QuestionSBA
QuestionChoice
Whilst this gentleman's potassium has raised, it hasn't risen significantly. There are no other mentions of any side effects associated with ramipril in the question - therefore he should continue on ramipril.
50216
a
Don't change his treatment
QuestionChoice
Whilst this gentleman's potassium has raised, it hasn't risen significantly. There are no other mentions of any side effects associated with ramipril in the question - therefore he should continue on ramipril.
50217
b
Stop his ramipril now
QuestionChoice
Whilst this gentleman's potassium has raised, it hasn't risen significantly. There are no other mentions of any side effects associated with ramipril in the question - therefore he should continue on ramipril.
50219
d
Switch him to amlodipine
QuestionChoice
There is no indication to increase this gentleman's ramipril dose as his blood pressure reading isn't too high.
50218
c
Increase ramipril to 10mg PO OD
QuestionChoice
Whilst this gentleman's potassium has raised, it hasn't risen significantly. There are no other mentions of any side effects associated with ramipril in the question - therefore he should continue on ramipril.
50220
e
Switch him to candesartan
QuestionComment
In the question his potassium has gone down from 4.4 to 3.6 - so it is not raised? Your answer comment doesn't correlate with the question!
17637
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Myotonia Hypertension
QuestionComment
isn't the BP still hypertensive so why wouldn't you increase ramipril to get a better contrl of his BP
33002
QuestionComment
increased by 1 in the clinic setting 
40253
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Serpiginous Defibrillator
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RNA Retrograde
QuestionComment
I get that his BP could be slightly raised due to the white coat effect, but given this is an exam where you have to follow BNF guidelines closely, the 141/82 reading is unnecessarily confusing. The cutoff for hypertension treatment targets is 140/90 in a patient under 80 years old. If you want to write the question to imply the patient's BP is well-controlled, why not just say his BP is 139/82?? 
40421
QuestionComment
mashallah Brether?Sester?

60940
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Gallbladder Poisoning
QuestionComment
agree so much
61586
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Vaccine Complement
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Edema Power
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3621
A potassium level change that is under the limit to change the dose of an ACE inhibitor
Topic
92
General Practice
10091
Case Presentation: A 49-year-old gentleman is attends his GP for a review of his blood pressure medication. 




 **PMH**
Hypertension


 **DH**
Ramipril 5mg PO OD.


 **Investigations**
Today's bloods:


||||
|---------------------------|:-------:|--------------------|
|Sodium|141 mmol/L|135 - 145|
|Potassium|3.6 mmol/L|3.5 - 5.3|
|Urea|3.4 mmol/L|2.5 - 7.8|
|Creatinine|66 µmol/L|60 - 120|



Bloods from 3 months ago:


||||
|---------------------------|:-------:|--------------------|
|Sodium|139 mmol/L|135 - 145|
|Potassium|4.4 mmol/L|3.5 - 5.3|
|Urea|3.6 mmol/L|2.5 - 7.8|
|Creatinine|71 µmol/L|60 - 120|


Today's blood pressure: 141/82 mmHg


Question: Select the most appropriate decision option based on this data
a