A 42 year-old male comes to your primary care office complaining of hearing loss. He was started on a new medication 8 months ago. His hearing loss progressively became worse over the time. Two months ago, he reduced the dose of the medication, yet his hearing has not improved. Of the following, which group of medications can cause ototoxicity independent of their dose?
A 68 year-old woman comes to your primary clinic complaining of ringing in the ears, hearing loss, lightheadedness, and a feeling that something is ‘stuffed in my ears’. She reports that these symptoms started after she was initiated on a ‘kidney pill’. Of the following, which is the most likely culprit?
A 45 year-old African-American patient comes to your office for the treatment of his blood pressure because last week he was disqualified to work as a commercial truck operator because of his uncontrolled hypertension. He has no other medical problems. His physical examination is unremarkable. Which of the following should be the initial medication in this patient?
Christina, a 55-year-old woman, presents to her primary care physician with a blood pressure reading of 150/90 mmHg. She has a history of hypertension but has not been consistently taking her medications. The physician discusses the importance of controlling blood pressure to reduce the risk of heart disease, stroke, and kidney disease. She is started on a diuretic to lower her blood pressure. She is educated about the potential side effects of the medication. She is advised to monitor her blood pressure at home and report any side effects to her doctor. Of the following, which diuretic is most commonly associated with development of gout?
A 54-year-old man presents to the clinic for a pre-employment physical examination. He has no complaints other than ‘occasional coughs and colds’. His only concern is elevated blood pressure for the last 4 weeks. He made some lifestyle changes including exercise, weight loss, smoking cessation and a low-salt diet. His temperature is 99 ⁰ F, heart rate is 72 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 160/90 mm Hg. You prescribe hydrochlorothiazide to treat his hypertension. Of the following, which is the mechanism of action of this medication?
A 54-year-old man presents to the clinic for a pre-employment physical examination. He has no complaints other than ‘occasional coughs and colds’. His only concern is elevated blood pressure for the last 4 weeks. He made some lifestyle changes including exercise, weight loss, smoking cessation and a low-salt diet. His temperature is 99 ⁰ F, heart rate is 72 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 160/90 mm Hg. You prescribe hydrochlorothiazide to treat his hypertension.What is the major site of action of this medication?
A 54-year-old man presents to the clinic for a pre-employment physical examination. He has no complaints other than ‘occasional coughs and colds’. His only concern is elevated blood pressure for the last 4 weeks. He made some lifestyle changes including exercise, weight loss, smoking cessation and a low-salt diet. His temperature is 99 ⁰ F, heart rate is 72 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 160/90 mm Hg. You prescribe hydrochlorothiazide to treat his hypertension. Which of the following is true about this medication?
A 54-year-old man presents to the clinic for a pre-employment physical examination. He has no complaints other than ‘occasional coughs and colds’. His only concern is elevated blood pressure for the last 4 weeks. He made some lifestyle changes including exercise, weight loss, smoking cessation and a low-salt diet. His temperature is 99 ⁰ F, heart rate is 72 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 160/90 mm Hg. You prescribe hydrochlorothiazide to treat his hypertension. Which of the following is an adverse effect of this medication?
A 55-year-old woman presents to your office because she would like to get started on a medication for hypertension.She reports she feels well and has no complaints today. Her blood pressure today is 140/86 mm Hg. Routine laboratory tests done are within normal limits. She never smoked and has no family history of abdominal aortic aneurysm. What is the most appropriate next step in the management of this patient?
