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Hypertension (25 Questions)
QUESTION 1: What is the blood pressure threshold for stage 1 hypertension in adults?
Answer: 130/80 mmHg
Rationale: Stage 1 hypertension is defined as systolic 130–139 mmHg or diastolic 80–89 mmHg
per ACC/AHA guidelines (Buttaro, 7th ed., Ch. 40).
QUESTION 2: What is a first-line medication class for hypertension?
Answer: Thiazide diuretics
Rationale: Thiazides (e.g., hydrochlorothiazide) are first-line for uncomplicated hypertension
(Hollier, 4th ed., Ch. 7).
QUESTION 3 (Scenario-Based): A 50-year-old male presents with BP 135/85 mmHg on two
visits. What is the diagnosis?
Answer: Stage 1 hypertension
Rationale: BP 130–139/80–89 mmHg confirms stage 1 hypertension (Buttaro, 7th ed., Ch. 40).
QUESTION 4: What lifestyle modification is recommended for hypertension?
Answer: DASH diet
Rationale: The DASH diet reduces blood pressure by emphasizing low sodium and high
potassium intake (Hollier, 4th ed., Ch. 7).
QUESTION 5 (Select All That Apply): Which are risk factors for hypertension? Select all that
apply: Obesity, Smoking, Family history, Stress, Age >65.
Answer: Obesity, Smoking, Family history, Age >65
Rationale: These are established risk factors. Stress is less specific (Buttaro, 7th ed., Ch. 40).
,QUESTION 6 (Scenario-Based): A 45-year-old female with BP 145/90 mmHg is prescribed
lisinopril. What is the medication class?
Answer: ACE inhibitor
Rationale: Lisinopril is an ACE inhibitor, effective for hypertension (Hollier, 4th ed., Ch. 7).
QUESTION 7: What is a potential complication of untreated hypertension?
Answer: Stroke
Rationale: Hypertension increases stroke risk by damaging blood vessels (Buttaro, 7th ed., Ch.
40).
QUESTION 8 (Select All That Apply): Which are first-line treatments for hypertension? Select
all that apply: Thiazide diuretics, Beta-blockers, ACE inhibitors, Calcium channel blockers,
Statins.
Answer: Thiazide diuretics, ACE inhibitors, Calcium channel blockers
Rationale: These are first-line per ACC/AHA. Beta-blockers are second-line, and statins are for
hyperlipidemia (Hollier, 4th ed., Ch. 7).
QUESTION 9 (Scenario-Based): A 60-year-old male with hypertension reports a dry cough on
lisinopril. What is a recommended alternative?
Answer: Losartan
Rationale: ARBs like losartan are alternatives for ACE inhibitor intolerance (Buttaro, 7th ed.,
Ch. 40).
QUESTION 10: What is the target BP for patients with diabetes and hypertension?
Answer: <130/80 mmHg
Rationale: Tighter control is recommended for high-risk patients like those with diabetes
(Hollier, 4th ed., Ch. 7).
QUESTION 11 (Select All That Apply): Which should be monitored in patients on thiazide
diuretics? Select all that apply: Potassium, Sodium, Creatinine, Glucose, Lipid profile.
Answer: Potassium, Sodium, Creatinine, Glucose
Rationale: Thiazides can affect electrolytes and glucose; lipid monitoring is for statins (Buttaro,
7th ed., Ch. 40).
, QUESTION 12: What is a common cause of secondary hypertension?
Answer: Renal artery stenosis
Rationale: Renal artery stenosis can elevate BP by activating the renin-angiotensin system
(Hollier, 4th ed., Ch. 7).
QUESTION 13 (Scenario-Based): A 55-year-old female with BP 150/95 mmHg has no
response to lifestyle changes. What is a next step?
Answer: Initiate pharmacotherapy
Rationale: Medication is indicated for stage 2 hypertension (≥140/90 mmHg) after lifestyle
failure (Buttaro, 7th ed., Ch. 40).
QUESTION 14 (Select All That Apply): Which lifestyle modifications reduce hypertension?
Select all that apply: Weight loss, Exercise, Low sodium diet, Smoking cessation, Stress
management.
Answer: Weight loss, Exercise, Low sodium diet, Stress management
Rationale: These directly lower BP. Smoking cessation reduces cardiovascular risk but not BP
directly (Hollier, 4th ed., Ch. 7).
QUESTION 15: What diagnostic test is indicated for suspected secondary hypertension?
Answer: Renal ultrasound
Rationale: Renal ultrasound evaluates for renal artery stenosis or kidney disease (Buttaro, 7th
ed., Ch. 40).
QUESTION 16 (Scenario-Based): A 65-year-old male with hypertension and diabetes is
prescribed amlodipine. What is the purpose of this medication?
Answer: Vasodilation
Rationale: Amlodipine, a calcium channel blocker, dilates blood vessels to lower BP (Hollier,
4th ed., Ch. 7).
QUESTION 17: What is a hallmark sign of hypertensive emergency?
Answer: BP >180/120 mmHg with organ damage
Rationale: Hypertensive emergency involves severe BP elevation with end-organ damage
(Buttaro, 7th ed., Ch. 40).