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ABFM + KSA Hypertension V1 (Latest Update 2025 / 2026) Questions & Answers | Grade A | 100% Correct (Verified Answers)

Question:

A 68-year-old male with a history of myocardial infarction is diagnosed with hypertension. His EKG is shown below. Given the EKG findings, which one of the following would NOT be safe to use in this patient?

• ACE inhibitors
• Angiotensin receptor blockers
• Dihydropyridine calcium channel blockers
• Hydrochlorothiazide
• Nondihydropyridine calcium channel blockers

Answer:

E

The EKG demonstrates a sinus bradycardia with second degree AV block (Mobitz I) and evidence of a septal myocardial infarction. Although the presence of a first degree block would not preclude the use of any of the listed options, the presence of heart block greater than first degree would contraindicate the use of β-blockers and nondihydropyridine calcium channel blockers in this patient.

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Question:

A 61-year-old female sees you for follow-up after a routine health maintenance examination. Her blood pressure at that visit was 132/84 mm Hg, and a follow-up measurement was 134/82 mm Hg.Based on current American College of Cardiology/American Heart Association guidelines, her blood pressure would be categorized as

• Normal
• Elevated
• Prehypertension
• stage 1 hypertension
• masked hypertension

Answer:

D

JNC 7 introduced the new blood pressure category of prehypertension for patients with a systolic blood pressure (SBP) of 120-139 mm Hg and/or a diastolic blood pressure (DBP) of 80-89 mm Hg. The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines eliminated

this term and divided blood pressure into four categories:

Normal blood pressure: SBP <120 mm Hg and DBP <80 mm Hg

Elevated blood pressure: SBP 120-129 mm Hg and DBP <80 mm Hg

Stage 1 hypertension: SBP 130-139 or DBP 80-89 mm Hg

Stage 2 hypertension: SBP >140 mm Hg or DBP >90 mm Hg

The term masked hypertension is used for patients found to consistently have hypertensive blood pressure readings at home or in nonhealthcare settings, or with ambulatory blood pressure monitoring, with consistently normal blood pressure readings in the office or clinic setting.Although JNC 7 did not recommend antihypertensive drug therapy for patients who continued to have prehypertension despite a trial of lifestyle modification, the 2017 ACC/AHA guidelines recommend drug therapy for those adults with stage 1 2 / 4

hypertension found to have an estimated 10-year atherosclerotic cardiovascular disease risk score ≥10%.

Question:

Which one of the following is most appropriate for initiating drug therapy for hypertension during pregnancy?

• Atenolol (Tenormin)
• Enalapril (Vasotec)
• Hydrochlorothiazide
• Labetalol (Trandate)
• Losartan (Cozaar)

Answer:

D

Antihypertensive therapy during pregnancy should be prescribed only for maternal safety, since it does not improve perinatal outcomes and may adversely affect uteroplacental blood flow. The 2017 American College of Cardiology/American Heart Association hypertension guidelines recommend that pregnant women or women who plan to become pregnant be transitioned to methyldopa, nifedipine, and/or labetalol (SOR C). ACE inhibitors and angiotensin receptor blockers are fetotoxic and are contraindicated during pregnancy. Atenolol has been associated with intrauterine growth retardation, as well as decreased placental growth and weight when taken during pregnancy. Although regarded in JNC 7 as probably safe, thiazide diuretics are not recommended as first-line therapy.

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Question:

A 19-year-old male college student sees you for follow-up of an emergency department (ED) visit. He says he was told that his symptoms were due to a panic attack. His past medical history is notable only for migraine headaches.On the day of his ED visit he was started on propranolol for the headaches.The initial physical examination in the ED was notable for a blood pressure of 198/114 mm Hg supine, dropping to 150/98 mm Hg on standing, and a heart rate of 112 beats/min. He reports that his symptoms improved after a couple hours in the ED and the record from the visit notes that his blood pressure was 140/90 mm Hg at the time of discharge.The patient says that he has always been an anxious person but has never experienced a similar attack in the past. He notes that his blood pressure has always been on the "high side" and his blood pressure in your office today is 144/86 mm Hg.Which one of the following should be c

Answer:

D

Pheochromocytomas are catecholamine-producing neuroendocrine tumors, and the majority arise from the adrenal medulla. They are a rare but important secondary cause of hypertension, whether sustained or paroxysmal. Paroxysmal hypertension with sweating, headaches, and palpitations is the usual presentation of pheochromocytoma. Other clinical clues to its presence include unexplained tachycardia, weight loss, episodic diaphoresis, unexplained orthostatic hypotension with a background of paroxysmal or refractory hypertension, and feelings of anxiety or panic attacks. β-Adrenergic blockers have been implicated in precipitating adverse reactions in patients with pheochromocytoma. The mechanism for β-blocker- associated adverse events is generally ascribed to inhibition of β2- adrenoceptor-mediated vasodilation, leaving adrenoceptor-mediated vasoconstriction unopposed. If a hypertensive crisis occurs in a patient taking β-blockers, the presence of a pheochromocytoma should be suspected.Furthermore, the Hypertension Canada 2017 guidelines recommend that the possibility of pheochromocytoma be considered in patients with

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