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To ensure you have learned the key points that will improve your
patient care, read the authors’ questions below. Please refer back to
relevant sections of the book to address any areas of uncertainty.
1
The dangers of raised blood pressure
1. Treatment decisions for patients with hypertension should
be based on which of the following?
a)Both diastolic and systolic pressure in all patients
b)Either diastolic or systolic pressure in younger patients
c) Diastolic pressure alone in older patients
d)Systolic pressure alone in older patients
Reveal Answer
2. Which of the following is a direct effect of high blood pressure?
a)Left ventricular hypertrophy
b)Atherosclerosis
c) Renal failure
d)Heart failure
e) Diabetes mellitus
Reveal Answer
2
Causes
3. Which of the following statements are true?
a)Most hypertension is of unknown cause
b)On average, 50% of salt intake is within the control of the
consumer in developed countries
c) A high potassium intake protects against some of the effects of a
high salt intake on blood pressure
d)Regular aerobic activity may lower blood pressure, even without
weight loss
e) Renovascular hypertension is the most common cause of secondary
hypertension
Reveal Answer
4. Which of the following statements are true?
a)High alcohol consumption has a sustained effect on blood pressure
and increases the risk of vascular disease
b)Moderate alcohol consumption has a protective effect on the
development of atherosclerosis
c) Heavy alcohol consumption causes marked elevations in blood
pressure
d)Acute stress causes an increase in blood pressure
e) Studies have shown that relaxation therapy can consistently lower
blood pressure
Reveal Answer
3
Investigation
5. Which of the following tests should be routine for all
patients being considered for treatment for high blood
pressure?
a)Blood tests for potassium and cholesterol levels
b)Fasting blood sugar
c)Urinalysis
d)Renal and/or abdominal ultrasound
e)ECG
Reveal Answer
4
When to treat
6. Which of the following statements are true?
a)Treatment for hypertension in people over 60 years of age does not
confer such great benefits as treatment for hypertension in younger
people
b)Elevated diastolic and systolic blood pressure confers a greater risk
than isolated systolic hypertension in people over 60 years of age
c) Caution should be taken to avoid over-treatment of individuals
with atrial fibrillation or tight carotid or coronary stenoses
d)Drug treatment should be started immediately in all patients with
blood pressure ≥ 140/90 mmHg
Reveal Answer
5
How to treat
7. Which of the following drug classes can be used to treat
newly hypertensive patients with no history of ischemic
heart disease or heart failure?
a)Angiotensin-receptor blockers (ARBs)
b)Angiotensin-converting enzyme (ACE) inhibitors
c)Beta-blockers
d)Calcium antagonists
e)Alpha-blockers
Reveal Answer
8. Which of the following statements are true?
a)If a patient experiences side effects with first-line treatment for
hypertension, they should be switched to another first-line
treatment
b)If first-line treatment lowers but does not control blood pressure,
addition of a second drug should be considered
c) Older individuals (55 years and older) tend to respond best to an
ACE inhibitor or ARB
d)If blood pressure is not controlled with an ARB then an ACE
inhibitor should be added
e) Combination therapy may permit the use of lower doses, thus
reducing the risk of adverse events
Reveal Answer
9. Which of the following statements are true?
a)A reduction of daily salt intake from 10–12 g/day to 5–6 g/day has
been shown to be as effective in lowering blood pressure as a
thiazide diuretic
b)Patients with mild-to-moderate hypertension should be started on
drug treatment as soon as possible
c) ARBs are remarkably free from side effects and, in particular, only
rarely cause the cough or angioedema associated with ACE
inhibitors
d)Amlodipine is a short-acting calcium antagonist that has to be given
in a sustained-release format in order to be effective
e) Amiloride and spironolactone can cause a rise in plasma potassium
levels
Reveal Answer
6
Special patient groups
10.Which of the following statements are true?
a)Normal blood pressure in children varies with age, sex and height
b)Obesity is always the cause of hypertension in prepubertal children
c) ACE inhibitors and ARBs are the most effective first-line drug
treatments in older people
d)Thiazide diuretics, ARBs and ACE inhibitors are contraindicated
during pregnancy
e) First-line treatment for women with pregnancy-induced
hypertension (PIH) is bed rest and a calcium antagonist
Reveal Answer
11.Which of the following characterizes pre-eclampsia?
a)Raised blood pressure
b)Edema
c) Weight loss
d)Raised blood glucose
e)Proteinuria
Reveal Answer
7
Uncontrolled hypertension
12.Which of the following are causes of resistant (or
apparently resistant) hypertension?
a)
b)
c)
d)
e)
Excess alcohol intake
Intensive physical activity
Type 2 diabetes mellitus
Renal disease
Oral contraceptives
Reveal Answer