PACKRAT Exam Study Guide | 100% Correct Answers | Verified | Latest 2024 Version

1. Health Maintenance/Obstetrics/Gynecology Which of the following portends the greatest risk for the development of breast cancer? A. Nulliparity B. Early menarche C. BRCA 1 positivity D. Maternal family history of breast cancer - (u) A. See C for explanation. (u) B. See C for explanation. (c) C. BRCA1 positivity is associated with half of the early onset breast cancers and 90% of the hereditary ovarian cancers. (u) D. See C for explanation. 2. Clinical Therapeutics/Urology/Renal In order to help delay the progression to kidney disease in a diabetic patient with proteinuria, which of the following would you consider using to treat the patient's concomitant hypertension? A. Atenolol (Tenormin) B. Amlodipine (Norvasc) C. Accupril (Quinapril) D. Amiloride (Midamor) - (u) A. Atenolol is a beta blocker. Beta blockers are not first line therapy for hypertensive diabetics. (u) B. Amlodipine is a calcium channel blocker. Calcium channel blockers are not first line therapy for hypertensive diabetics. (c) C. Accupril is an ACE inhibitor. Because of their beneficial effects in diabetic neuropathy, ACE inhibitors (and ARBs) should be part of the initial treatment regimen for hypertension in diabetics. (u) D. Amiloride is a potassium-sparing diuretic. An ACE inhibitor is the standard first line therapy for hypertensive diabetics.