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MBBS VI - SpC - Medicine > Cardiac - Hypertension and lipid disorders > Flashcards

Cardiac - Hypertension and lipid disorders Flashcards

1
Q

Hypertension

Definition
Cut-offs

A
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2
Q

Hypertension

Define ambulatory and white coat hypertension

A
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3
Q

Hypertension

Define malignant hypertension

A

ABCDEF:
* Azotemia
* BP ≥220/120
* Cardiac failure
* Distress
* Encephalopathy
* Fundus

Clinical presentation: ↑BP + rapidly progressive TOD
□ Retina: papilloedema, retinal haemorrhages and exudates
□ HTN encephalopathy: severe headache, vomiting, visual disturbances, transient paralyses, convulsions, stupor and coma
□ Heart: acute LV failure
□ Kidneys: acute RF with oliguria, proteinuria

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4
Q

Define urgency hypertension

A
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5
Q

Define emergency hypertension

A
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6
Q

Primary/ Essential hypertension

Risk factors

A
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7
Q

Secondary hypertension

Causes

A
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8
Q

Hypertension

Physiological variation of BP

A
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9
Q

Hypertension

Clinical presentation, target organ damage

A
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10
Q

Hypertension

Diagnosis

A
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11
Q

on

Hypertension

History taking questions

A
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12
Q

Hypertension

P/E

A

`

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13
Q

Hypertension

Biochemical Ix

A
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14
Q

Hypertension

Radiological Ix

A
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15
Q

Hypertension

Treatment target
General lifestyle modifications

A

Lifestyle modifications:

  • Weight reduction
  • Diet: Low sodium, Low fat, High fruit/ vegetables, High K, DASH diet
  • Exercise: 30min/day
  • Alcohol: moderation ≤2 (M) or ≤1 (F) drinks/day
  • Medical therapy: Change dose/ combination therapy accordingly

First line: ACEI/ARB, CCB, thiazide diuretic (+/- BB)
Second line: Alpha blocker, Aldosterone antagonist or vasodilator
Adjunctive drugs: Aspirin (lower CVD risk), Statins (hyperlipidemia)
Substitute drugs: Methyldopa, hydralazine for pregnancy; Loop diuretics for CKD
Compelling indications: DM, CKD, CAD, LV dysfunction, Ischemic stroke

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16
Q

ACEi

Examples
MoA
S/E
C/I

A
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17
Q

ARB

Examples
MoA
S/E
C/I

A
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18
Q

B-blockers

Examples
MoA
S/E
C/I

A
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19
Q

CCB

Examples
MoA
S/E
C/I

A
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20
Q

Loop diuretics

Examples
MoA
S/E
C/I

A
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21
Q

Thiazide diuretics
Examples
MoA
S/E
C/I

A
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22
Q

Potassium sparing diuretics

Examples
MoA
S/E
C/I

A
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23
Q

Hypertension

Drug choice combinations

A

A= ACEi/ ARB
B = B-blocker
C = CCB
D = Diuretics

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24
Q

Hypertension

Drug combination for asymptomatic organ damage

A
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25
Q

Hypertension

Drug combinations for stroke, MI, stable angina, HF, AA, Afib

A
26
Q

Hypertension

Drug combination for isolated systolic HTN, metabolic syndrome, DM, pregnancy

A
27
Q

Hypertension

Contraindication of ACEi/ARB

A
28
Q

Hypertension

Contraindications of BB, CCB

A
29
Q

Hypertension

Contraindications of diuretics

A
30
Q

Hypertensive urgency

Treatment

A
31
Q

Hypertensive emergency

Treatment

A
32
Q

Hypertension

Macrovascular complications

A
33
Q

Hypertension

Microvascular complications

A
34
Q

Hypertension

Risk factors for poor prognosis

A
35
Q

histological findings of renal disease induced by hypertension?

A
36
Q

Lipoprotein

Classes and functions

A
37
Q

Lipid profile

Metrics
Procedure

A
38
Q

Lipoprotein pattern

Metrics
Procedure

A
39
Q

Hyperlipidemia

Investigations (apart from lipoprotein pattern and profile)

A
40
Q

Reference lipoprotein levels

A
41
Q

CHD risk equivalent

Definition
Risk factors of major coronary event

A
42
Q

Hyperlipidemia

Major risk factors that modify LDL-C target

A
43
Q

Hyperlipidemia

Risk categories and corresponding LDL targets

A
44
Q

Hyperlipidemia

Phenotypes and associated defects

A
45
Q

Primary Hyperlipidemia

Phenotypes associated with CHD, pancreatitis

A
46
Q

Familial hypercholesterolemia

Types
Genetic causes
Pathophysiology

A
47
Q

Familial hypercholesterolemia

Clinical manifestations
Diagnosis
Treatment

A
48
Q

Statins

MoA
Effect on lipid profile
S/E
Example

A
49
Q

Fibrates

MoA
Effect on lipid profile
S/E
Example

A
50
Q

Resins

MoA
Effect on lipid profile
S/E
Examples

A
51
Q

Niacin

MoA
Effect on lipid profile
S/E
Example

A
52
Q

Cholesterol absorption inhibitors

MoA
Effect on lipid profile
S/E
Example

A
53
Q

Summary of lipid lowering drug effect on lipid profile

A
54
Q

What can contribute to hypertriglyceridemia?

A
55
Q

P/E for secondary hypertension

A
56
Q

Indicators of secondary hypertension

A
57
Q

Resistant HTN

Definition
Diagnosis
Treatment

A

Definition
Poor HTN control under 3 antihypertensive with 1 diuretic
HTN only controlled by ≥4 drugs

Diagnosis: Exclude pseudoresistance:
→ Adherence
→ Timing of drugs
→ Home and ambulatory BP
→ Exclude secondary hypertension
→ Identify confounding factors: diet, obesity, drugs

Treatment:
* Increase dosage of existing therapy
* Use second-line drugs: Aldosterone blockers, Loop diuretics
* Alter combination of therapy

58
Q

Differentiate hypertensive emergency with hypertensive urgency

A

Hypertensive emergency (i.e. with TOD)
* BP >180/120 + worsening/new TOD
* Indication for acute BP control
* e.g. aortic dissection, pheochromocytoma, eclampsia

Hypertensive urgency (i.e. no TOD)
* Malignant HTN without TOD
* HT with grade III or IV retinal changes
* e.g. Hypertension with pre-op/ perioperative bleeding, Hypertension complicated by pregnancy, AMI, unstable angina
* e.g. Catecholamine excess or sympathomimetic overdose

59
Q

Indications for immediate treatment of hypertension

A
60
Q

Investigations for target organ damage due to hypertension

A
61
Q

Indications for emergency BP reduction with IV treatments

A

MBBS VI - SpC - Medicine (80 decks)

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