Hypertension Flashcards

1
Q

Chronic elevation in BP (systolic ≥140 mmHg or diastolic ≥90 mmHg)

A

Hypertension

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2
Q

systolic ≥140 mmHg

A

Hypertension

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3
Q

In HT systolic is …..

A

≥140 mmHg

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4
Q

In HT diastolic is …..

A

≥90 mmHg

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5
Q

diastolic ≥90 mmHg

A

Hypertension

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6
Q

more common in some ethnic groups, particularlyAfrican Americans and Japanese

A

Hypertension

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7
Q

Systolic BP < 120

A

Optimal

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8
Q

Systolic BP < 130

A

Normal

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9
Q

Systolic BP 130 - 139

A

High normal

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10
Q

Systolic BP 140 - 159

A

Grade 1 (mild) HT

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11
Q

Systolic BP 160 - 179

A

Grade 2 (moderate) HT

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12
Q

Systolic BP ≥ 180

A

Grade 3 (severe) HT

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13
Q

diastolic BP < 80

A

Optimal

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14
Q

diastolic BP = 85

A

Normal

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15
Q

diastolic BP 85 - 89

A

High normal

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16
Q

diastolic BP 90 - 99

A

Grade 1 (mild) HT

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17
Q

diastolic BP 100 - 109

A

Grade 2 (moderate) HT

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18
Q

diastolic BP > 110

A

Grade 3 (severe) HT

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19
Q

systolic 140 - 159 mmHg and diastolic < 90 mmHg

A

Isolated systolic HT grade 1

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20
Q

systolic ≥ 160 mmHg and diastolic < 90 mmHg

A

Isolated systolic HT grade 2

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21
Q

HT types (4)

A

White-coat hypertension

Primary or essential hypertension

Secondary hypertension

Malignant or accelerated phase hypertension

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22
Q

elevated BP when measured at a health care provider’s office , but normal ABPM (day average <135/85)

A

White-coat hypertension

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23
Q

more likely to develop hypertension in future, and may have the risk of CVD

A

White-coat hypertension

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24
Q

ABPM

A

Ambulatory BP monitoring - 24hr

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25
Q

more than 95% of cases of HT

A

Essential hypertension

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26
Q

no specific underlying cause can be found for HT

A

Essential hypertension

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27
Q

patients who develop hypertension at an early age with or without a positive family history.

A

Secondary hypertension

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28
Q

patients who first exhibit hypertension when over age 50 years

A

Secondary hypertension

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29
Q

patients previously well-controlled now become refractory to treatment.

A

Secondary hypertension

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30
Q

Approximately 5% of patients with hypertension

A

Secondary hypertension

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31
Q

hypertension have specific causes

A

Secondary hypertension

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32
Q

Alcohol

A

Cause of 2ry HT

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33
Q

Obesity

A

Cause of 2ry HT

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34
Q

Renal disease

A

Cause of 2ry HT

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35
Q

Endocrine disease (slides)

A

Cause of 2ry HT

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36
Q

Drugs

A

Cause of 2ry HT

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37
Q

Coarctation of aorta

A

Cause of 2ry HT

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38
Q

rapid rise in BP leading to vascular damage

A

Malignant or accelerated phase hypertension

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39
Q

pathological hallmark is fibrinoid necrosis

A

Malignant or accelerated phase hypertension

40
Q

Usually there is severe hypertension (eg systolic >200, diastolic>130mmHg)
+ bilateral retinal haemorrhages and exudates

A

Malignant or accelerated phase hypertension

41
Q

Papilloedema may or may not be present

A

Malignant or accelerated phase hypertension

42
Q

may precipitate acute kidney injury, heart failure, or encephalopathy

A

Malignant or accelerated phase hypertension

43
Q

It is more common in younger and in black subjects

A

Malignant or accelerated phase hypertension

44
Q

Due to old age:↓Elasticity and ↓compliance of the large blood vessels resulting in ↑ SYSTOLIC BP

A

Isolated Systolic Hypertension

45
Q

60% of hypertensives > 80 years old

A

Isolated Systolic Hypertension

46
Q

Usually asymptomatic (except in malignant)

A

HT

47
Q

Radiofemoral delay, or weak femoral pulses (coarctation)

Renal bruits, palpable kidneys

Cushing’s syndrome

A

Signs of renal disease

48
Q

Signs of renal disease

A

HT

49
Q

Radiofemoral delay,

A

HT

50
Q

weak femoral pulses (coarctation)

A

HT

51
Q

Renal bruits

A

HT

52
Q

palpable kidneys

A

HT

53
Q

Cushing’s syndrome

A

HT

54
Q

Retinopathy and proteinuria

A

HT

55
Q

end-organ damage

A

HT

56
Q

Renal dysfunction is a factor which may cause ……

A

HT

57
Q

Peripheral resistance is a factor which may cause ……

A

HT

58
Q

Vascular tone is a factor which may cause ……

A

HT

59
Q

Endothelial dysfunction is a factor which may cause ……

A

HT

60
Q

Autonomic tone is a factor which may cause ……

A

HT

61
Q

Age

A

Risk factor of HT

62
Q

High salt intake

A

Risk factor of HT

63
Q

Obesity

A

Risk factor of HT

64
Q

Lack of exercise

A

Risk factor of HT

65
Q

Impaired intrauterine growth and low birth weight

A

Risk factor of HT

66
Q

All with BP ≥160/100mmHg

A

Need to be treated

67
Q

BP ≥140/90 with risk of coronary events

A

Need to be treated

68
Q

BP ≥140/90 with presence of diabetes

A

Need to be treated

69
Q

BP ≥140/90 with end-organ damage

A

Need to be treated

70
Q

Management of HT

A

antihypertensive therapy
(Slides)

71
Q

Urinalysis for Blood, protein and glucose

A

HT investigation

72
Q

Blood urea, electrolytes and creatinine

A

HT investigation

73
Q

Blood glucose

A

HT investigation

74
Q

Serum total and HDL cholesterol

A

HT investigation

75
Q

Thyroid function tests

A

HT investigation

76
Q

12-lead ECG (L. Ventricular hypertrophy, coronary artery disease)

A

HT investigation

77
Q

Chest X-ray
To detect …. (3)

A

Cardiomegaly, heart failure, coarctation of aorta

78
Q

Ambulatory BP recording
To assess

A

Borderline/ white-coat HT

79
Q

Echocardiogram
To detect or quantify

A

L ventricular hypertrophy

80
Q

Renal ultrasound
To detect …..

A

Possible renal disease

81
Q

Renal angiography
To detect or confirm ……

A

Presence of renal artery stenosis

82
Q

Urinary catecholamines
To detect …

A

Possible pheochromocytoma

83
Q

Urinary cortisol + dexamethasone suppression test
To detect ….

A

Possible Cushing’s syndrome

84
Q

Plasma renin activity + aldosterone
To detect

A

Possible primary aldosteronism

85
Q

HT treatment goal

A

<140/90 mmHg

86
Q

HT treatment goal in diabetes

A

<130/80 mmHg

87
Q

HT treatment goal if aged > 80

A

150/90 mmHg

88
Q

In HT BP should be reduced slowly why?

A

rapid reduction can be fatal, especially in the context of an acute stroke

89
Q

Lifestyle changes in HT (5)

A

Stop smoking
Low-fat diet , ↑ vegetables and fruits and low-fat diet
Reduce alcohol and salt intake
Regular exercise
Reduce weight if obese.

90
Q

Diuretics

A

HT treatment drug

91
Q

Beta Blockers/Alpha-blockers

A

HT treatment drug

92
Q

Calcium channel blockers

A

HT treatment drug

93
Q

ACE-i or ARB

A

HT treatment drug

94
Q

Aldosterone antagonists

A

HT treatment drug

95
Q

Vasodilators

A

HT treatment drug