Return to course: NICE CKS Question Banks
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Hypertension (P)
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Course Curriculum
1. At what clinic BP should hypertension be diagnosed, confirmed by ABPM or HBPM?
*
≥130/80 mmHg
≥140/90 mmHg
≥160/100 mmHg
≥120/80 mmHg
2. When should antihypertensive treatment be offered in stage 1 hypertension?
*
Only when BP >160/100 mmHg
To all patients regardless of age
If <80 years with organ damage or 10-year CVD risk ≥10%
Only in symptomatic patients
3. What is the target clinic BP for someone <80 years on treatment?
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<150/90 mmHg
<130/80 mmHg
<140/90 mmHg
<120/70 mmHg
4. What is the first-line antihypertensive in people <55 years with no comorbidities?
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Thiazide-like diuretic
Calcium-channel blocker
Beta-blocker
ACE inhibitor or ARB
5. Which class is preferred first-line in people ≥55 or Black African/African-Caribbean origin?
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ACE inhibitor
Beta-blocker
ARB
Calcium-channel blocker
6. What lifestyle advice is important in hypertension?
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High-protein diet and vitamin supplements
Reduce salt, exercise, weight loss, alcohol moderation
Increase dairy and caffeine
Strict calorie restriction
7. What is third-line treatment in resistant hypertension?
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Spironolactone
Statin
Calcium-channel blocker
Nitrate
8. How often should BP be monitored in controlled hypertension <80 yrs
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Every 6 months
At least annually
Every 2 years
Every 3 years
9. Key investigations before starting antihypertensives include:
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LFTs, INR, chest X-ray
U&E, eGFR, HbA1c, lipids, urinalysis, ECG
CRP, spirometry, echo
Troponin, ESR, CT angiogram
10. Clinic BP ≥180/120 mmHg with symptoms or papilloedema requires:
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Recheck in 1 month
Reassurance and lifestyle advice
Immediate referral and organ damage workup
Start aspirin only
11. What test should confirm a diagnosis of hypertension after raised clinic BP?
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Fasting blood glucose
ABPM or HBPM
ECG
Echocardiogram
12. What antihypertensive combination is appropriate at step 2?
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ACE inhibitor + CCB
Beta-blocker + nitrate
Statin + aspirin
Thiazide + nitrate
13. What is the recommended initial dose of spironolactone for resistant hypertension?
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25 mg OD
100 mg OD
5 mg twice daily BD
50 mg weekly
14. In people aged ≥80 years, what is the target clinic BP?
*
<140/90 mmHg
<150/90 mmHg
<160/100 mmHg
<130/80 mmHg
15. Which investigation assesses for left ventricular hypertrophy?
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Urinalysis
Fundoscopy
ABPM
ECG
16. Which medication is avoided in pregnancy for hypertension?
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Methyldopa
Labetalol
Nifedipine
ACE inhibitors
17. In diabetic patients with hypertension, which class is preferred first-line?
*
CCB
Thiazide
Beta-blocker
ACE inhibitor
18. Which symptom would trigger urgent referral in hypertension?
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Dizziness
Headache and blurred vision
Mild chest discomfort
Dry mouth
19. A QRISK3 score ≥10% in stage 1 hypertension warrants:
*
Starting antihypertensive treatment
Referral to cardiology
Lifestyle advice only
Annual ECG
20. Why is beta-blocker monotherapy no longer first-line in hypertension?
*
Worse outcomes in stroke prevention
Not effective in lowering BP
Too expensive
Causes significant hyperkalaemia