繼續教育考題
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1.
(E) |
In patients with
primary aldosteronism, which of the following statements is wrong? |
A | A benign aldosterone-producing
adenoma accounts for 75% of cases of primary aldosteronism. |
B | Idiopathic hyperaldosteronism
accounts for about 20 % of cases. |
C | In idiopathic
hyperaldosteronism the adrenals are either normal in appearance or
reveal bilateral micro- or macronodular adrenal hyperplasia. |
D | After 2-4 hrs in upright
posture, 90% of patients with adenoma will show no significant
change or a frank decrease in plasma aldosterone levels. |
E | After 2-4 hrs in upright
posture, aldosterone levels almost always decrease in those with
idiopathic hyperaldosteronism. |
2.
(D) |
Which of the following
is not a common ECG change of hypokalemia? |
A | Flattening or inversion of the
T wave. |
B | A prominent U wave. |
C | ST segment depression. |
D | A shortened QU interval. |
E | A prolonged PR interval. |
3.
(A) |
For diagnosing
secondary causes of hypertension, which of the following patients
with hypertension should have a workup beyond routine laboratory
studies (blood urea nitrogen, glucose, creatinine, calcium, uric
acid, potassium, cholesterol, triglyceride, ECG and CxR)? |
A | A 45-year-old man with an
unknown prior history that presents with a BP of 160/100-mmHg and
left ventricular heave on physical examination. |
B | A 35-year-old woman with a
prior history of normotension who presents with a BP of 160/105 and
an abdominal bruit. |
C | A 60-year-old man with a prior
history of normotension who presents with a BP of 160/100. |
D | A 40-year-old woman with a
prior history of normotension who presents with a BP of 160/105
unresponsive to captopril and hydrochlorothiazide. |
E | A 22-year-old man with a prior
history of normotension who presents with a BP of 160/105 but
otherwise normal physical examination. |
4.
(B) |
Patients with primary
aldosteronism typically come to medical attention because of
symptoms of followings, except: |
A | Fatigue and weakness. |
B | Clinical edema. |
C | Increased thirst and
polyuria. |
D | Increased diastolic blood
pressure. |
E | All of the above statements
are correct. |
5.
(E) |
Persistent
post-operative hypertension may related to: |
A | The chronicity of
hypertension. |
B | The presence of end-organ
damages. |
C | The coexistence of essential
hypertension. |
D | Idiopathic hyperplasia of
bilateral adrenals |
E | All of the above are correct. |
6.
(C) |
6. About the
mechanisms by which mineralocorticoids produce hypertension, which
of the following statements is incorrect? |
A | The initiating events are the
physiologic consequences of mineralocorticoid-induced expansion of
plasma and extracellular fluid volume. |
B | After gaining 1-2 L of
extracellular fluid, the phenomenon of Na+ “escape” follows. |
C | The chronic phase of
mineralocorticoid excess is characterized by an increase in stroke
volume and cardiac output. |
D | The chronic phase of
mineralocorticoid excess is characterized by an increase in
peripheral vascular resistance. |
E | A direct central action of
aldosterone. |
7.
(C) |
In the diagnosis of
diastolic hypertension with hypokalemia, if no tumor is seen in
adrenal CR or MRI, measuring plasma aldosterone level after
dexamethasone administration is intended to rule out which of the
following disease? |
A | Liddle’s syndrome. |
B | 11 beta-hydroxysteroid
dehydrogenase deficiency. |
C | Glucocorticoid-remediable
aldosteronism. |
D | Chronic licorice ingestion. |
E | Aldosterone-producing
adrnocortical carcinoma |
8.
(C) |
Which is the accurate
pathway of aldosterone synthesis? (1) Cholesterol (2)
Corticosterone (3) Deoxycorticosterone (4) Pregnenolone
(5) Progesterone (6) Aldosterone |
A | (1)(4)(2)(3)(5)(6) |
B | (1)(4)(5)(2)(3)(6) |
C | (1)(4)(5)(3)(2)(6) |
D | (1)(4)(2)(5)(3)(6) |
E | (1)(4)(3)(5)(2)(6) |
9.
(B) |
Which of the following
is not included in pseudohyperaldosteronism, in which the clinical
features are consistent with mineralocorticoid excess yet endogenous
mineralocorticoid secretion is abnormally low? |
A | Liddle’s syndrome. |
B | Bartter’s syndrome. |
C | Syndrome of apparent
mineralocorticoid excess |
D | 11 beta-hydroxysteroid
dehydrogenase deficiency |
E | Chronic ingestion of licorice. |
10.
(A) |
About the treatment
options of primary aldosteronism, which of the following is
incorrect? |
A | Subtotal adrenalectomy usually
corrects hypokalemia and hypertension in patients with idiopathic
aldosteronism. |
B | Unilateral adrenalectomy is
recommended in patients with an aldosterone-producing adenoma. |
C | The surgical cure rate of
hypertension associated with adenoma is excellent. |
D | Patients with idiopathic
aldosteronism should not be routinely sent to surgery. |
E | Spironolactone reduces the
volume of the expanded extracellular fluid toward normal and
promotes potassium retention, is suitable for preoperative
preparation of these patients. |