Question 1

Which of the following best defines orthostatic hypotension?

Accepted Answer

A decrease in systolic blood pressure of $$\geq 20 mm Hg or $$diastolic blood pressure of $$\geq 10 mm Hg $$upon moving from supine to upright position.

Question 2

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

Accepted Answer

Baroreceptor-mediated sympathetic nervous system activation

Question 3

Which medication is most likely to cause orthostatic hypotension due to decreased intravascular volume?

Accepted Answer

Loop diuretics

Question 4

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

Accepted Answer

Parkinson's disease

Question 5

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

Impaired compensatory mechanisms due to aging

Question 6

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

Accepted Answer

Rise slowly from a sitting position

Question 7

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

Accepted Answer

Cardiogenic shock

Question 8

A patient with severe diarrhea and vomiting presents with hypotension and tachycardia. Which type of shock is most likely?

Accepted Answer

Hypovolemic shock

Question 9

Which of the following best explains the initial compensatory response to standing in a healthy individual?

Accepted Answer

Baroreceptors signal the brainstem to increase sympathetic output, causing increased peripheral vascular resistance and heart rate.

Question 10

Which of the following is a common symptom of orthostatic hypotension due to decreased cardiac output?

Accepted Answer

Syncope (loss of consciousness)

Question 11

A patient with diabetes develops orthostatic hypotension. What is the most likely underlying mechanism?

Accepted Answer

Peripheral neuropathy causing autonomic dysfunction

Question 12

Which of the following agents is used to treat orthostatic hypotension by promoting vasoconstriction via alpha-1 receptor activation?

Accepted Answer

Midodrine

Question 13

Which shock syndrome is associated with proinflammatory cytokine-induced vasodilation and normal or increased cardiac output?

Accepted Answer

Septic shock

Question 14

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

Accepted Answer

Neurogenic shock

Question 15

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

Accepted Answer

Neurodegenerative disorders

Question 16

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

Accepted Answer

Neck pain secondary to muscle hypoperfusion

Question 17

Which of the following medications can cause orthostatic hypotension by vasodilation?

Accepted Answer

Nitrates

Question 18

A patient with anaphylactic shock is most likely to have which primary blood pressure derangement?

Accepted Answer

Decreased systemic vascular resistance ($$SVR) $$due to histamine-induced vasodilation

Question 19

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

Accepted Answer

Vasopressin release and RAAS activation

Question 20

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

Accepted Answer

Decreased effective blood volume and venous return

Disorders of Low Blood Pressure: Orthostatic Hypotension and Shock Syndromes

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