Problem 7: As the nurse coordinator for Lowtensin RX, you enrolled 1,000 hyperte
ID: 3515803 • Letter: P
Question
Problem 7: As the nurse coordinator for Lowtensin RX, you enrolled 1,000 hypertensive subjects in a drug trial for the new aldosterone receptor antagonist ARBX. After the initial screening, you find the subjects segregate in three distinct groups A, B, and C as follows:
Group
Subjects
Enrolled
Mean Age
Mean BMI
BP
Plasma AT II
Plasma Aldo
Plasma Renin
Plasma Na
Plasma
K
Plasma
pH
Normal
NA
NA
20-25
120/80
20-60
5-20
8.5-9.5
145
4.5
7.43
A
898
55
28
158/102
22
7
9.3
145
4.5
7.43
B
52
51
26
175/105
5
35
7.9
146
3.4
7.19
C
50
59
27
172/102
115
35
16.0
146
3.5
7.18
1. Group B should be screened first for:
A. A norepinephrine secreting tumor.
B. An epinephrine secreting tumor.
C. An aldosterone secreting tumor.
D. Partial occlusion of the renal arteries..
E. Partial occlusion of the carotid arteries.
2. Group C should be screened first for:
A. A norepinephrine secreting tumor.
B. An epinephrine secreting tumor.
C. An aldosterone secreting tumor.
D. Partial occlusion of the renal arteries.
E. Partial occlusion of the carotid arteries.
3. Which group(s) would respond significantly to ARBX?
A. None.
B. Group A.
C. Group B
D. Group C.
E. Groups B and C.
4. Which group(s) would respond significantly to an ACE inhibitor?
A. None.
B. Group A.
C. Group B
D. Group C.
E. All groups equally well.
Group
Subjects
Enrolled
Mean Age
Mean BMI
BP
Plasma AT II
Plasma Aldo
Plasma Renin
Plasma Na
Plasma
K
Plasma
pH
Normal
NA
NA
20-25
120/80
20-60
5-20
8.5-9.5
145
4.5
7.43
A
898
55
28
158/102
22
7
9.3
145
4.5
7.43
B
52
51
26
175/105
5
35
7.9
146
3.4
7.19
C
50
59
27
172/102
115
35
16.0
146
3.5
7.18
Explanation / Answer
1.
D. Partial occlusion of the renal arteries.
Because there is low angiotensin II causes vaso dilatation which may ultimately reduces the perfusion to the kidneys.
2.
E. Partial occlusion of carotid arteries. Because the increased AT-II effects on the blood pressure leads to smooth muscle damage and also causes atherosclerosis.
3.
B. Group- B. In the treatment aim is to reduce the bp by means of reducing angiotensin-II. At-II main function is to reduce the pb
4.
D. Group C. Rationale is about patient is having high angiotensin-II which may causes vary disorders, so ACE inhibitors are significant to reduce the BP.