1. Case I A 47 old male presents to your office for a yearly checkup. He smokes 40 cigarette/day, and examination detect wheezy chest and bronchospasm. His blood pressure is 175/105 mm Hg. (measured more than once). His fundoscopic examination is normal. 1-Mention the stage of hypertension in this case? 2-Mention the investigations of a patient with hypertension? 3-What is the goal of hypertension therapy ? 4-What are the most common drug classes in therapy of hypertension now ?

2. 5-What are other drug classes used for treatment of hypertension ? Can you start with thiazide in this case? 6-What is the mechanism of action of the thiazide in this case ? 7-Mention the adverse effects of the thiazide ? 8-After 2 weeks of therapy the patient bl.pr. became 150/95 do you recommend adding a new drug? 9- What, and why? 10-What is the mechanism of action of this drug As antihypertensive ? 11-What is the possible side effects in this patient ? 12-If the patient develop bradycardia ( 60 beats/min ), how to deal with ?

3. Case II A male patient is presented to you by moderate degree of hypertension and chronic renal impairment ( serum creatinine 4 mg /dl ). Can you give diuretic in this case ? what and why ? Can you give ACE inhibitors in this case? When? and Why? What are other safe drugs used for treatment of hypertension in presence renal insufficiency? Mention antihypertensive drug/s contraindicated in treatment of hypertension with renal failure?

4. Case III A 35 old obese pregnant lady with moderate degree of hypertension and What is your advice as regard to diet in this case? What is /are the antihypertensive drugs/s of choice? Mention mechanism of action of methyldopa as antihypertensive? What are antihypertensive drugs absolutely contraindicated in pregnancy and why?

5. Case IV A 45 old diabetic female presented in your office with headache and dizziness, her blood pressure 170/100 and fasting blood glucose level 130 mg/dl and postprandial blood glucose 160 mg/ dl, she is controlled by glimpride drug. Mention antihypertensive drug/s used in this case? What are antihypertensive drugs contraindicated in this case? Why?

6. Case V If you are faced with a male patient with hypertension and left sided congestive heart failure, what are the antihypertensive of choice in this case and what is/are the drug/s contraindicated and why?

7. Case VI Patient with hypertension and elevated cholesterol and triglyceride What are antihypertensives that can be used ? What are antihypertensives that are contraindicated ?

8. Case VII How can you treat a patient in a state of hypertensive emergency?

9. Case : A 56 year old obese male lawyer was found to have a blood pressure of 180/110mmHg during routine checkup, otherwise he was clinically free. The same BP was noted on three subsequent visits. He smoked at least 30 cigarettes a day for 20 years. How would you proceed to manage this case? Case : A 58 year old professor complained of headache. His blood pressure was found to be 220/115 mmHg and there was no evidence of cardiac failure or renal impairment. How would you treat this patient? Case: A 47 year old man presented with a history of attacks of chest pain provoked by exertion and relieved by rest. Exercise stress test was performed and the patient was diagnosed as (exertional angina pectoris).How would you proceed to manage this man taking in consideration that his blood pressure was 170/100 mmHg and that he is a heavy smoker?