Question 1

Which of the following best defines orthostatic hypotension?

Accepted Answer

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

Question 2

A patient experiences dizziness and blurred vision upon standing. Their blood pressure drops from 130/80 mm Hg to 108/68 mm Hg. Does this meet the criteria for orthostatic hypotension?

Accepted Answer

No, because the drop in systolic BP is less than $$20 mm Hg.$$

Question 3

Which of the following is a common symptom of orthostatic hypotension due to decreased cerebral perfusion?

Accepted Answer

Blurred vision

Question 4

Which medication is most likely to cause orthostatic hypotension by reducing blood volume?

Accepted Answer

Thiazide diuretics

Question 5

Which of the following mechanisms is primarily responsible for the quick compensation of blood pressure when moving from supine to upright position?

Accepted Answer

Baroreceptor-mediated increase in sympathetic nervous system output

Question 6

Which population is at greatest risk for developing orthostatic hypotension?

Accepted Answer

Elderly individuals, especially those institutionalized

Question 7

A patient with Parkinson’s disease is experiencing frequent episodes of dizziness upon standing. What is the most likely cause?

Accepted Answer

Neurogenic orthostatic hypotension due to autonomic dysfunction

Question 8

Which of the following is NOT a recommended intervention for managing orthostatic hypotension?

Accepted Answer

Encouraging rapid standing from a lying position

Question 9

Which shock syndrome is characterized by impaired cardiac contractility leading to decreased cardiac output ($$CO$$)?

Accepted Answer

Cardiogenic shock

Question 10

A patient presents with sustained hypotension ($$BP \u003c 90 mm Hg$$), tachycardia, and cool, clammy skin after severe blood loss. Which type of shock is most likely?

Accepted Answer

Hypovolemic shock

Question 11

Which of the following is a distinguishing feature of distributive (septic) shock compared to hypovolemic shock?

Accepted Answer

Proinflammatory cytokine-induced vasodilation

Question 12

Which of the following best explains why patients with diabetes are at increased risk for neurogenic orthostatic hypotension?

Accepted Answer

Diabetes leads to peripheral neuropathies that impair autonomic nervous system function.

Question 13

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

Accepted Answer

Nocturnal diuresis leading to decreased blood volume

Question 14

A patient with heart failure is at risk for orthostatic hypotension primarily due to which mechanism?

Accepted Answer

Decreased intravascular volume and venous return

Question 15

Which of the following medications acts as a vasoconstrictor via alpha-1 receptor stimulation to treat orthostatic hypotension?

Accepted Answer

Midodrine

Question 16

Which shock syndrome is most likely to present with warm, flushed skin due to histamine-induced vasodilation?

Accepted Answer

Anaphylactic shock

Question 17

A patient with spinal cord injury develops hypotension and bradycardia. Which shock syndrome is most likely?

Accepted Answer

Neurogenic shock

Question 18

Which of the following is a multi-step compensatory response to standing that helps maintain blood pressure?

Accepted Answer

Baroreceptor activation $$\rightarrow$$ increased sympathetic output $$\rightarrow$$ increased peripheral vascular resistance and heart rate

Question 19

Which of the following is a plausible reason why post-prandial orthostatic hypotension occurs?

Accepted Answer

Increased splanchnic blood capacity after meals reduces effective circulating blood volume.

Disorders of Low Blood Pressure: Orthostatic Hypotension and Shock Syndromes

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