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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Related Questions
Correct Answer is B
Explanation
Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.
Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.
Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.
Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.
Correct Answer is C
Explanation
Exposure to cold temperatures should be avoided by the patient with peripheral vascular disease such as Raynaud’s disease.
This is because cold temperatures can trigger vasospasm, which is a sudden narrowing of the small arteries in the fingers or toes, limiting blood flow and causing pain, numbness and color changes.
Choice A is wrong because wearing warm mitten gloves can help prevent or reduce the severity of Raynaud’s attacks by keeping the hands warm.
Choice B is wrong because wearing socks can also help protect the feet from cold exposure and prevent or reduce Raynaud’s attacks.
Choice D is wrong because engaging in regular exercise can improve blood circulation and reduce the frequency and duration of Raynaud’s attacks.However, exercise should be done with caution and proper clothing to avoid injury or frostbite to the affected areas.
Normal ranges for peripheral vascular disease are not applicable, as it is a condition that affects the blood vessels and not a specific blood test or measurement.
However, some tests that can help diagnose peripheral vascular disease or its underlying causes are blood pressure measurement, ankle-brachial index, Doppler ultrasound, angiography, blood tests for cholesterol, glucose, clotting factors and inflammatory markers.
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