Question 1

Which of the following best defines orthostatic hypotension?

Accepted Answer

An abnormal decrease in blood pressure upon moving from supine to upright position, defined as a drop of $$\geq 20 mm Hg in $$systolic or $$\geq 10 mm Hg in $$diastolic blood pressure.

Question 2

A patient experiences dizziness and blurred vision when standing up quickly in the morning. Which physiological mechanism is most likely impaired?

Accepted Answer

Baroreceptor-mediated increase in peripheral vascular resistance and heart rate.

Question 3

Which of the following medications is most likely to cause orthostatic hypotension due to decreased blood volume?

Accepted Answer

Thiazide diuretics

Question 4

A 75-year-old patient in a nursing home is at increased risk for orthostatic hypotension. Which factor contributes most to this risk?

Accepted Answer

Decreased compensatory autonomic nervous system response

Question 5

Which of the following is a neurogenic cause of orthostatic hypotension?

Accepted Answer

Diabetes-induced peripheral neuropathy

Question 6

A patient with heart failure develops orthostatic hypotension. Which mechanism best explains this?

Accepted Answer

Decreased intravascular volume leading to reduced venous return

Question 7

Which of the following symptoms is most directly related to decreased cerebral perfusion in orthostatic hypotension?

Accepted Answer

Blurred vision

Question 8

A patient is prescribed midodrine for orthostatic hypotension. What is the primary pharmacological action of this drug?

Accepted Answer

Alpha-1 receptor agonist causing vasoconstriction

Question 9

Which of the following shock syndromes is primarily characterized by impaired cardiac contractility and reduced cardiac output ($$CO$$)?

Accepted Answer

Cardiogenic shock

Question 10

In distributive (septic) shock, which of the following is the main cause of hypotension?

Accepted Answer

Proinflammatory cytokine-induced vasodilation leading to decreased systemic vascular resistance ($$SVR)$$

Question 11

A patient with Parkinson’s disease develops orthostatic hypotension. Which underlying mechanism is most likely responsible?

Accepted Answer

Autonomic nervous system dysfunction leading to impaired baroreflex response

Question 12

Which of the following is a recommended non-pharmacological intervention for orthostatic hypotension?

Accepted Answer

Rise slowly from a sitting position

Question 13

Which shock syndrome is most likely to present with histamine-induced vasodilation and decreased $$SVR$$?

Accepted Answer

Anaphylactic shock

Question 14

A patient with severe diarrhea and vomiting is at risk for orthostatic hypotension due to which mechanism?

Accepted Answer

Decreased intravascular volume from excessive gastrointestinal losses

Question 15

Which of the following is a common clinical sign of orthostatic hypotension?

Accepted Answer

Presyncope (feeling faint) upon standing

Question 16

Which of the following best describes the pathophysiology of hypovolemic shock?

Accepted Answer

Insufficient stroke volume ($$SV) $$due to decreased blood volume

Question 17

A patient with diabetes develops orthostatic hypotension. Which complication of diabetes is most likely responsible?

Accepted Answer

Peripheral neuropathy affecting autonomic nervous system function

Question 18

Which of the following is a structural (neurogenic) cause of orthostatic hypotension?

Accepted Answer

Parkinson’s disease

Question 19

Which of the following shock syndromes is associated with sympathetic outflow failure and decreased $$SVR$$?

Accepted Answer

Neurogenic shock

Question 20

A patient with orthostatic hypotension is advised to move their legs before standing. What is the physiological rationale for this advice?

Accepted Answer

Promotes venous blood return to the heart, reducing pooling in lower extremities

Disorders of Low Blood Pressure: Orthostatic Hypotension and Shock Syndromes

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