and eyes
B.
Heart
C.
Kidneys
D.
Peripheral arteries
E.
Liver
ANSWER: E
In patients with a history of stroke or TIA the preferred drug combination is:
A.
ACE-inhibitor and diuretic
B.
Calcium-channel blocker and beta-blocker
C.
Beta-blocker and diuretic
D.
Angiotensin receptor blocker and beta blocker
E.
Beta- and alpha blocker
ANSWER: A
Grades 1 and 2 arteriolar retinal changes do not have a significant prognostic value. The initial
antihypertensive medication recommended for patients who have no compelling indications or
contraindications is
A.
ACE-inhibitor
B.
Calcium-channel blocker
C.
Diuretics
D.
Beta blocker
E.
Any of the above
ANSWER: E
A 40-year-old diabetic patient presents with a blood pressure (BP) of 145/90 mmHg and
proteinuria. Which BP profile represents the best therapeutic goal for this patient?
A.
<160/90
B.
<140/90
C.
<130/85
D.
<125/75
E.
<140/85
ANSWER: C
In the elderly with systolic hypertension antihypertensive therapy should be initiated if SBP
A.
?120 mmHg
B.
?130 mmHg
C.
?140 mmHg
D.
?160 mmHg
E.
?170 mmHg
ANSWER: C
The best medication for the treatment of isolated systolic hypertension in the elderly:
A.
ACE-inhibitor and diuretic
B.
Dihydropiridine calcium-channel blocker and diuretic
C.
Beta-blocker and diuretic
D.
Non-dihydropiridine calcium-channel blocker and diuretic
E.
Beta- and alpha blocker
ANSWER: B
The following medications can be used in pregnancy EXCEPT
A.
Methyldopa
B.
Labetalol
C.
ACE-inhibitor / ARB
D.
Hydralazine
E.
Nifidipine
ANSWER: C
In patients of African descent the drug of choice for initial treatment of hypertension is:
A.
Verapamil
B.
Atenolol
C.
Perindopril
D.
Hydrochlorothiazide
E.
Amlodipine
ANSWER: D
Which of the following antihypertensive agents is INCORRECTLY matched with the indication
for therapy?
A.
ACE inhibitor – diabetic nephropathy
B.
Beta-blocker – coronary artery disease
C.
Calcium channel blocker – angina pectoris
D.
Diuretics – heart failure
E.
Loop diuretic – gout
ANSWER: E
All the following patients should be evaluated for secondary causes of hypertension EXCEPT
A.
A 47-year-old male with strong family history hypertension who presents to your office
with a BP of 150/100
B.
A 26-year-old female with hematuria and a family history of early renal failure who has a
BP of 160/90
C.
A 73-year-old male with no past history with a BP of 165/90
D.
A 58-year-old male with a history of hypertension since age 45 whose BP has become
increasingly difficult to control on four antihypertensive agents
E.
A 31-year-old female with complaints of severe headaches, weight gain, and new-onset
DM with a BP of 145/90
ANSWER: A
Which of the following diagnostic studies is most likely to demonstrate the cause of the
headaches?
A.
MRI of the head
B.
MRI of the kidney
C.
MRI of the thorax
D.
24-h urinary 5-HIAA
E.
24-h urinary free cortisol
ANSWER: C
What is the correct feature of the hypertensive urgency?
A.
It is always a life-threatening situation
B.
Patient must be hospitalized
C.
Patients can be managed as outpatients
D.
Therapy should not be given orally
E.
None of the above
ANSWER: C
If there is suspicion of phaeochromocytoma, the first line drug is:
A.
Sodium-nitroprusside
B.
Nifedipine
C.
Phentolamine
D.
Verapamil
E.
Enalapril
ANSWER: C
If you are in your office and a patient sees you with the following symptoms:
A.
long history of hypertension, home BP usually 160/100 mmHg
B.
suddenly developed severe headache
C.
blurred vision
D.
weakness in the right arm
E.
blood pressure: 200/110 mmHg
ANSWER: A
What will you do:
A.
Give the patient 20 mg nifedipine orally, and check the BP in 15 min. If it is still
>200/100 mmHg, give another dose of nifedipine
B.
Give the patient 20 mg nifedipine, and check the BP in 30 min. If it is 160/80 mmHg,
send the patient home and give another appointment in two weeks
C.
Give the patient 10 mg amlodipine, send the patient home and give another appointment
in two days
D.
Call the ambulance and send the patient to the nearest hospital
E.
Give the patient some pain-killer drug (e.g. acetaminophen), call the ambulance and send
the patient to the nearest hospital with stroke-unit
ANSWER: E
A rise in SBP ?25 mmHg or a rise in DPB ?15 mmHg compared to pre-pregnancy values, or
those in the first trimester. The following drug combinations are effective to treat hypertension
EXCEPT
A.
Diuretics + beta-blockers
B.
Beta-blockers + dihydropiridine calcium channel blockers
C.
Diuretics + ACE-inhibitors/ARB
D.
ACE-inhibitors/ARB + calcium channel blockers
E.
Beta-blockers + ACE-inhibitors/ARB
ANSWER: E
Each of the following statements regarding hypertension is true EXCEPT:
A.
Pure "white coat hypertension is found in 20 to 30% of patients
B.
When measuring BP, an inappropriately small cuff size results in a spuriously low
systolic measurement
C.
Pseudohypertension may occur in patients with sclerotic brachial arteries
D.
Chronic renal disease is the second most common cause of hypertension after essential
hypertension
E.
Coarctation of the aorta, Cushing disease, primary aldosteronism account for
approximately 1% of all hypertensive patients
ANSWER: B
With respect to renovascular disease, all of the statements are true EXCEPT:
A.
Worsening renal function with ACE-inhibitor therapy suggests bilateral renovascular
disease
B.
Atherosclerotic disease most commonly involves the proximal third of the main renal
artery
C.
The most common form of fibroplastic renovascular disease in adults involves the media
D.
The incidence of renovascular hypertension falls with increased age
E.
Patients with severe, accelerated hypertension have the highest prevalence of
renovascular disease
ANSWER: D
Each of the following statements regarding pheochromocytoma is true EXCEPT:
A.
Approximately 15% of pheochromocytomas are extra-adrenal
B.
Ten percent of pheochromocytomas are malignant
C.
Ten percent of adrenal pheochromocytomas are bilateral
D.
Hypertension related to pheochromocytoma is nearly always episodic and only rarely
persistent
E.
Pheochromocytoma can be inherited
ANSWER: D
A newly diagnosed diabetic patient presents with BP readings that are 155/95 or higher. All of
the following statements about the treatment of this patient's hypertension are correct EXCEPT:
A.
Pharmacologic blockade of the renin-angiotensin system reduces the risk of both
microvascular and macrovascular events
B.
Aggressive BP control reduces cardiovascular events more in diabetics than in
nondiabetics
C.
Calcium channel blockers show no benefit in reducing cardiovascular events
D.
The goal BP for this patient is <130/80 mmHg
E.
All the above statements are correct
ANSWER: C
All of the following statements regarding the association of oral contraceptive pills and
hypertension are correct EXCEPT:
A.
The likelihood of developing hypertension is increased by significant alcohol
consumption
B.
The incidence of hypertension is about twice as great in pill users as in non-users
C.
The likelihood of developing hypertension is dependent on the age of the user
D.
Hypertension resolves in almost all cases after discontinuation of oral contraceptives
E.
The mechanism for contraceptive-induced hypertension likely involves reninaldosterone-mediated volume expansion
ANSWER: D
All of the following are features of renovascular hypertension due to fibromuscular hyperplasia,
as opposed to atherosclerosis, EXCEPT:
A.
Age <50 years
B.
Female gender
C.
More likely to progress to complete renal artery occlusion
D.
No family history of hypertension
E.
Absence of carotid bruits
ANSWER: C
Which of the following ACE-inhibitors are not prodrugs?
A.
Captopril, lisinopril, ramipril
B.
Lisinopril, enalapril, banazepril
C.
Captopril, lisinopril, enalaprilat
D.
Moexipril, captopril, lisinopril
E.
Perindopril, ramipril, enalapril
ANSWER: C
Each of the following statements regarding hypertension is true EXCEPT:
A.
The prevalence of hypertension rises progressively with age in both men and women
B.
Systolic and diastolic hypertension are each associated with an increased crisk of
coronary heart disease
C.
The target blood pressure for hypertensive patients with cardiovascular disease or
diabetes is 140/90 mmHg
D.
Patients with prehypertension (SBP 120-139 mmHg or DBP 80-89 mmHg) benefit from
lifestyle modifications incl. weight reduction, regular exercise, and smoking cessation
E.
Drug therapy of hypertension benefits patients greater than 80 years of age
ANSWER: C
All of the following interventions have a BP-lowering effect EXCEPT:
A.
A diet that reduces caloric intake by 1000 calories per day
B.
Reduction of dietary sodium
C.
Daily magnesium supplements
D.
Tobacco cessation
E.
Reduction of ethanol consumption to less than 30 ml/day
ANSWER: C
Each of the following statements regarding hypertension is true EXCEPT:
A.
Increased LV muscle mass in hypertension is an independent risk factor of cardiac
mortality
B.
The risk of ventricular arrhythmias in hypertension is increased 2-fold in the presence of
LV hypertrophy
C.
Low birth weight is associated with an increased incidence of hypertension later in life
D.
Chronic caffeine consumption is associated with an increased risk of hypertension
E.
In hypertensive adolescents, essential hypertension is the most likely etiology
ANSWER: D
The following statements regarding the association of oral contraceptive pills and hypertension
are correct EXCEPT:
A.
The likelihood of developing hypertension is increased by significant alcohol
consumption
B.
The incidence of hypertension is about twice as great in pill users as in non-users
C.
The likelihood of developing hypertension is dependent on the age of the user
D.
Hypertension resolves in almost all cases after discontinuation of oral contraceptives
E.
The mechanism for contraceptive-induced hypertension likely involves reninaldosterone-mediated volume expansion
ANSWER: D
Thiazide diuretics can contribute to each of the following metabolic effects EXCEPT:
A.
Hypomagnesemia
B.
Hypouricemia
C.
Hypercalcemia
D.
Hypercholesterolemia
E.
Hyponatremia
ANSWER: B
Which of the following statements regarding prevention of stroke is correct?
A.
Treatment of systolic hypertension does not decrease the risk of stroke in patients older
than age 60
B.
Hypertension should not be a target of secondary prevention after an ischemic stroke
because elevated BP is desirable to maintain adequate cerebral perfusion
C.
Treatment with HMG-CoA reductase inhibitors reduces the risk of recurrent stroke
D.
The combination of aspirin and clopidogrel is superior to aspirin alone for prevention of
recurrent stroke
E.
None of the above
ANSWER: C
Which of the following antihypertensive agents is a known cause of autoimmune hemolytic
anemia?
A.
Metoprolol
B.
Methyldopa
C.
Captopril
D.
Losartan
E.
Monoxidine
ANSWER: B
All of the following characteristics are typical of hypertensive crisis EXCEPT:
A.
Diastolic BP >120 mmHg
B.
Retinal hemorrhages
C.
Constriction of cerebral arterioles with decreased vascular permeability
D.
Proteinuria
E.
Microangiopathic hemolytic anemia
ANSWER: C
Which of the following pairs of medical conditions and antihypertensive medications would be
INCORRECT to use in a patient with essential hypertension?
A.
Beta-blocker and a history of myocardial infarction
B.
Alpha-blocker and prostatic hypertrophy
C.
Thiazide diuretic and gout
D.
Amlodipine and heart failure
E.
ACE-inhibitor and diabetes mellitus
ANSWER: C
Which lifestyle change has been shown to produce the biggest reduction in systolic blood
pressure?
A.
10-kg weight loss
B.
Dietary sodium reduction
C.
Moderation of alcohol consumption
D.
Change to a vegetarian diet
E.
Magnesium supplement
ANSWER: A
Which of the following statements regarding antihypertensive agents and atrial fibrillation (AF)
is TRUE?
A.
Losartan has been shown to decrease new-onset AF more effectively than atenolol
B.
Valsartan has been shown to decrease new-onset AF more effectively than amlodipine
C.
Atenolol has been shown to decrease new-onset AF more effectively than captopril
D.
Nifedipine has been shown to decrease new-onset AF more effectively than diltiazem
E.
All of the above are false
ANSWER: A
Which of these statements is true regarding renin-angiotensin system-blocking agents?
A.
Less effective when combined with a diuretic than when used alone
B.
More effective in patients of African descent than in white patients
C.
Preserve kidney function in addition to lowering blood pressure
D.
Are the first-line antihypertensive medications in pregnancy
E.
All of the above
ANSWER: C
Which of the following antihypertensive agents is INCORRECTLY matched with the indication
for therapy?
A.
ACE inhibitor – diabetic nephropathy
B.
Beta-blocker – coronary artery disease
C.
Calcium channel blocker – angina pectoris
D.
Hydrochlorthiazide – diabetes mellitus
E.
Loop diuretic – heart failure
ANSWER: D
Which of the following statements about microalbuminuria is TRUE?
A.
To be of clinixal value, microalbuminuria must be measured in a timed 12- to 24-hour
sample
B.
Microalbuminuria is a cardiovascular risk factor that is independent of traditional
Framingham risk factors
C.
Microalbuminuria is a predictor of risk only in patients with diabetes
D.
Microalbuminuria is present when the “spot” urine albumin-to-creatinine ration is >500
mg/g
E.
All of the above statements are correct
ANSWER: B
Renin-dependent hypertension includes:
A.
Primary hyperaldosteronism
B.
Essential hypertension
C.
Renovascular hypertension
D.
Pheochromocytoma
E.
Cushing syndrome
ANSWER: C
A young hypertensive patient has serum potassium 2.8 mEq/l and increased aldosterone level
with decreased plasma renin activity. The likely diagnosis is....
A.
Renal artery stenosis
B.
Ectopic ACTH syndrome
C.*
Conn syndrome
D.
Liddle syndrome
E.
Cushing syndrome
ANSWER: C
The proportion of essential (primary) hypertension among all hypertension causes is as high as
A.
25-30%
B.
40-45%
C.
60-65%
D.
70-75%
E.
90-95%
ANSWER: E
All of the following are risk factors for hypertension, EXCEPT
A.
Increased body weight
B.
Family history of hypertension
C.
Excessive intake of sodium
D.
Regular use of one glass of wine per day
E.
Cigarette smoking
ANSWER: D
All of the following statements concerning hypertension are true, EXCEPT
A.
In a western adult population the prevalence of hypertension exceeds 20%
B.
Hypertension is a major risk factor for cardiovascular and cerebrovascular disease
C.
The pathophysiology of hypertension differs in black adults compared to South Asians
and whites
D.
People of African descent commonly have a high renin type hypertension
E.
An increase in potassium intake may significantly reduce blood pressure in hypertensive
patients
ANSWER: D
The results of the glucose tolerance test: a fasting serum glucose is 5,7 mmol/l, 2-hour
postprandial serum glucose is 7,4 mmol/l. What is your diagnosis?
A.
Normal.
B.
Impaired glucose tolerance.
C.
Diabetes mellitus.
D.
Impaired fast glucose tolerance.
E.
Neither
ANSWER: D
All the following are forms or complications of nonproliferative (background) diabetic
retinopathy EXCEPT
A.
retinal detachment
B.
increased capillary permeability
C.
microaneurysms
D.
cotton-wool spots
E.
dot and blot hemorrhages
ANSWER: A
The risk for which endocrine problem increases with aging?
A.
Hyperthyroidism
B.
Diabetes mellitus
C.
Diabetes insipidus
D.
Cushing’s disease
E.
Non of above
ANSWER: B
All the following interact with seven-transmembrane- domain receptors EXCEPT
A.
LH
B.
insulin
C.
TSH
D.
parathyroid hormone
E.
epinephrine
ANSWER: B
The complication of diabetes which cannot be preventing by strict control of blood sugar is:
A.
amyotrophy
B.
nerve conductivity
C.
fluorescein leak
D.
microalbuminuria
E.
retinopathy
ANSWER: E
Which situation or condition is likely to result in an increased production of thyroid hormones?
A.
Starvation
B.
Dehydration
C.
Adequate sleep
D.
Cold environmental temperature
E.
Non of above
ANSWER: D
Which test results should the physician check to ascertain how well the patient is managing her
diabetes mellitus overall?
A.
Blood glucose level
B.
Glucose tolerance test
C.
Glycosylated hemoglobin
D.
Radioimmunoassay of insulin
E.
None of above
ANSWER: C
For what complications is the patient with hypercortisolism at greater risk?
A.
Skin breakdown, infection, GI ulceration
B.
Anorexia, constipation, hypotension
C.
Kidney stones, weight loss, cataracts
D.
Diabetes insipidus, bradycardia, arthritis
E.
Non of above
ANSWER: A
Which serum electrolyte values alert the physician to the possibility of hyperaldosteronism?
A.
Serum sodium 150 mmol/L, serum potassium 2.5 mmol/L
B.
Serum sodium 140 mmol/L, serum potassium 5.0 mmol/L
C.
Serum sodium 130 mmol/L, serum potassium 2.5 mmol/L
D.
Serum sodium 130 mmol/L, serum potassium 7.5 mmol/L
E.
Non of above
ANSWER: A
Which of the following statements regarding thyroid disorders is true?
A.
The presence of a “goiter” always indicates hypothyroidism.
B.
The effects of thyroid dysfunction are found in all body tissues and organs.
C.
The hormones synthesized by the thyroid gland are not essential for life.
D.
The effects of hypothyroidism are less serious than those of hyperthyroidism.
E.
Non of above
ANSWER: B
Which manifestation of Graves’ disease is unaffected by medical treatment for the
hyperthyroidism?
A.
Thinning hair
B.
Exophthalmos
C.
Weight loss
D.
Tachycardia
E.
Non of above
ANSWER: B