A 65-year-old female presents to the rapid access transient ischaemic attack clinic with a history of transient loss of vision in the right eye over the past three weeks. Upon examination, a carotid ultrasound reveals a 48% stenosis of her right carotid artery and an ECG shows sinus rhythm. The patient was initiated on aspirin 300 mg od by her GP after the first episode. What is the optimal course of action for managing this patient?
A 75 year old man has come for a surgical consultation regarding an ambulatory blood pressure monitoring reading of 142/84 mmHg. He has no history of coronary heart disease, renal disease or diabetes, and is only taking lansoprazole regularly. His 10-year cardiovascular risk score was recently assessed to be 8%. Which of the following should be included in his management plan for follow up?
A 57-year-old caucasian woman is diagnosed with stage 2 hypertension. Baseline investigations do not reveal evidence of end-organ damage. She has a history of atrial fibrillation and takes apixaban. Her ECG is normal. Her QRISK3 score is calculated as 12.4%. She has no known drug allergies. Lifestyle advice is given and appropriate follow-up is scheduled. What is the most effective supplementary treatment choice?
A 79-year-old man presents with ongoing angina attacks despite being on atenolol 100 mg od for his known ischaemic heart disease. On examination, his cardiovascular system appears normal with a pulse of 72 bpm and a blood pressure of 158/96 mmHg. What would be the most suitable course of action for further management?
A 70-year-old man visits a neurovascular clinic for a check-up. He had a stroke caused by a blood clot 3 weeks ago but has been recovering well. However, the patient had to discontinue taking clopidogrel 75 mg due to severe abdominal discomfort and diarrhea after switching from aspirin 300 mg daily. Since then, the symptoms have subsided.
What would be the best medication(s) to recommend for preventing another stroke in this case?
An 80-year-old woman is brought to the clinic by her family members. She has been experiencing increasing shortness of breath and low energy levels for the past 6 weeks. Upon conducting an ECG, it is revealed that she has atrial fibrillation with a heart rate of 114 / min. Her blood pressure is 128/80 mmHg and a chest x-ray shows no abnormalities. What medication should be prescribed to manage her heart rate?
An 80-year-old man has been diagnosed with atrial fibrillation during his annual hypertension review after an irregular pulse was detected. He has no bleeding risk factors, no other co-morbidities, and a CHA2DS2VASc score of 3. He consents to starting medication for stroke prevention. What is the recommended first-line treatment for stroke prevention in this case?
Which one of the following statements regarding calcium channel blockers is accurate?
Which one of the following statements regarding B-type natriuretic peptide is incorrect?
A 64-year-old man visits his primary care physician for a blood pressure check-up. He has a medical history of hypertension, hypercholesterolemia, and ischemic heart disease.
The patient is currently taking the following medications:
– Ramipril 10 mg once daily
– Amlodipine 10 mg once daily
– Bendroflumethiazide 2.5mg once daily
– Atorvastatin 80 mg once daily
– Aspirin 75 mg once daily
The most recent change to his blood pressure medication was the addition of bendroflumethiazide 6 months ago, which has reduced his average home systolic readings by approximately 15 mmHg. The average of home blood pressure monitoring over the past two weeks is now 160/82 mmHg.
A blood test is conducted, and the results show:
– K+ 4.6 mmol/L (3.5 – 5.0)
After ruling out secondary causes of hypertension, what is the next course of action in managing his blood pressure?