AGNP EXAM 3 QUESTIONS WITH ANSWERS 2025/2026
GRADED A
ACE-I - Lisinopril, Benzapril, Captopril, Ramipril
blocks conversion of angiotensin 1 to 2, which blocks the production of aldosterone,
arterioles dilate and PVR is reduced
s/e of ACE - dry cough
ACE-I used in - LV failure, dec EF, post MI
first choice for DM, CKD
NOT used in bilateral renal artery stenosis
ACE-I considerations - baseline Creatinine, monitor, must be stable because ACE's
increase creat.
Can tolerate up to 35% rise
monitor BMP for Cr and K
ARBs - blocks ngiotensin 2 receptor--> blocks stimulation of aldosterone.
no effect on bradykinin associated w/ cough and angioedema!
no benefit when ACE/ARB are combined.
can used with DM and CHF
s/e of ARBs - increased K. ARF if used with bilateral renal artery stenosis
Beta Blockers - reduce cardiac output, renin, catecholamine release and decrease
peripheral resistance
blocks adrenergic B1 receptors and dec HR
used in preexisting heart conditions
cardioselective beta blockers - B1
preferred w/ asthma and COPD
metoprolol succinate/tartrate, atenolol
less sexual dysfunction
Noncardioselective beta blockers - B1 and B2
more lipid soluble, CNS penetration, crosses bb barrier
propanolol, nadolol, good w/ migraines
Alpha-1 Beta Adrenergic - alpha blockade dilation of peripheral blood vessels and B1
effects
Labetolol, Carvedilol
Second line therapy for HTN is used in... - renal failure or those with refractory to
combination of first line agents.
,Second line therapy HTN examples - alpha blockers
loop/K sparing diuretics
centrally acting sympatholytics
direct vasodilators
Alpha blockers - dilation of arterial and venous blood vessels via SNS
less reflex tachy
Doxazosin, Terazosin
HS dosing! d/t orthostasis
useful in BPH, it relaxes the bladder and muscle tone
Loop diuretics - Decreases Na reabsorption = inc Na and H2o loss
Lasix, Bumex, Toresimide
S/e = decrease K/Na/Cl/mag. Inc glycemia/LDLs
K sparing diuretics - used with thiazide or loop to reduce decreases in K.
spironolactone
Extreme caution w/ CKD. Avoid Cr >2.5 and with the use of ARBs/ACEs!
Central acting Sympatholytics - causes Na retention, used with a diuretic
clonidine, methyldopa
CNS s/e--drowsy, fatigue, impotence, dry mouth
rebound HTN w/ abrupt cessation
Direct vasodilators - used in resistant patients, added to BB and Loop
Hydralazine
S/e=Lupus like syndrome >150mg/d over 6months
Pharmacology management with HTN - 2-3 week follow up
titrate up if needed or add another
check BMP
not at goal with 2 agents--add a 3rd
refer to nephrology
Health promotion definition - the process of empowering people to increase control over
their health and its determinants through health literacy efforts and multisectional action
to increase healthy behaviors
disease prevention definition - specific, population based/individual based interventions
for primary/secondary prevention, aiming to minimize the burden of diseases and RFs
Primary prevention - prevent occurance of a disease to spare the individual the suffer,
burden, cost associated with the disease/condition. this is the most cost effective step
ex) immunization, health counsel, chemoprophylaxis
, Secondary prevention - detect and treat asymptomatic people who have RF for a
disease. This is the treatable stage, positive outcomes.
ex) mammogram, Pap, BP measurements, Lipid panel, low dose CT
Tertiary prevention - management of established disease
to minimize disease associated complications and prevent disabilities
ex) glucose control, pulmonary rehab for copd, PT after a CVA
Quarternary prevention - identify patients RF over medications/treatments
Sensitivity - tests ability to designate an individual with the disease as positive
have the disease = tests positive
high = few false negative results, good
specificity - tests ability to designate an individual who dose not have the disease as
negative
high = few false positives
Leading cause of death by age - birth-12months = congenital malformations
adolescents = accidents, suicide, homicide
1-44y = unintentional injuries
45-64 = CA
>65y = heart diseases
screening definition - application of medical procedure/test to people with NO s/s of
disease, to determine the likelihood of having a disease. it does not diagnose!
Lung Ca - most common >55yo and those who smoke
Low dose CT Q1year for:
-55-80y
->30 pack/yr hx
-quit <15y
stop screening if >80, quit >15y, or developes a problem that limits the life expectancy
sensitivty 94% good!... specificity 73% not good
Colorectal Ca RF - age >50 and family history
Colorectal polyps - 1. inflammatory
2. Serrated (hyperplastic..small..rarely malignant) (sessile...larger...preCA)
3. Adenomatous....bad and malignant
colorectal Ca screening - 50-75 yr
gFOBT Q1y
FIT Q1yr
FIT/DNA Q1-3yr
Sigmoidoscopy Q10yr with FIT Q1yr
GRADED A
ACE-I - Lisinopril, Benzapril, Captopril, Ramipril
blocks conversion of angiotensin 1 to 2, which blocks the production of aldosterone,
arterioles dilate and PVR is reduced
s/e of ACE - dry cough
ACE-I used in - LV failure, dec EF, post MI
first choice for DM, CKD
NOT used in bilateral renal artery stenosis
ACE-I considerations - baseline Creatinine, monitor, must be stable because ACE's
increase creat.
Can tolerate up to 35% rise
monitor BMP for Cr and K
ARBs - blocks ngiotensin 2 receptor--> blocks stimulation of aldosterone.
no effect on bradykinin associated w/ cough and angioedema!
no benefit when ACE/ARB are combined.
can used with DM and CHF
s/e of ARBs - increased K. ARF if used with bilateral renal artery stenosis
Beta Blockers - reduce cardiac output, renin, catecholamine release and decrease
peripheral resistance
blocks adrenergic B1 receptors and dec HR
used in preexisting heart conditions
cardioselective beta blockers - B1
preferred w/ asthma and COPD
metoprolol succinate/tartrate, atenolol
less sexual dysfunction
Noncardioselective beta blockers - B1 and B2
more lipid soluble, CNS penetration, crosses bb barrier
propanolol, nadolol, good w/ migraines
Alpha-1 Beta Adrenergic - alpha blockade dilation of peripheral blood vessels and B1
effects
Labetolol, Carvedilol
Second line therapy for HTN is used in... - renal failure or those with refractory to
combination of first line agents.
,Second line therapy HTN examples - alpha blockers
loop/K sparing diuretics
centrally acting sympatholytics
direct vasodilators
Alpha blockers - dilation of arterial and venous blood vessels via SNS
less reflex tachy
Doxazosin, Terazosin
HS dosing! d/t orthostasis
useful in BPH, it relaxes the bladder and muscle tone
Loop diuretics - Decreases Na reabsorption = inc Na and H2o loss
Lasix, Bumex, Toresimide
S/e = decrease K/Na/Cl/mag. Inc glycemia/LDLs
K sparing diuretics - used with thiazide or loop to reduce decreases in K.
spironolactone
Extreme caution w/ CKD. Avoid Cr >2.5 and with the use of ARBs/ACEs!
Central acting Sympatholytics - causes Na retention, used with a diuretic
clonidine, methyldopa
CNS s/e--drowsy, fatigue, impotence, dry mouth
rebound HTN w/ abrupt cessation
Direct vasodilators - used in resistant patients, added to BB and Loop
Hydralazine
S/e=Lupus like syndrome >150mg/d over 6months
Pharmacology management with HTN - 2-3 week follow up
titrate up if needed or add another
check BMP
not at goal with 2 agents--add a 3rd
refer to nephrology
Health promotion definition - the process of empowering people to increase control over
their health and its determinants through health literacy efforts and multisectional action
to increase healthy behaviors
disease prevention definition - specific, population based/individual based interventions
for primary/secondary prevention, aiming to minimize the burden of diseases and RFs
Primary prevention - prevent occurance of a disease to spare the individual the suffer,
burden, cost associated with the disease/condition. this is the most cost effective step
ex) immunization, health counsel, chemoprophylaxis
, Secondary prevention - detect and treat asymptomatic people who have RF for a
disease. This is the treatable stage, positive outcomes.
ex) mammogram, Pap, BP measurements, Lipid panel, low dose CT
Tertiary prevention - management of established disease
to minimize disease associated complications and prevent disabilities
ex) glucose control, pulmonary rehab for copd, PT after a CVA
Quarternary prevention - identify patients RF over medications/treatments
Sensitivity - tests ability to designate an individual with the disease as positive
have the disease = tests positive
high = few false negative results, good
specificity - tests ability to designate an individual who dose not have the disease as
negative
high = few false positives
Leading cause of death by age - birth-12months = congenital malformations
adolescents = accidents, suicide, homicide
1-44y = unintentional injuries
45-64 = CA
>65y = heart diseases
screening definition - application of medical procedure/test to people with NO s/s of
disease, to determine the likelihood of having a disease. it does not diagnose!
Lung Ca - most common >55yo and those who smoke
Low dose CT Q1year for:
-55-80y
->30 pack/yr hx
-quit <15y
stop screening if >80, quit >15y, or developes a problem that limits the life expectancy
sensitivty 94% good!... specificity 73% not good
Colorectal Ca RF - age >50 and family history
Colorectal polyps - 1. inflammatory
2. Serrated (hyperplastic..small..rarely malignant) (sessile...larger...preCA)
3. Adenomatous....bad and malignant
colorectal Ca screening - 50-75 yr
gFOBT Q1y
FIT Q1yr
FIT/DNA Q1-3yr
Sigmoidoscopy Q10yr with FIT Q1yr
