The College of Pharmacy Practice
Credit for Learning: 3
Set out below is a series of multiple choice questions designed to test your understanding of the first three articles in our series on hypertension (August 21, p280, September 4, p351 and September 11, p383).
All pharmacists are invited to complete the questions and send their answers, together with a stamped and addressed A5 (230 x 160mm) envelope, to: The College of Pharmacy Practice, Barclays Venture Centre, University of Warwick Science Park, Coventry CV4 7EZ, by October 11. Results will be returned along with a certificate of completion which, for college members, will count towards continuing education requirements. Negative marking will not be used. The correct answers will be published in The Journal. A provisional time of four hours is given for the articles relating to this Credit for Learning exercise.
Genus Pharmaceuticals will provide a £500 prize to the pharmacist who achieves the highest marks overall in the four Credit for Learning exercises published in 1999. There will be a runner up prize of £200.
This page is for information only - answers should be supplied on a copy of the original page printed in The Pharmaceutical Journal 18 September 1999, page 459
Draw a ring around either T or F (T=true, F=false). There may be more than one true answer to each question.
| 1. Regarding hypertension: | ||
| (a) The prevalence in people in England between the ages of 65 and 74 years was estimated to be 50 per cent in 1996 | T | F |
| (b) The prevalence in young adults in the US is thought to be around 1 per cent | T | F |
| (c) The prevalence varies regionally within the UK | T | F |
| (d) In general, blood pressure measurements in a population exhibit a bimodal distribution pattern | T | F |
| (e) In around 5 per cent of patients, hypertension can be attributed to a known underlying cause | T | F |
| 2. Untreated hypertension is associated with: | ||
| (a) Liver impairment | T | F |
| (b) Coronary heart disease | T | F |
| (c) Stroke | T | F |
| (d) Diabetes mellitus | T | F |
| (e) Renal failure | T | F |
| 3. In the assessment of blood pressure: | ||
| (a) Readings are frequently lowest in the morning and rise through the course of the day | T | F |
| (b) Mercury sphygmomanometers require regular calibration to be accurate | T | F |
| (c) The use of a cuff which covers less than 80 per cent of the arm circumference is likely to give an over-estimate of blood pressure | T | F |
| (d) "White coat hypertension" is best confirmed by repeated measurements carried out on the individual in different environments | T | F |
| (e) "White coat hypertension" does not require long-term follow up | T | F |
| 4. Regarding the consequences of hypertension: | ||
| (a) The McMahon study (1990) suggested that a 5-6mmHg fall in diastolic blood pressure in a population may result in a 40 per cent reduction of strokes | T | F |
| (b) Under the age of 55 years, women appear less susceptible than men to the cardiovascular sequelae of hypertension | T | F |
| (c) Haemorrhagic stroke is positively associated with hypertension, whereas thrombotic stroke is not | T | F |
| (d) Appropriate management of hypertension has been shown to reduce risk of myocardial infarct by around 50 per cent | T | F |
| (e) Left ventricular hypertrophy is frequently missed on ECG in hypertensive patients | T | F |
| 5. In a patient with hypertension: | ||
| (a) Blood pressure may return to normal values in a patient with heart failure | T | F |
| (b) And with renal artery stenosis, acute pulmonary oedema may occur | T | F |
| (c) The risk of peripheral vascular disease appears to be reduced | T | F |
| (d) Hyperuricaemia and gout may be a consequence | T | F |
| (e) The accelerated ("malignant") form is almost invariably associated with retinopathy | T | F |
| 6. In relation to non-pharmacological management of hypertension: | ||
| (a) In a 90kg male with a blood pressure (BP) of 165/110mmHg, losing 10kg body weight may be expected to result in a lowering of BP to 149/97mmHg | T | F |
| (b) Restriction of dietary salt intake is likely to have a negligible effect on blood pressure control in most patients | T | F |
| (c) Potassium chloride has a hypotensive effect of its own, when used as a salt substitute | T | F |
| (d) In a man, alcohol consumption in excess of 21 units/week correlates with a rise in blood pressure | T | F |
| (e) Smoking cessation represents the most effective mode of reducing cardiovascular risk in the hypertensive patient | T | F |
| 7. In relation to the use of thiazides in management of hypertension: | ||
| (a) These agents tend to be most effective in young, white patients | T | F |
| (b) There is little benefit in using a dose of bendrofluazide in excess of 2.5mg/day | T | F |
| (c) The adverse effects of these agents on glucose tolerance contraindicates their use in patients with diabetes | T | F |
| (d) There is evidence that the drugs have a protective effect against both stroke and coronary heart disease | T | F |
| (e) Thiazides may increase LDL cholesterol and reduce HDL cholesterol | T | F |
| 8. Regarding the use of beta-blockers: | ||
| (a) These drugs reduce renin secretion | T | F |
| (b) Agents with intrinsic sympathomimetic activity (ISA) are likely to produce less bradycardia than those with no ISA | T | F |
| (c) Beta-1 selective agents are safe to use in patients with asthma | T | F |
| (d) Atenolol may need dosage reduction in renal impairment | T | F |
| (e) They are first-line treatment in a patient who also has a history of variant (Prinzmetal's) angina | T | F |
| 9. Using calcium channel blockers in hypertension: | ||
| (a) Dihydropyridines have less effect on cardiac conductivity than the other members of this group of drugs | T | F |
| (b) Any of these drugs may be used safely in combination with a beta-blocker | T | F |
| (c) Diltiazem may increase circulating digoxin levels | T | F |
| (d) Grapefruit juice should be avoided in a patient receiving amlodipine | T | F |
| (e) Shorter acting agents tend to be associated with a greater risk of headache and flushing than longer acting or sustained-release agents | T | F |
| 10. In hypertension management: | ||
| (a) ACE inhibitors are considered less effective in Afro-Caribbean patients than in white patients | T | F |
| (b) Patients receiving long-term ACE inhibitor therapy may be at particular risk of hypokalaemia | T | F |
| (c) Angioedema occurs in around 0.5 per cent of patients taking ACE inhibitors | T | F |
| (d) Angiotensin II antagonists are particularly useful in patients who have developed a dry cough while taking ACE inhibitors | T | F |
| (e) Moxonidine can be used safely in patients who have had an episode of angioedema with an ACE inhibitor | T | F |
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