This week's Med-Challenger free CME quiz - Hypertension - the quick quiz covers the conflict in currently accepted guidelines about appropriate first-line medical therapy for hypertension, medications that may cause hypertension, the appropriate imaging modality to confirm renovascular hypertension, and the effects of ACE inhibitors and ARBs on renal function in patients with chronic kidney disease and proteinuria.
A free sample Hypertension question included below. The full Hypertension CME quiz is free online for a limited time. You can earn AMA CME credit - and now you can earn ANCC contact hours as well! Play now.
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Here's this week's sample CME board review question on hypertension:
A 47-year-old woman with long-standing lupus nephritis presents to her physician for her biannual checkup. She is currently taking no medication and she feels generally well.
On physical examination, her blood pressure is 160/98 mm Hg. Pressures were equal in both arms. Previous blood pressures have been in the range of 130/70 mm Hg.
Her physician asked her to return a week later for a recheck of the pressure. At that time, repeat blood pressure was 158/100 mmHg. The remainder of the physical examination was normal.
Laboratory studies:
Serum creatinine: 4.3 mg/dL
Blood urea nitrogen: 38 mg/dL
Serum potassium: 5.1 mEq/L
Urinary protein: 1 g/24 hrs.
These laboratory results were only slightly higher than those taken 6 months earlier. This patient is presumed to have hypertension as the result of her lupus nephritis.
Question:
What is the first-line anti-hypertensive agent for this patient?
Answer Options:
Thiazide diuretic
Angiotensin-converting enzyme (ACE) inhibitor
Sympathetic blocker such as aldomet
Beta-blocker
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