Antihypertensive question set 7

Anesthesia Pharmacology Chapter 8: Antihypertensive Drug Practice Questions

Primary or idiopathic hypertension:
1. caused by Cushing's syndrome
2. may be due to pheochromocytoma
3. caused by hyperaldosteronism
4. > 90% of cases
Increases stroke volume:
1. hypothyroidism
2. peripheral vasodilators
3. aortic regurgitation
4. tachycardia
Systolic/diastolic hypertension:
1. acromegaly
2. hypocalcemia
3. alpha1 adrenergic receptor antagonists
4. beta2 adrenergic receptor activation
Acute intermittent porphyria may produce hypertension
1. true
2. false
Cardiac output:
1. heart rate x peripheral resistance
2. stroke volume x peripheral resistance
3. heart rate x arterial pressure
4. stroke volume x heart rate
Preload and contractility:
1. increased ventricular stretch may reduce ventricular function (reduced output)
2. most antihypertensive drugs promote calcium release from sarcoplasmic reticulum stores
3. reduced preload coupled with increased contractility will lead to increased stroke volume and usually an increase in arterial pressure
4. metoprolol (Lopressor) administration would tend to increase contractility
Antihypertensive agents, directly or indirectly:
1. typically increase afterload
2. may increase heart rate
3. usually increase contractility
4. usually increased peripheral resistance
Patients receiving antihypertensive medications prior to undergoing anesthesia:
1. reduced likelihood of orthostatic hypotension
2. increased hypotensive response to acute blood loss
3. supersensitivity (significantly increase sensitivity) to actions of indirect-acting sympathomimetic drugs
4. hyperactivity would be expected
Maintenance of antihypertensive drug treatment during perioperative time frame:
1. associated with increased systemic blood-pressure and heart rate fluctuations during anesthesia
2. decrease likelihood of arrhythmias
3. since previously effective antihypertensive drug therapy typically should be continued during the perioperative time frame, the pharmacology of the particular antihypertensive agent need not be considered in the development of the anesthesia plan.
4. usually, is appropriate to maintaina patient on preoperative diuretics when those drugs are used to reduce blood pressure
usual physiological response to blood pressure reduction:
1. a reduction in heart rate
2. a reduction in contractility
3. a reduction in renin secretion
4. none of the above
Essential hypertension:
1. beta adrenergic receptor up regulation
2. increased endothelium-mediated vascular relaxation
3. increased vasoconstrictive tone (chronic vasoconstriction)
4. reduced sympathetic activation
Renal function in the hypertensive patients
1. Pressure-naturesis is enhanced in hypertensive kidneys
2. Patients with elevated renin levels are likely to respond to calcium channel blockers
3. angiotensin II elevation may cause an increase in aldosterone production
4. angiotensin II vasoconstrictive effects would be blocked by phentolamine (Regitine)
Typical cause/causes of secondary hypotension
1. endocrine-related
2. kidney-related
3. both
4. neither
Adrenal hyperplasia:
1. thymic carcinoma
2. pancreatic carcinoma
3. adrenal nodular hyperplasia
4. pituitary-hypothalamic dysfunction
5. all of the above
Most common cause of Cushing's disease:
1. bronchial adenoma
2. exogenous, iatrogenic causes
3. pituitary ACTH-producing microadenoma
4. all of the above
About 75% of Cushing's syndrome patients have adrenal neoplasm
1. true
2. false
: Adenoma composed of basophilic cells in Cushing's disease
1. true
2. false
Presenting symptom/symptoms associate with Cushing's disease:
1. truncal obesity
2. striae
3. glucose intolerance
4. hypotension
5. muscle weakness
Iatrogenic cause/causes: Cushing's disease
1. adrenal neoplasia
2. bilateral adrenal hyperplasia
3. long-term ACTH use
4. long-term glucocorticoid use
Adrenal hyperplasia: secondary to excessive pituitary ACTH production --
1. pituitary-hypothalamic dysfunction
2. pituitary ACTH-producing micro-or macroadenomas
3. both
4. neither
Primary aldosteronism:
1. more common in men than women
2. most often presents in individuals < 25 years old
3. most common cause: adrenal adenoma
4. may be caused by hyperplastic adrenal glands
5. generally associated with hyperkalemia
Primary aldosteronism: clinical presentation --
1. weakness
2. prominent U waves in ECG
3. metabolic acidosis
4. hypernatremia
Secondary aldosteronism:
1. increased plasma renin levels
2. hypokalemic alkalosis
3. severe arteriolar nephrosclerosis (malignant hypertension)
4. edema
Pheochromocytoma:
1. phentolamine (Regitine) may be useful in managing interoperative hypertension
2. patients with pheochromocytoma usually exhibit intravascular volume expansion
3. may occur along with other endocrine neoplasias
Chronic hypertension:
1. diastolic dysfunction
2. angina
3. left ventricular hypertrophy