Up to one-third of patients who take ACE inhibitors for hypertension report which symptom after beginning therapy?
Decreased white blood cells.
Swelling of the face and lips.
Chronic cough.
Renal failure.
The Correct Answer is C
ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. They work by blocking the production of a hormone called angiotensin II, which narrows the blood vessels and increases blood pressure. By preventing this hormone from acting, ACE inhibitors lower blood pressure and reduce the workload on the heart. One of the most common side effects of ACE inhibitors is a dry cough, which occurs in 12–19% of people who take them. The cough is caused by the accumulation of a substance called bradykinin, which is normally broken down by angiotensin-converting enzyme (ACE). When ACE is inhibited, bradykinin levels increase and cause irritation and inflammation in the airways.
Choice A is wrong because decreased white blood cells are not a common side effect of ACE inhibitors.
However, some people may develop a condition called neutropenia, which is a low level of a type of white blood cell called neutrophils. This can increase the risk of infections and may require stopping the medication.
Choice B is wrong because swelling of the face and lips is not a common side effect of ACE inhibitors.
However, some people may develop a rare but serious allergic reaction called angioedema, which is a swelling of the deeper layers of the skin and mucous membranes.
This can affect the face, lips, tongue, throat, or other parts of the body and can cause difficulty breathing or swallowing. Angioedema can be life-threatening and requires immediate medical attention.
Choice D is wrong because renal failure is not a common side effect of ACE inhibitors.
However, some people may experience a decrease in kidney function or an increase in blood levels of creatinine, which is a waste product filtered by the kidneys.
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Correct Answer is B
Explanation
PT stands for prothrombin time, which is a measure of how long it takes the blood to clot. INR stands for international normalized ratio, which is a standardized way of reporting the PT result. Warfarin is a blood thinner that works by slowing down the clotting process.Therefore, people who take warfarin need to have their PT/INR monitored regularly to make sure they are getting the right dose and not bleeding too much or too little.
Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting that is not affected by warfarin.PTT is used to monitor heparin, another type of blood thinner.
Choice C is wrong because CBC stands for complete blood count, which is a test that measures the number and types of cells in the blood, such as red blood cells, white blood cells and platelets.CBC can show if there is anemia, infection or bleeding, but it does not measure the effect of warfarin on clotting.
Choice D is wrong because LFTs stand for liver function tests, which are a group of tests that check how well the liver is working.
LFTs can show if there is liver damage or disease, which can affect how warfarin is metabolized and cleared from the body.However, LFTs do not directly measure the effect of warfarin on clotting.
The normal range for PT/INR varies depending on the laboratory and the reason for taking warfarin.
Generally, the normal range for PT is 10 to 13 seconds, and the normal range for INR is 1.1 or below for healthy people.For people taking warfarin, the target INR range depends on their condition and risk factors, but it is usually between 2.0 and 3.0.
Correct Answer is D
Explanation
Alpha 1 adrenergic blocking agents have a vasodilating effect and can be used for the management of hypertension. They work by blocking the alpha 1 receptors on the vascular smooth muscle, which normally cause vasoconstriction when stimulated by catecholamines like epinephrine and norepinephrine.By preventing this constriction, alpha 1 blockers lower the peripheral resistance and blood pressure
Choice A is wrong because alpha 3 adrenergic blockers do not exist.There are only two types of alpha receptors: alpha 1 and alpha 2
Choice B is wrong because alpha 2 adrenergic antagonists do not have a vasodilating effect.
They block the alpha 2 receptors, which are located presynaptically on the sympathetic nerve terminals and postsynaptically on some vascular smooth muscle cells.Alpha 2 receptors inhibit the release of norepinephrine when activated, so blocking them would increase the sympathetic activity and vasoconstriction
Choice C is wrong because alpha 1 adrenergic agonists do not have a vasodilating effect.
They stimulate the alpha 1 receptors, which cause vasoconstriction and increase the blood pressure.Alpha 1 agonists are used to treat hypotension and nasal congestion
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