CMN 572 TESTS III FINAL PAPER 2026 STUDY
GUIDE DETAILED ANSWERS READY
◉ Chemoprevention with nonsteroidal antiinflammatory (NSAIDs).
Answer: MAY reduce risk of colorectal adenomas and polyps but inc
risk of heart dx and GIB = not recommended for colon cancer
prevention in average risk patients
◉ Chemoprevention with antioxidant vitamin (E, C and beta
carotene).
Answer: No significant refuction in 5 year incident of mortality from
vascular, cancer, or other major outcomes in high risk patients with
CAD or other arterial disease or DM.
◉ Osteoporosis chemoprevention (p. 11).
Answer: Screening for women >65yo or younger at inc risk for fx
Low adherence to biphosphonate tx (femoral fx, jaw osteonecrosis)
◉ HTN stats.
Answer: >45% os US adults have BP >140/90 or are being tx for htn
- only controlled in 52% of ppl. SBP and PP better predictors >50yo.
More blacks than whites.
,◉ Measuring BP.
Answer: Cuff encircle 80% of the arm circumference, pt resting for at
least 5 min or at least 30 min after smoking or coffee. Ambulatory
pressures are better (white coat)
One single elevated BP not sufficient for tx.
Normal in office <120/80, elevate 120-129/80, st 1 130-139/80-89,
stage 2 >140/90
◉ HTN exacerbating factors (primary HTN).
Answer: Obesity, OSA(CPAP improves BP), inc salt intake, alcohol,
smoking, polycythemia, NSAIDs(avoid if high BP), low potassium
intake
Metabolic syndrome - waist, insulin resistance, triglycerimia) - high
c reactive protein and low hdl
◉ Genetics and HTN.
Answer: Glucocorticoid aldoteronism - autosomal dominant - early
onset
Mineralocorticoid excess - autosomal recessive
Licorice causes high BP
Pregnancy HTN - autosomal dominant
Gordon syndrome - autosomal dominant - thiazide diuretic
◉ Fibromuscular dysplasia.
,Answer: Most commonly affects renal artery and carotid artery in
women <50yo - HTN!
Renal causes - onset before 20 or after 50, resistant to drugs, no
atherosclerosis, no aorta problems, no pad, presence of pulm htn
◉ Primary hyperaldosteronism.
Answer: Adenoma of adrenal cortex (aldesterone elevated>16ng);
take plasma aldosterone/renin ratio, hold BP meds for 2-4 weeks,
replace with verapimil)
Resistant HTN
◉ Cushing syndrome and htn
Pheochromocytoma and htn.
Answer: cushing: Excess glucocorticoid - salt and water retention
pheo: cathecolamine excess - crisis precipitated by TCA,
antidopaminergics, naloxone, metoclopramine
◉ Drugs that can cause inc in BP.
Answer: Cyclosporine, tacrolumys, angiogenesis inhibitors, and
erythropoetin
NSAIDs, cocaine, alcohol
Yohimbine - libido - severe rebound with clonidine
, ◉ Most adverse events associated with HTN are seen with ___________
rather than ___________..
Answer: Thrombosis; rather than bleeding!
Remember that home and ambulatory BPs are superior to office
readings (major predisposing factor in all types of stroke - SBP)
◉ Labs for HTN.
Answer: Hemoglobin; serum electrolytes and serum creatinine;
fasting blood sugar level (hypertension is a risk factor for the
development of diabetes, and hyperglycemia can be a presenting
feature of pheochromocytoma); plasma lipids (necessary to
calculate cardiovascular risk and as a modifiable risk factor); serum
uric acid (hyperuricemia is a relative contraindication to diuretic
therapy); and urinalysis.
◉ Lifestyle modifications for HTN.
Answer: diet rich in fruits, vegetables, and low-fat dairy foods and
low in saturated and total fats (DASH diet) has been shown to lower
blood pressure. Increased dietary fiber lowers blood pressure. For
every 7 g of dietary fiber ingested, cardiovascular risk could be
lowered by 9%.
◉ HTN risk factors.
Answer: Hypertension1
Cigarette smoking
GUIDE DETAILED ANSWERS READY
◉ Chemoprevention with nonsteroidal antiinflammatory (NSAIDs).
Answer: MAY reduce risk of colorectal adenomas and polyps but inc
risk of heart dx and GIB = not recommended for colon cancer
prevention in average risk patients
◉ Chemoprevention with antioxidant vitamin (E, C and beta
carotene).
Answer: No significant refuction in 5 year incident of mortality from
vascular, cancer, or other major outcomes in high risk patients with
CAD or other arterial disease or DM.
◉ Osteoporosis chemoprevention (p. 11).
Answer: Screening for women >65yo or younger at inc risk for fx
Low adherence to biphosphonate tx (femoral fx, jaw osteonecrosis)
◉ HTN stats.
Answer: >45% os US adults have BP >140/90 or are being tx for htn
- only controlled in 52% of ppl. SBP and PP better predictors >50yo.
More blacks than whites.
,◉ Measuring BP.
Answer: Cuff encircle 80% of the arm circumference, pt resting for at
least 5 min or at least 30 min after smoking or coffee. Ambulatory
pressures are better (white coat)
One single elevated BP not sufficient for tx.
Normal in office <120/80, elevate 120-129/80, st 1 130-139/80-89,
stage 2 >140/90
◉ HTN exacerbating factors (primary HTN).
Answer: Obesity, OSA(CPAP improves BP), inc salt intake, alcohol,
smoking, polycythemia, NSAIDs(avoid if high BP), low potassium
intake
Metabolic syndrome - waist, insulin resistance, triglycerimia) - high
c reactive protein and low hdl
◉ Genetics and HTN.
Answer: Glucocorticoid aldoteronism - autosomal dominant - early
onset
Mineralocorticoid excess - autosomal recessive
Licorice causes high BP
Pregnancy HTN - autosomal dominant
Gordon syndrome - autosomal dominant - thiazide diuretic
◉ Fibromuscular dysplasia.
,Answer: Most commonly affects renal artery and carotid artery in
women <50yo - HTN!
Renal causes - onset before 20 or after 50, resistant to drugs, no
atherosclerosis, no aorta problems, no pad, presence of pulm htn
◉ Primary hyperaldosteronism.
Answer: Adenoma of adrenal cortex (aldesterone elevated>16ng);
take plasma aldosterone/renin ratio, hold BP meds for 2-4 weeks,
replace with verapimil)
Resistant HTN
◉ Cushing syndrome and htn
Pheochromocytoma and htn.
Answer: cushing: Excess glucocorticoid - salt and water retention
pheo: cathecolamine excess - crisis precipitated by TCA,
antidopaminergics, naloxone, metoclopramine
◉ Drugs that can cause inc in BP.
Answer: Cyclosporine, tacrolumys, angiogenesis inhibitors, and
erythropoetin
NSAIDs, cocaine, alcohol
Yohimbine - libido - severe rebound with clonidine
, ◉ Most adverse events associated with HTN are seen with ___________
rather than ___________..
Answer: Thrombosis; rather than bleeding!
Remember that home and ambulatory BPs are superior to office
readings (major predisposing factor in all types of stroke - SBP)
◉ Labs for HTN.
Answer: Hemoglobin; serum electrolytes and serum creatinine;
fasting blood sugar level (hypertension is a risk factor for the
development of diabetes, and hyperglycemia can be a presenting
feature of pheochromocytoma); plasma lipids (necessary to
calculate cardiovascular risk and as a modifiable risk factor); serum
uric acid (hyperuricemia is a relative contraindication to diuretic
therapy); and urinalysis.
◉ Lifestyle modifications for HTN.
Answer: diet rich in fruits, vegetables, and low-fat dairy foods and
low in saturated and total fats (DASH diet) has been shown to lower
blood pressure. Increased dietary fiber lowers blood pressure. For
every 7 g of dietary fiber ingested, cardiovascular risk could be
lowered by 9%.
◉ HTN risk factors.
Answer: Hypertension1
Cigarette smoking
