Quiz: Veterinary Hypertension Management — 12 perguntas

1. What best describes secondary hypertension in dogs and cats?

A. Low arterial pressure caused by heart failure

B. Idiopathic hypertension that is common in humans but rare in pets

C. Persistently elevated systemic arterial pressure caused by an underlying disease

D. A temporary blood pressure rise after stress or exercise

Answer: (C)

Explicação

Secondary hypertension is caused by a specific underlying disorder that drives the elevated blood pressure. Idiopathic hypertension is primary hypertension, which is rare in dogs and cats.

2. Which disease is most commonly associated with systemic hypertension in dogs and cats?

A. Otitis externa

B. Intervertebral disk disease

C. Pancreatitis

D. Chronic renal disease

Answer: (D)

Explicação

Chronic renal disease is the most common associated disease with systemic hypertension. The other choices are not listed as common associations.

3. Which set of signs best reflects target organ damage from systemic hypertension?

A. Lameness, fever, and weight gain

B. Hypertensive retinopathy, azotemia, and proteinuria

C. Pruritus, vomiting, and diarrhea

D. Sneezing, coughing, and nasal discharge

Answer: (B)

Explicação

Target organ damage commonly affects the eyes and kidneys, producing signs such as retinopathy, azotemia, and proteinuria. The other options do not match the typical organ systems involved.

4. A pheochromocytoma is best described as what kind of lesion?

A. A thyroid follicular tumor

B. A cardiac muscle inflammation

C. A renal cortical cyst

D. A rare adrenal medulla tumor from chromaffin cells

Answer: (D)

Explicação

A pheochromocytoma is a rare adrenal medulla tumor arising from chromaffin cells. It is one of the diseases associated with hypertensive target organ damage.

5. When should antihypertensive treatment be started if systemic hypertension is accompanied by active target organ damage?

A. Only after several months of observation

B. When SBP is above 160 mm Hg

C. Only if the patient also has hypotension signs

D. When SBP is above 120 mm Hg

Answer: (B)

Explicação

Treatment is initiated when systolic blood pressure is greater than 160 mm Hg with active target organ damage. The 160 mm Hg threshold is the key trigger.

6. How should persistent hypertension be managed when systolic blood pressure is repeatedly confirmed above 160 mm Hg?

A. Begin treatment even without active target organ damage

B. Use no treatment unless seizures occur

C. Treat only if azotemia is absent

D. Wait until blood pressure exceeds 200 mm Hg

Answer: (A)

Explicação

Repeated confirmation of systolic blood pressure above 160 mm Hg is itself an indication to start treatment. Waiting for severe complications would be inappropriate.

7. Which drug is an appropriate initial ACE inhibitor option for systemic hypertension in dogs?

A. Amlodipine

B. Telmisartan

C. Spironolactone

D. Enalapril

Answer: (D)

Explicação

Enalapril is one of the ACE inhibitors used as initial therapy in dogs. Amlodipine is the first-line feline drug, while telmisartan is an ARB.

8. What is recommended for a dog with persistent systolic blood pressure above 160 mm Hg despite initial ACE inhibitor therapy?

A. Reduce the ACE inhibitor dose because the pressure is still high

B. Switch immediately to no medication

C. Increase the ACE inhibitor dose and add a second-line drug

D. Stop antihypertensive therapy and recheck in three months

Answer: (C)

Explicação

If systolic blood pressure remains above 160 mm Hg, the ACE inhibitor dose should be increased and a second-line agent added. This is the prescribed step-up approach in dogs.

9. Which medication is considered first-line therapy for feline systemic hypertension?

A. Amlodipine besylate

B. Atenolol

C. Benazepril

D. Enalapril

Answer: (A)

Explicação

Amlodipine besylate is the first-line drug for cats with systemic hypertension. The other options are not the primary first-line choice in cats.

10. How does telmisartan differ from amlodipine in cats with systemic hypertension?

A. Amlodipine is an ACE inhibitor, while telmisartan is a calcium-channel blocker

B. Both drugs have identical onset and peak timing

C. Telmisartan works faster than amlodipine in every case

D. Telmisartan reaches peak effect later, while amlodipine reaches steady effect within days

Answer: (D)

Explicação

Amlodipine reaches steady effect within 3 to 5 days, whereas telmisartan reaches peak effect later, around 14 days. This difference is important when planning follow-up.

11. Which adverse effect is specifically noted with enalapril in dogs?

A. Retinal detachment

B. Marked salivation

C. Fever and coughing

D. Severe hyperglycemia

Answer: (C)

Explicação

Enalapril may induce fever and coughing in dogs. Other adverse effects listed in the material are associated with different drugs or are not mentioned.

12. Why might RAAS-suppressing medication be considered in some hypertensive cats treated with amlodipine?

A. RAAS activation prevents any cardiovascular remodeling

B. RAAS suppression is needed only because amlodipine causes kidney stones

C. Amlodipine permanently eliminates RAAS activity

D. Amlodipine can activate RAAS, which may contribute to cardiac fibrosis and salt and water retention

Answer: (D)

Explicação

In hypertensive cats treated with amlodipine, RAAS was found to be activated, and long-term activation may increase cardiac fibrosis risk and promote salt and water retention. That is why RAAS-suppressing drugs may be needed in some cases.