[MCQ] Hypertensive Vascular Disease- Part 2

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Hypertensive Vascular Disease- Part 2

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Question 1

Renin-producing carcinomas may be found in ?

A	Lung
B	Liver
C	Pancreas
D	All of the above

Question 1 Explanation:

Renin-producing carcinomas have been described in lung, liver, pancreas, colon and adrenals.

Question 2

Angiotensinogen, renin, and angiotensin II are also synthesized locally in ?

A	Uterus
B	Brain
C	Spleen
D	All of the above

Question 2 Explanation:

Angiotensinogen, renin, and angiotensin II are also synthesized locally in brain, pituitary, aorta, arteries, heart, adrenal glands, kidneys, adipocytes, leukocytes, ovaries, testes, uterus, spleen, and skin.

Question 3

Angiotensin II in tissues may be formed by the enzymatic activity of ?

A	Tonin
B	Chymase
C	Cathepsins
D	All of the above

Question 3 Explanation:

Angiotensin II in tissues may be formed by the enzymatic activity of renin or by other proteases like tonin, chymase, and cathepsins

Question 4

Which of the following is the primary trophic factor regulating synthesis & secretion of aldosterone by zona glomerulosa of adrenal cortex ?

A	Potassium
B	Adrenocorticotropic hormone (ACTH)
C	Angiotensin II
D	All of the above

Question 4 Explanation:

Angiotensin II is the primary trophic factor regulating synthesis & secretion of aldosterone by zona glomerulosa of adrenal cortex. Aldosterone synthesis is also dependent on potassium and acute elevations of adrenocorticotropic hormone (ACTH)

Question 5

Mineralocorticoid receptors are expressed in which of the following ?

A	Colon
B	Salivary glands
C	Sweat glands
D	All of the above

Question 5 Explanation:

Mineralocorticoid receptors also are expressed in the colon, salivary glands, and sweat glands.

Question 6

Which of the following has no affinity for the mineralocorticoid receptor ?

A	Aldosterone
B	Cortisol
C	Cortisone
D	All of the above

Question 6 Explanation:

Aldosterone is a potent mineralocorticoid that increases sodium reabsorption by amiloridesensitive epithelial sodium channels (ENaC) on the apical surface of the principal cells of the renal cortical collecting duct. Cortisol also binds to mineralocorticoid receptors but is a less potent mineralocorticoid than aldosterone because cortisol is converted to cortisone by the enzyme 11 b-hydroxysteroid dehydrogenase type 2. Cortisone has no affinity for the mineralocorticoid receptor

Question 7

Myocardial fibrosis, nephrosclerosis, vascular inflammation and remodeling are the effects of which of the following ?

A	Aldosterone
B	Cortisol
C	Cortisone
D	All of the above

Question 7 Explanation:

Aldosterone and/or mineralocorticoid receptor activation induces structural & functional alterations in heart, kidney & blood vessels, leading to myocardial fibrosis, nephrosclerosis & vascular inflammation and remodeling, as a consequence of oxidative stress. These effects are amplified by a high salt intake.

Question 8

In CHF, low-dose spironolactone reduces the risk of progressive heart failure and sudden death from cardiac causes by ?

A	10 %
B	20 %
C	30 %
D	40 %

Question 8 Explanation:

In CHF, low-dose spironolactone reduces the risk of progressive heart failure and sudden death from cardiac causes by 30%

Question 9

Intracellular pH (pHi) is regulated by ?

A	Na+ - H+ exchange
B	Na+ - dependent HCO3– - Cl– exchange
C	Cation-independent HCO3 - Cl– exchange
D	All of the above

Question 10

Which of the following is increased in hypertension ?

A	A Sympathetic outflow
B	Activity of the Na+ - H+ exchanger
C	Atrial natriuretic factor
D	All of the above

Question 11

Which of the following is synthesized in adrenal medulla and released into circulation upon adrenal stimulation ?

A	A Epinephrine
B	Norepinephrine
C	Dopamine
D	All of the above

Question 11 Explanation:

Adrenergic neurons synthesize norepinephrine & dopamine, which are stored in vesicles within neuron. When neuron is stimulated, these neurotransmitters are released into synaptic cleft. Epinephrine is synthesized in adrenal medulla & released into circulation upon adrenal stimulation.

Question 12

Atherosclerotic, hypertension-related vascular lesions in the kidney primarily affect ?

A	Preglomerular arterioles
B	Glomerular capillaries
C	Postglomerular arterioles
D	All of the above

Question 12 Explanation:

Atherosclerotic, hypertension-related vascular lesions in the kidney primarily affect preglomerular arterioles, resulting in ischemic changes in the glomeruli and postglomerular structures.

Question 13

Renal lesion associated with malignant hypertension is ?

A	Fibrinoid necrosis of afferent arterioles
B	Fibrinoid necrosis of glomerular capillaries
C	Fibrinoid necrosis of efferent arterioles
D	All of the above

Question 13 Explanation:

Renal lesion associated with malignant hypertension consists of fibrinoid necrosis of the afferent arterioles.

Question 14

For every 20-mm Hg increase in SBP & 10-mm Hg increase in DBP, cardiovascular disease risk increases by ?

A	1.5 times
B	2 times
C	2.5 times
D	3 times

Question 14 Explanation:

RG Cardiovascular disease risk doubles for every 20 mm Hg increase in systolic and 10 mm Hg increase in diastolic pressure.

Question 15

Among older individuals, which of the following is the least powerful predictor of cardiovascular disease ?

A	Systolic blood pressure
B	Diastolic blood pressure
C	Pulse pressure
D	None of the above

Question 15 Explanation:

Among older individuals, systolic blood pressure & pulse pressure are more powerful predictors of cardiovascular disease than diastolic blood pressure

Question 16

Blood pressure tends to be higher during which of the following times ?

A	A Early morning hours soon after waking
B	Following meals
C	Evenings
D	Night

Question 17

Generally, night time blood pressures are lower than day time blood pressures by ?

A	5 - 10 %
B	10 - 20 %
C	20 - 30 %
D	30 - 40 %

Question 17 Explanation:

Nighttime blood pressures are generally 10 - 20% lower than daytime blood pressures.

Question 18

Which of the following about hypertension is false ?

A	More severe in glomerular than in interstitial diseases
B	Low-renin patients have volume-dependent hypertension
C	White coat hypertension does not develop into sustained hypertension
D	White coat hypertension does not develop into sustained hypertension

Question 18 Explanation:

Individuals with white coat hypertension are at increased risk for developing sustained hypertension

Question 19

Which is the most common histologic variant of fibromuscular dysplasia ?

A	Medial fibroplasia
B	Perimedial fibroplasia
C	Medial hyperplasia
D	Intimal fibroplasia

Question 19 Explanation:

Histologic variants of fibromuscular dysplasia include medial fibroplasia, perimedial fibroplasia, medial hyperplasia & intimal fibroplasia. Medial fibroplasia is the most common variant (66%).

Question 20

Lesions of fibromuscular dysplasia mostly affect which portion of renal artery ?

A	Proxima
B	Mid
C	Distal
D	Any of the above

Question 20 Explanation:

Lesions of fibromuscular dysplasia are frequently bilateral and in contrast to atherosclerotic renovascular disease tend to affect more distal portions of renal artery. 1411 Which of the following serves as “gold standard” for evaluation and identification of renal artery lesions ? Harrison’s 18th Ed. 2049 A. DTPA scan B. Gadolinium-contrast magnetic resonance angiography C. Contrast arteriography D. Doppler ultrasound of the renal arteries Contrast arteriography remains the “gold standard” for evaluation and identification of renal artery lesions. 1412 In renal artery obstruction, functionally significant lesions occlude ? Harrison’s 18th Ed. 2049 A. > 30 % of the lumen B. > 50 % of the lumen C. > 70 % of the lumen D. > 90 % of the lumen Functionally significant renal artery lesions generally occlude more than 70% of the lumen of the affected renal artery. 1413 Which of the following is not a feature of primary aldosteronism ? Harrison’s 18th Ed. 2049 A. Sodium retention B. Hypertension C. Hypokalemia D. High PRA Excess aldosterone production in primary aldosteronism is independent of the renin-angiotensin system and leads to sodium retention, hypertension, hypokalemia, and low PRA. 1414 Hypokalemic hypertension is seen in ? Harrison’s 18th Ed. 2049 A. Primary aldosteronism B. Glucocorticoid-induced hypertension C. Pheochromocytoma D. All of the above Besides primary aldosteronism, hypokalemic hypertension may be a consequence of secondary aldosteronism, other mineralocorticoid- and glucocorticoid-induced hypertensive disorders, and pheochromocytoma. 1415 Plasma aldosterone (adult) level in supine position with patient on normal sodium diet normally is ? Harrison’s 18th Ed., Appendix: Laboratory Values of Clinical Importance, Table 2 A. < 16 ng/dL B. < 32 ng/dL C. < 48 ng/dL D. < 72 ng/dL 1416 Plasma aldosterone is suppressed by all except ? Harrison’s 18th Ed. 2050 A. Oral NaCl load B. Fludrocortisone C. Captopril D. Spironolactone Aldosterone antagonists, angiotensin receptor antagonists, and ACE inhibitors may increase renin. Aldosterone antagonists may increase aldosterone. IV infusion of isotonic saline, oral NaCl load, fludrocortisone, or captopril suppress aldosterone. 1417 Which of the following is false about aldosterone-producing adrenal adenoma

Question 21

Which of the following serves as “gold standard” for evaluation and identification of renal artery lesions ?

A	DTPA scan
B	Gadolinium-contrast magnetic resonance angiography
C	Contrast arteriography
D	Doppler ultrasound of the renal arteries

Question 21 Explanation:

Contrast arteriography remains the “gold standard” for evaluation and identification of renal artery lesions

Question 22

In renal artery obstruction, functionally significant lesions occlude ?

A	> 30 % of the lumen
B	> 50 % of the lumen
C	> 70 % of the lumen
D	> 90 % of the lumen

Question 22 Explanation:

Functionally significant renal artery lesions generally occlude more than 70% of the lumen of the affected renal artery

Question 23

Which of the following is not a feature of primary aldosteronism ?

A	Sodium retention
B	Hypertension
C	Hypokalemia
D	High PRA

Question 23 Explanation:

Excess aldosterone production in primary aldosteronism is independent of the renin-angiotensin system and leads to sodium retention, hypertension, hypokalemia, and low PRA.

Question 24

Hypokalemic hypertension is seen in ?

A	Primary aldosteronism
B	Glucocorticoid-induced hypertension
C	Pheochromocytoma
D	All of the above

Question 24 Explanation:

Besides primary aldosteronism, hypokalemic hypertension may be a consequence of secondary aldosteronism, other mineralocorticoid- and glucocorticoid-induced hypertensive disorders, and pheochromocytoma.

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See all quizzes of Hypertensive Vascular Disease at here:

Hypertensive Vascular Disease- Part 1 | Hypertensive Vascular Disease- Part 2 |Hypertensive Vascular Disease- Part 3|Hypertensive Vascular Disease- Part4| Hypertensive Vascular Disease- Part 5

1.Renin-producing carcinomas may be found in ?
A. Lung
B. Liver
C. Pancreas
D. All of the above

2. Angiotensinogen, renin, and angiotensin II are also synthesized locally in ?

A. Uterus
B. Brain
C. Spleen
D. All of the above

3. Angiotensin II in tissues may be formed by the enzymatic activity of ?
A. Tonin
B. Chymase
C. Cathepsins
D. All of the above

4. Which of the following is the primary trophic factor regulating synthesis & secretion of aldosterone by zona glomerulosa of adrenal cortex ?
A. Potassium
B. Adrenocorticotropic hormone (ACTH)
C. Angiotensin II
C. All of the above

5. Mineralocorticoid receptors are expressed in which of the following ?
A. Colon
B. Salivary glands
C. Sweat glands
D. All of the above

6. Which of the following has no affinity for the mineralocorticoid receptor ?
A. Aldosterone
B. Cortisol
C. Cortisone
D. All of the above

7. Myocardial fibrosis, nephrosclerosis, vascular inflammation and remodeling are the effects of which of the following ?
A. Aldosterone
B. Cortisol

C. Cortisone
D. All of the above

8. In CHF, low-dose spironolactone reduces the risk of progressive heart failure and sudden death from cardiac causes by ?
A. 10 %
B. 20 %
C. 30 %
D. 40 %

9. Intracellular pH (pHi) is regulated by ?
A. Na+ – H+ exchange
B. Na+ – dependent HCO3– – Cl– exchange
C. Cation-independent HCO3 – Cl– exchange
D. All of the above

10. Which of the following is increased in hypertension ?
A. Sympathetic outflow
B. Activity of the Na+ – H+ exchanger
C. Atrial natriuretic factor
D. All of the above
11. Which of the following is synthesized in adrenal medulla and released into circulation upon adrenal stimulation ?
A. Epinephrine
B. Norepinephrine
C. Dopamine
D. All of the above

12. Atherosclerotic, hypertension-related vascular lesions in the kidney primarily affect ?
A. Preglomerular arterioles
B. Glomerular capillaries
C. Postglomerular arterioles
D. All of the above

13. Renal lesion associated with malignant hypertension is ?
A. Fibrinoid necrosis of afferent arterioles

B. Fibrinoid necrosis of glomerular capillaries
C. Fibrinoid necrosis of efferent arterioles
D. All of the above

14. For every 20-mm Hg increase in SBP & 10-mm Hg increase in DBP, cardiovascular disease risk increases by ?
A. 1.5 times
B. 2 times
C. 2.5 times
D. 3 times

15. Among older individuals, which of the following is the least powerful predictor of cardiovascular disease ?
A. Systolic blood pressure
B. Diastolic blood pressure
C. Pulse pressure
D. None of the above

16. Blood pressure tends to be higher during which of the following times ?
A. Early morning hours soon after waking
B. Following meals
C. Evenings
D. Night

17. Generally, night time blood pressures are lower than day time blood pressures by ?
A. 5 – 10 %
B. 10 – 20 %
C. 20 – 30 %
D. 30 – 40 %

18. Which of the following about hypertension is false ?
A. More severe in glomerular than in interstitial diseases
B. Low-renin patients have volume-dependent hypertension
C. White coat hypertension does not develop into sustained hypertension
D. ~80 – 95% of hypertensive patients have “essential” hypertension

19. Which is the most common histologic variant of fibromuscular dysplasia ?
A. Medial fibroplasia
B. Perimedial fibroplasia
C. Medial hyperplasia
D. Intimal fibroplasia
.
20. Lesions of fibromuscular dysplasia mostly affect which portion of renal artery ?
A. Proximal
B. Mid
C. Distal
D. Any of the above

21. Which of the following serves as “gold standard” for evaluation and identification of renal artery lesions ?
A. DTPA scan
B. Gadolinium-contrast magnetic resonance angiography
C. Contrast arteriography
D. Doppler ultrasound of the renal arteries

22. In renal artery obstruction, functionally significant lesions occlude ?
A. > 30 % of the lumen
B. > 50 % of the lumen
C. > 70 % of the lumen
D. > 90 % of the lumen

23. Which of the following is not a feature of primary aldosteronism ?
A. Sodium retention
B. Hypertension
C. Hypokalemia
D. High PRA
.
24. Hypokalemic hypertension is seen in ?
A. Primary aldosteronism
B. Glucocorticoid-induced hypertension
C. Pheochromocytoma
D. All of the above

Hypertensive Vascular Disease

[MCQ] Hypertensive Vascular Disease- Part 2

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Hypertensive Vascular Disease- Part 2

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