special considerations for Thiazides - ./ ./ ./ ./
correct answer Chlorthalidone is preferred on the basis of prolon
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ged half-life and proven trial reduction of CVD.
./ ./ ./ ./ ./ ./ ./
Monitor for hyponatremia and hypokalemia, monitor uric acid an
./ ./ ./ ./ ./ ./ ./ ./
d calcium levels.
./ ./
Use with caution in patients with history of acute gout unless pati
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ent is on uric acid-lowering therapy.
./ ./ ./ ./ ./
special considerations for ACE inhibitors -
./ ./ ./ ./ ./
correct answer Do not use in combination with ARBs or direct re
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
nin inhibitor. ./
There is an increased risk of hyperkalemia, especially in patients
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
with CKD or in those on K+ supplements or K+-sparing drugs.
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
There is a risk of acute renal failure in patients with severe bilater
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
al renal artery stenosis.
./ ./ ./
,Do not use if patient has history of angioedema with ACE inhibit
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ors.
ACE inhibitor cough is common, in 5 to 20 percent of patients, du
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
e to bradykinin production.
./ ./ ./
Avoid in pregnant females or females of reproductive age withou
./ ./ ./ ./ ./ ./ ./ ./ ./
t adequate contraception
./ ./
special considerations for Angiotensin receptor blockers -
./ ./ ./ ./ ./ ./
correct answer Do not use in combination with ACE inhibitors or
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
direct renin inhibitor.
./ ./ ./
There is an increased risk of hyperkalemia in CKD or in those on
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
K+ supplements or K+-sparing drugs.
./ ./ ./ ./
There is a risk of acute renal failure in patients with severe bilater
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
al renal artery stenosis.
./ ./ ./
,Do not use if patient has history of angioedema with ARBs. Patie
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
nts with a history of angioedema with an ACE inhibitor can recei
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ve an ARB beginning 6 weeks after ACE inhibitor is discontinue
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
d.
Avoid in pregnant females or females of reproductive age withou
./ ./ ./ ./ ./ ./ ./ ./ ./
t adequate contraception.
./ ./
Lower risk of cough than ACE-Is.
./ ./ ./ ./ ./
special considerations for Calcium channel blockers -
./ ./ ./ ./ ./ ./
correct answer Associated with dose-
./ ./ ./ ./ ./
related pedal edema, which is more common in females than men
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
.
When should you Refer to a Nephrologist or Cardiologist in a hyp
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ertensive patient? - correct answer -signs of end-organ damage
./ ./ ./ ./ ./ ./ ./ ./
-evidence of a secondary cause of hypertension ./ ./ ./ ./ ./ ./
-only on one to two medications
./ ./ ./ ./ ./
Generally, failure to achieve blood pressure goal in patients who
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
are adhering to full doses of an appropriate three to four drug regi
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
, men that includes a diuretic may warrant referral to a nephrologis
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
t or cardiologist
./ ./
Before referring, clinicians should first review other causes of ina
./ ./ ./ ./ ./ ./ ./ ./ ./
dequate hypertension control such as:./ ./ ./ ./
-Improper blood pressure measurement ./ ./ ./
-White coat hypertension ./ ./
-Excess sodium intake ./ ./
-Medication issues (e.g., nonsteroidal anti- ./ ./ ./ ./
inflammatory drugs (NSAIDs), illicit drugs, sympathomimetics, ./ ./ ./ ./ ./ ./
oral contraceptives)./
-Excess alcohol intake ./ ./
-
Underlying identifiable causes of hypertension (secondary hypert
./ ./ ./ ./ ./ ./
ension)
A researcher is studying potential risk factors for obesity. She sen
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
ds a questionnaire to 5000 patients who meet the CDC criteria for
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ .
obesity that asks them about sedentary lifestyle factors, consumpt
/ ./ ./ ./ ./ ./ ./ ./ ./
ion of processed food, and family history of obesity. The research
./ ./ ./ ./ ./ ./ ./ ./ ./ ./
er sends the same questionnaire to 5000 patients who are not obes
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./
e. Which of the following best describes the design of the study?
./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./