Question

6- A 78- year-old hispanic man has a past medical history of hypertension for 10 years. His BP today is 158/82 mm Hg, HR is 70 bmp, SCr 1.2 mg/dL, eGFR 58 ml/min/1.73m2, serum potassium is 4.3 mEq/L. He is adherent to benazepril 40 mg daily and amlodipine 10 mg daily, weighs 93 kg, is 6 ft 7 in. He smokes 1⁄2 pack cigarettes daily, and consume 2-3 ethanol-containing drinks weekly. Which of the following medication(s) will ​worsen​ his condition? (​select all that apply​)

A. Hydrochlorothiazide

B. Metoprololsuccinate

C. Verapamil
D. Phenylephrine

E. Venlafaxine

7- All of the following are common in patients with type II DM ​except​?

1. Declining beta-cell mass
2. Reduced hepatic gluconeogenesis
3. Diminished incretin hormone after meals
4. Increase postprandial glucagon release

8- A 71-year-old male presents to his primary care physician complaining of shortness of breath with exertion. He recently started to feel shortness of breath after walking a few blocks. He also complains of choking sensation when supine that is relieved by sitting up. His medical history is notable for coronary artery disease, diabetes mellitus, and alcohol abuse. Physical examination reveals a diffuse, left-displaced point of maximal impact. Auscultation demonstrates an early diastolic gallop best heart over the apex with the patient in the left lateral decubitus position. A chest radiograph of the patient is shown. Which of the following sets of cardiac parameters would be expected in this patient?

1. Increased ejection fraction and decreased left ventricular end diastolic volume
2. Preservedejectionfractionandnormalcompliance
3. Preserved ejection fraction and decreased compliance
4. Decreased ejection fraction with increase left ventricular end diastolic volume
5. Decreased ejection fraction and decreased left ventricular end diastolic volume

9- A 43-year-old man comes to the ER complaining of chest discomfort. He describes the feeling as “tightness”, and also reports weakness and palpitations for the past hour. He denies shortness of breath, diaphoresis, or lightheadedness. He has no significant past medical history, and does not smoke, drink, or use illicit drugs. His father had a myocardial infarction at age of 71. He is afebrile, heart rate is 125/min, and his blood pressure is 120/75. He is alert and oriented to person, place, and time. His EKG is shown below. If left untreated, which of the following complication(s) is he most likely to have?

A. Thromboembolic formation

B. Acutekidneyinjury
C. Hypertension
D. Diabetes

Answer 1

6) the phenyephrine( decongestant) and Venlafaxine(Antidepressant) should b avoided as these has adverse efeect on bp means these can increase bp

Other options are used for the rx of high blood pressure

7) optn b is wrong ....in type 2 diabetes there is elevated hepatic gluconeogenesis in relation to increased secretion of glucogon which is high in type 2 diabetes. Other options are right related to type 2 diabetes

8) Pt is suffering from congestive heart failure.in this disease there is decreased ejection fraction and increased left ventricular end diastole which might lead to pulmonary congestion that is why pt feels choking when in supine position.

9) pt may b having heart valve disease as suspected from the symptoms, the complications of this disease is hypertension. There is a strong link between heart valve disease and hypertension .

Thromboembolism formations is a complications of prosthesis for the correction of heart valve disease, kidney injury occurs in case of prolonged hypertension