682 Buttaro Final Exam [100% verified]

682 Buttaro Final Exam [100% verified] In obtaining an office BP measurement, which of the following is most reflective of the best practice? *Ans* The patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the reading What is the correct drug class of diltiazem? *Ans* nondihydropyridine calcium channel blocker A risk factor for acquired aortic stenosis is: *Ans* prior rheumatic fever. From the 2017 update to the 2013 heart failure ACC/AHA guidelines, which of the following would NOT be a first line treatment for HFrEF? *Ans* Amlodipine 5 mg qd You examine a 24-year-old woman with mitral valve prolapse (MVP). Her physical examination findings may also include: *Ans* pectus excavatum. The S4 heart sound has which of the following characteristics? *Ans* It is noted in the presence of poorly controlled hypertension. You see a 59-year-old man with poorly controlled hypertension. On physical examination, you note grade 1 hypertensive retinopathy. You anticipate all of the following will be present except: *Ans* patient report of acute visual change. You see a 38-year-old African American male with hypertension who is currently being treated with thiazide-type diuretic. His current blood pressure reading is 156/94 mm Hg and he has no history of diabetes mellitus or chronic kidney disease. Following current best evidence, you consider adding which of the following medications? *Ans* calcium channel blocker Mr. G is a 63 year old patient with a long history of hypertension, previously controlled on Lisinopril and HCTZ. His BP has been rising, to 170/104 at the last visit. He insisted he is adherent with his medications. The clinician added amlodipine, which dropped the BP to 160/96, but it is 180/110 today. He is asymptomatic with an essentially negative ROS. The patient has sleep apnea, which is effectively treated with CPAP. His GFR was 64 last month. According to figure 10 (page e193) in the 2017 ACC/AHA hypertension treatment guidelines, what other causes of secondary hypertension would be most likely to be causing Mr. G's new onset resistant hypertension? *Ans* Primary Aldosteronism A 68-year-old woman presents with hypertension and BP of 152-158/92-96 mm Hg documented over 2 months on three different occasions. Electrocardiogram (ECG) and creatinine are normal, and she has no proteinuria. Clinical findings include the following: BMI 26.4 kg/m2; no S3, S4, or murmur; and point of maximal impulse at fifth intercostal space, mid-clavicular line. Which of