4. HTN Flashcards
1
Q
normal BP
A
120/8-0
2
Q
elevated
A
120-129/80
3
Q
stage 1 HTN bp
A
130-139/80-89
4
Q
stage 2 HTN bp
A
> 140/90
5
Q
HTN means we cannot
A
perfuse the heart as well
6
Q
HTN causes
A
LV hypertrophy
coronary insufficiency
HF
7
Q
baroreceptors: high pressure zone
A
sensitive > 60mmHg
aortic arch
carotid sinus
8
Q
baroreceptors: low pressure zones
A
large veins
wall of atria
9
Q
what regulates sympathetic changes
A
high pressure baroreceptors
10
Q
what regulates blood volume
A
low pressure baroreceptors
11
Q
what contributes to acute and long term volume control
A
RAAS
12
Q
angiotensin 2
A
vasocontriction
incr aldosterone
13
Q
aldosterone
A
incr Na+
incr H2O
exretes K+
14
Q
ADH aka
A
vasopressing
15
Q
ADH low doses
A
reabsoprtion of water
16
Q
ADH high doses
A
vasoconstriction
17
Q
endothelin
A
vasoconstriction
18
Q
ANP is secreted by
A
atrial myocytes
19
Q
ANP effects
A
incr GFR
incr Na+ excretion
incr H2O excretion
20
Q
BNP secreted by
A
ventricular myocytes
21
Q
BNP effects
A
vessel dilation
22
Q
ANP/BNP prevent
A
myocardial remodeling/hypertophy
23
Q
secondary HTN causes in kids
A
renal disease
coarctation of aorta
24
Q
secondary HTN adolescnets
A
coarctation of aorta
25
secondary HTN young adults
thyroid
fibromuscular dysplasia
renal disease
26
secondary HTN mid age adults
hyperaldosteronism
thyroid
OSA
cushings
pheochromocytoma
27
secondary HTN elderly
renal artery stenosis
renal failure
hypothyroidism
28
HTN pathophysiological effects
vasculopathy
heart disease
cerebrovascular damage
nephropathy
29
HTN: initial treatment
lifestyle modification
30
1 kg weight loss =
1 mmHg BP reduction
31
alcohol BP effect
alcohol incr BP
inhibit ADH
incr renin
reduces med efficacy
32
HTN: primary line treatment (4)
thiazide diuretics
CCB
ACE inhibitors
ARBS
33
CCB
amlodipine
verapamil
(DIPINE)
(MIL)
34
ACE inhibitors
lisinopril
(PRIL)
35
ARBs
Losartan
(SARTAN)
36
HTN: secondary treatment
(8)
loop diuretics
aldo antagnoist
b blocker
a blocker
a/b blocker
clonidine
vasodilators
renin inhibitor
37
loop diuretic
furosemide
38
aldosterone antagonist
spironolactone
39
a blocker
zosin
40
direct renin inhibitor
aliskiren
41
more drugs means the pt has
less control
42
drug for pheochromocytoma
a blocker
(ZOSIN(
43
what drugs taken day of surgery have profound post-induction hyptension
ACE inhibitor (PRIL)
ARBs (SARTAN)
44
what HTN drug is associated with sedation
clonidine
45
secondary HTN pnemonic
Cushings
Hyperaldosteronism
Aortic coarctation
Pheochromocytoma
Stenosis of renal arteries
46
day of surgery: ACE / ARBS
withhold for 10 hours prior
47
day of surgery: b blocker
take as normal
48
day of surgery: CCB
take as normal
49
day of surgery: clonidine
take as normal
50
which HTN drug has profound rebound if held
clonidine
51
claudications
plaque build up
52
carotid bruit indicates
atherosclerotic vascular disease
53
which pt should you give a fluid bolus to for HTN
pts that took ACE/ARB before surgery
54
pheochromocytoma signs
flushing
sweating
palpitations
55
renal artery stenosis signs
renal bruit
56
hyperaldosteronism sign
hypokalemia
57
what BP indicates cancellectomy for elective procedures?
> 180/110
58
HTN causes what risks in surgery
incr EBL
incr MI risk
incr hemodynamic volatility
59
what should you consider perepping for surgery on HTN pt
additional PIV
type and match
preemptive art line
60
what drugs help decr BP effects during induction and laryngoscopy
propofol
narcotics
VA
esmolol
phenylephrine
61
pts with preoperative ______ are more likely to have intraoperative ______
pts with preoperative hyertension are more like to have intraoperative hypotension
62
induction causes
hypotension
63
laryngoscopy causes
hypertension
64
best practice BP range off baseline
+/- 20% of baseline MAP
65
hypertensive crisis
based on presence of end-organ damage symptoms
66
hypertensive crisis treatment
sodium nitroprusside
nicardipine
clevidipine
67
CNS end organ damage
encephalopathy
intracerebral hemorrhage
subarachnoid hemorrhage
acute stroke
68
renal end organ damage
renal dysfunction
69
CV end organ damage
unstable angina
MI
HF
aortic dissection
70
NO prodrugs
NTG
nitroprusside
71
nicardipine receptor
CCB - DHP
72
hydralazine receptor
Ca2+ release from SR in arterioles
73
NTG bolus
10-100 mcg
74
nipride bolus
dont bolus
75
nicardipine bolus
0.2-0.5 mg
76
hydralazine bolus
5-10mg
77
esmolol bolus
10-50mg
78
esmolol infusion
25-200mcg/kg/min
79
NTG infusion
0.1-2 mcg/kg/min
80
nipride infusion
0.1-2 mcg/kg/min
81
max NTG infusion
5 mcg/kg/min
82
max nipride infusion
10 mcg/kg/min
83
nicardipine infusion
5-15 mg/hr
84
hydralizine infusion
dont infuse
85
labetalol bolus
5 mg
86
labetalol infusion
dont infuse
87
which anti-HTN drug should you avoid in pts on PDE5 inhibitor
NTG
88
which anti-HTN drug increases risk of methemoglobinemia
nipride
89
which anti-HTN drug has reflex tachy?
nicardipine
90
which anti-HTN drug is slow onset/long acting?
hydralazine
91
which anti-HTN drug is very potent
hydralazine
92
what indicates acute postop HTN
> 180/110
93
what surgeries incr risk of acute postop HTN
carotid endarterectomy
abdominal aortic surgery
radical neck dissection
intracranial surgery
94
common post op HTN symptoms
pain
anxiety
hypoxemia
hypercarbia
shivering
bladder distention
95
