QCM : Veterinary Hypertension Management — 12 questions

Questions et réponses du QCM

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

Low arterial pressure caused by heart failure
Idiopathic hypertension that is common in humans but rare in pets
Persistently elevated systemic arterial pressure caused by an underlying disease
A temporary blood pressure rise after stress or exercise

Persistently elevated systemic arterial pressure caused by an underlying disease

Explication

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?

Otitis externa
Intervertebral disk disease
Pancreatitis
Chronic renal disease

Chronic renal disease

Explication

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?

Lameness, fever, and weight gain
Hypertensive retinopathy, azotemia, and proteinuria
Pruritus, vomiting, and diarrhea
Sneezing, coughing, and nasal discharge

Hypertensive retinopathy, azotemia, and proteinuria

Explication

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 thyroid follicular tumor
A cardiac muscle inflammation
A renal cortical cyst
A rare adrenal medulla tumor from chromaffin cells

A rare adrenal medulla tumor from chromaffin cells

Explication

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?

Only after several months of observation
When SBP is above 160 mm Hg
Only if the patient also has hypotension signs
When SBP is above 120 mm Hg

When SBP is above 160 mm Hg

Explication

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?

Begin treatment even without active target organ damage
Use no treatment unless seizures occur
Treat only if azotemia is absent
Wait until blood pressure exceeds 200 mm Hg

Begin treatment even without active target organ damage

Explication

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?

Amlodipine
Telmisartan
Spironolactone
Enalapril

Enalapril

Explication

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?

Reduce the ACE inhibitor dose because the pressure is still high
Switch immediately to no medication
Increase the ACE inhibitor dose and add a second-line drug
Stop antihypertensive therapy and recheck in three months

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

Explication

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?

Amlodipine besylate
Atenolol
Benazepril
Enalapril

Amlodipine besylate

Explication

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?

Amlodipine is an ACE inhibitor, while telmisartan is a calcium-channel blocker
Both drugs have identical onset and peak timing
Telmisartan works faster than amlodipine in every case
Telmisartan reaches peak effect later, while amlodipine reaches steady effect within days

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

Explication

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?

Retinal detachment
Marked salivation
Fever and coughing
Severe hyperglycemia

Fever and coughing

Explication

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?

RAAS activation prevents any cardiovascular remodeling
RAAS suppression is needed only because amlodipine causes kidney stones
Amlodipine permanently eliminates RAAS activity
Amlodipine can activate RAAS, which may contribute to cardiac fibrosis and salt and water retention

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

Explication

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.

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Mémorisez les réponses avec 12 flashcards sur Veterinary Hypertension Management.

Systemic hypertension — definition?

Persistent high pressure in systemic arteries.

Primary hypertension — cause?

Idiopathic, no identifiable underlying disease.

Secondary hypertension — cause?

Result of specific underlying disease.

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