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Category: Cardiology--->Aorta And Hypertension
Page: 5

Question 21# Print Question

An overweight (BMI 35) 45-year old man has been referred for investigation of his high blood pressure (160/95 mmHg). He has no significant past medical or family history, but socially he consumes at least 15 pints of beer per week and smokes five cigarettes per day. A 24-hour urinary cortisol is raised and low-dose dexamethasone test is normal. 

What is the appropriate management?

A. Advise lifestyle changes including weight loss, exercise, and reduced alcohol intake
B. A renal ultrasound
C. A MIBI scan
D. Refer to an endocrinologist
E. Commence an ACE inhibitor


Question 22# Print Question

A 16-year-old patient has been referred to you for investigation of a murmur. Auscultation reveals a mid-systolic murmur on the anterior chest. There does not appear to be a radiofemoral delay, but the recorded brachial blood pressure is 143/90 mmHg. There is a family history of premature stroke but no family history of kidney problems. 

What would the best investigation be?

A. Echocardiogram
B. CT aorta
C. Cardiac MRI
D. Renal ultrasound
E. Cerebral MRA


Question 23# Print Question

A patient is followed up at a 6-week appointment following a primary percutaneous intervention for an anterior STEMI. An echocardiogram pre-discharge estimated overall LVEF as 40%. He is asymptomatic, compliant with all medications, and has no problems from side effects. His blood pressure is 95/70 mmHg, with no evidence of a postural drop, and his heart rate is 55 bpm. His GP has recently increased his medication to 5 mg bisoprolol and 7.5 mg ramipril.

What are your recommendations?

A. Continue on the current regime
B. Reduce ramipril to 5 mg
C. Reduce bisoprolol to 2.5 mg
D. Reduce both medications
E. Repeat echocardiogram to assess the left ventricle and then decide the treatment regime


Question 24# Print Question

A 65-year-old hypertensive non-diabetic has an eGFR <40. Screening tests showed microalbuminuria and a normal renal ultrasound. 

Which class of antihypertensive medication should you instigate?

A. ACE inhibitor
B. Beta-blocker
C. Calcium-channel blocker
D. Thiazide diuretic
E. Angiotensin receptor blocker


Question 25# Print Question

The side effects of the broad spectrum of calcium-channel blockers (CCBs) include the following, except:

A. Peripheral oedema
B. Gum hypertrophy
C. Dyslipidaemia
D. Negatively ionotropic
E. Negatively chronotropic




Category: Cardiology--->Aorta And Hypertension
Page: 5 of 25