Renal Hypertension Final PDF

1) The first step when evaluating a patient with suspected endocrine-related hypertension is to exclude other causes of secondary hypertension, such as: a) Hypoactivity of Islets of Langerhans b) Hypoactivity of adrenal cortex c) renal disorders D) Spleen disorders 2)The most common c...

1) The first step when evaluating a patient with suspected endocrine-related hypertension is to exclude other causes of secondary hypertension, such as: a) Hypoactivity of Islets of Langerhans b) Hypoactivity of adrenal cortex c) renal disorders D) Spleen disorders 2)The most common cause of secondary hypertension is: a) Renal disease b) Primary aldosteronism c) Diabetes d) Sleep apnea - 3)Your patient with elevated BP complains of polyuria and nocturia, muscle weakness, and palpitations. What do you suspect is the cause of the elevated BP? a) Muscular dystrophy b) Diabetes Mellitus c) primary hyperaldosteronism d) Paroxismal supraventriculur tachycardia 4)Which of the following are reasonable next steps if your suspect your patient has obstructive sleep apnea? a) Ask them to do CPAC trial b) Suggest to sleep on other side, not on back c) Asses them using the Friedman Palate scale d)all of the above 5) A systolic blood pressure of over 180 mmHg with evidence of organ damage is known as: a) primary hypertension b) hypertensive crisis c) secondary hypertension d) tertiary hypertension 6) Which of the following are the primary regulatory mechanisms for blood pressure? a) antidiuretic hormone, adrenaline and aldosterone b) adrenaline, aldosterone, angiotensin c) renin, aldosterone, adrenaline d) angiotensin, aldosterone, renin 7) - About home BP monitoring, which of the following statement is correct? a) HBMP has been shown to provide better prediction of end organ damage and cardiovascular risk compared to clinic BP b) HMBP does not require much patient participation c) HMBP is not able to detect diurnal BP variation d)HMBP does not eliminate the problem of white coat hypertension 8) The most common thyroid disorder is: a)hypothyroidism b) Riedel's thyroiditis c)hyperthyroidism d)hydrocele 9) Which of the following confirmed values meet the diagnostic threshold for diabetes? a) fasting blood glucose 140 mg/dl b) random glucose > 160 mg/dl c) 2 hour post prandial glucose ≥ to 126 mg/dl d) fasting blood glucose ≥ 126 mg/dl 10) One of the symptoms of hypothyroidism is: a) Fatigue b) Intolerance to cold c) Weight gain d) All of the above 11) Hypothyroidism can affect pregnancy by: a) Reducing the chance of getting pregnant b) Boosting the chance of getting pregnant c) increasing the chance of gestional diabetes d) Making labor and delivery more difficult 12) A person with untreated hypothyroidism may also have: a) High cholesterol b) High glucose c) Low blood sugar c) Low blood sugar d) None of the above  13) How is hypothyroidism treated: a) With radiation. b) With surgery. c) With a synthetic hormone d) The condition can't be treated 14) The main hormone secreted by the Thyroid gland is : a) T4 B) T3 C) a & b both d) TSH 15 Iodine deficiency can cause: a) Goitre b) Thyroid cancer c) Solitary thyroid nodules d) Thyroiditis 16) Medications for hypothyroidism include treatment that: a) Replaces insulin b) Replaces ADH c) Replaces FT4 d) Replaces surfactant 17) Which of these diseases is not related to thyroid glands? a) Cretinism b) Myxoedema c) Goitre d) Acromegaly 18) Drugs used in treatment of thyrotoxicosis: a) metformin b) levothyroxine c) sulfonylureas d) methimasole 19) Thyroid storm: a) May occur in euthyroid patient during thyroid surgery b) occurs in surgery unrelated to thyroid gland c) Patient becomes hypothermic d) Patient becomes hyperthermic  20) Immediate postoperative complication of thyroid surgery is: a) Keloid formation b) Hyperthyroidism c) Diabetes d) Hemorrhage 21) This measure does not help to prevent diabetes complications: a) controlling blood lipids and blood pressure b) Prompt detection of diabetic eye and kidney disease c) Eliminating all carbohydrates from the diet d) controlling blood glucose 22) This diabetes drug acts by decreasing the amount of glucose produced by the liver: a) Alpha-glucosidase inhibitors b) Sulfonylureas c) Biguanides d) Meglitinides  23) SGLT2 inhibitors are characterized by the following, except: a) Potential for weight loss b) Reduction in hospitalisation for heart failure c) weight gain d) A class effect of increased risk of urogenital track infections 24) What is the most common symptom of renal artery stenosis? a) Low blood pressure b) High blood pressure c) Decreased urination d) pain during urination 25) Renal artery stenosis may occur in all of the following except: a) Atherosclerosis b) Fibromuscular dysplasia c) polycystic renal disease d) Takayasu’s arteritis 26) The main reason for the arterial hypertension in chronic glomerulonephritis is: A)Diminished Na and K glomerular filtration B). Calcium deposits in blood vessels wall C) Activization of the renin-angiotensin-aldosterone system D) Retention of the catecholamine 27) Benign nephrosclerosis is characterized morphologically by: A) fibrinoid necrosis of afferent arterioles with ischemic atrophy of nephrons B) diffuse thickening of the glomerular capillary basement membranes leading to glomerulosclerosis C) hyalinization of afferent arterioles with ischemic atrophy of nephrons D) deposition of basement membrane-like material within the glomerular mesangium leading to glomerulosclerosis 28) A 79 year old lady presents to hospital with high blood pressure ( T/ A 170/100), vomiting and a serum creatinine of 270 umol/L (normal range: 70-90 umol/L), with an estimated glomerular filtration rate of 15 mL/min/1.73 m2. Which investigation result best indicates that she has an underlying chronic rather than acute kidney disease? A) reduced kidney size on renal ultrasound B) Increased haemoglobin concentration C) A disproportionate elevation in the serum urea compared to the serum creatinine D) 1+ protein on the urine dipstick test 29) Which of these can increase your risk of high blood pressure? A) Obesity B) A family history of high blood pressure C) Smoking D) All of the above 30) What can you do to control high blood pressure? A) Get to and stay at a healthy weight B) Exercise regularly C) Take the blood pressure medicine prescribed by your provider D) All of the above 31) Why does reducing how much salt (sodium) you eat help prevent high blood pressure? A) It reduces fluid buildup in the body B) It allows vessels to relax C) It raises levels of HDL (good) cholesterol D) It helps keep your heartbeat steady 32) 59 ears old male complains with lower back pain and oliguria. His past medical history remarkable for prostate enlargement. Blood pressure 160/100 mmHg; a pulse 90, laboratory test showed: serum creatinine - 5.2mg/dl; (normal range up to 1.0 mg/dl); Hemoglobin level – 11.5g/dl; Urinalysis reveals: specific gravity 1. 010; pH-5.0 protein- neg, blood – 35-45 HPF , presented with isomorphic and dysmorphic RBCs. What is the most likely cause of the patient’s renal disease? A) Acute post renal kidney injury B) Acute tubular necrosis C) Acute prerenal kidney injury D) acute glomerulonephritis o 33) 22 years old girl presents to her after awaking with a swollen face. Arterial hypertension, Blood pressure is 160/80 mmHg. There is swelling of the face, abdomen and legs. Serum creatinine is 1.6 mg/dl; (normal range up to 1.0 mg/dl); Albumin is 2.7 g/dl; (normal range 3.5-4.5 g/dl); The 24 hour urine excretion is 2.6g. The most likely diagnostic test should be perfomed is A) Kidney biopsy B) Renal scan with Tc-99 C)CT D)MRI 34) Which of the following classes of antihypertensive medications is not recommended for initial treatment? A)Thiazide-type diuretics B) Potassium-sparing diuretics C) Angiotensin receptor blockers D) ACE inhibitor 35) Which of the following causes of renovascular hypertension is more common among younger patients? A) Atherosclerosis B) Fibromuscular dysplasia C) Surgical errors D) Tumors  36) Which of the following diagnostic tests for renovascular hypertension may also be therapeutic? A) Radionuclide imaging B) Magnetic resonance angiography C) Renal angiography D) Ultrasonography 37) The cause of death of most patients with chronic kidney disease is A)cardiovascular disease B) kidney failure C) malnutrition D) volume overload 38) in patient with GFR 22, drug of choice for hypertension is? A) ACE inhibitors B) B blockers C) Loop diuretics D) Ca channel blockers 39) The nephrotic syndrome is primarily due to: A) diabetic glomerulosclerosis B) toxic necrosis of renal tubular epithelium C) increased permeability of the glomerular filtration barrier D) narrowing of the afferent arteriole  40) Nephrotic syndrome is characterized by: A) hematuria, proteinuria, hypertension B) hematuria, azotemia, hypertension C) proteinuria, edema, hyperlipidemia D) bacteriuria, azotemia, hypertension 41) Normal range for proteinuria in 24 hour urine collection is_ A)