Lippincott's Cardio Questions with correct answers

17.1 A 45-year-old man was just started on therapy for hypertension and developed a persistent, dry cough. Which is most likely responsible for this side effect? A. Enalapril. B. Losartan. C. Nifedipine. D. Prazosin. E. Propranolol. - Answer A. The cough is most likely an adverse effect of the ACE inhibitor enalapril. Losartan is an ARB that has the same beneficial effects as an ACE inhibitor but is less likely to produce a cough. Nifedipine, prazosin, and propranolol do not cause this side effect. 17.2 Which may cause reflex tachycardia and/or postural hypotension on initial administration? A. Atenolol. B. Hydrochlorothiazide. C. Metoprolol. D. Prazosin. E. Verapamil. - Answer D. Prazosin produces first-dose hypotension, presumably by blocking α1 receptors. This effect is minimized by initially giving the drug in small, divided doses. The other agents do not have this adverse effect. 17.3 Which can precipitate a hypertensive crisis following abrupt cessation of therapy? A. Clonidine. B. Diltiazem. C. Enalapril. D. Losartan. E. Hydrochlorothiazide. - Answer A. Increased sympathetic nervous system activity occurs if clonidine therapy is abruptly stopped after prolonged administration. Uncontrolled elevation in blood pressure can occur. Patients should be slowly weaned from clonidine while other antihypertensive medications are initiated. The other drugs on the list do not produce this phenomenon. 17.4 A 48-year-old hypertensive patient has been successfully treated with a thiazide diuretic for the last 5 years. Over the last 3 months, his diastolic pressure has steadily increased, and he was started on an additional