Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal Exam III > Clinical Key Htn > Flashcards

Clinical Key Htn Flashcards

(77 cards)

Start Studying
1
Q

Definition of Htn

A 
Office blood pressure ≥140 and/or ≥90
Home blood pressure ≥135 and/or ≥85
Ambulatory blood pressure
• Daytime (or awake) ≥135 and/or ≥85
• Nighttime (or sleep) ≥120 and/or ≥70
• 24 hour ≥130 and/or ≥80
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for Htn

A
  • Male
  • Age (men ≥55”yr, women ≥65”yr)
  • Smoking
  • Dyslipidemia
  • Impaired fasting glucose (100-125”mg/dL)
  • Obesity (BMI ≥ 30”kg/m 2 or waist circumference: men, ≥102”cm, women, ≥88”cm)
  • Family history or premature cardiovascular disease (men aged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asymptomatic Target organ damage of Htn

A
  • Left ventricular hypertrophy by ECG or transthoracic echocardiography
  • Chronic kidney disease (eGFR ≤ 60”mL/min/1.73”m 2 )
  • Microalbuminuria (albumin-to-creatinine ratio, 30-300”mg/g)
  • Ankle-brachial index 10”m/sec
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diabetes Mellitus diagnosis

A

(fasting plasma glucose ≥126”mg/dL × 2; or hemoglobin A 1C ≥ 7%; or postload plasma glucose >
198”mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Established cardiovascular or renal disease

A
  • Stroke or TIA
  • CAD: myocardial infarction, angina, myocardial revascularization
  • Heart failure (with decreased or preserved ejection fraction)
  • Intermittent claudication (symptomatic peripheral artery disease)
  • Chronic kidney disease with eGFR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chronic kidney disease

clinical clues

diagnostic testing

A

Estimated GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Renovascular disease

clinical clues

diagnostic testing

A 
New elevation in serum creatinine, marked
elevation in serum creatinine with ACE
inhibitor or ARB, drug-resistant
hypertension, flash pulmonary edema,
abdominal or flank bruit

Renal sonography (atrophic
kidney), CT or MR
angiography, invasive
angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Coarctation of the aorta

clinical clues

diagnostic testing

A

Arm pulses > leg pulses, arm BP > leg BP,
chest bruits, rib notching on chest
radiography

MR angiography, TEE,
invasive angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Primary aldosteronism

clinical clues

diagnostic testing

A

Hypokalemia, drug-resistant hypertension

Plasma renin and
aldosterone, 24-hour urine
aldosterone and potassium
after oral salt loading,
adrenal vein sampling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cushing Syndrome

clinical clues

diagnostic testing

A

Truncal obesity, wide and blanching purple
striae, muscle weakness

1”mg dexamethasonesuppression
test, urinary
cortisol after
dexamethasone, adrenal CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pheocromocytoma

clinical clues

diagnostic testing

A

Paroxysms of hypertension, palpitations,
perspiration, and pallor; diabetes

Plasma metanephrines, 24-
hour urinary metanephrines
and catecholamines,
abdominal CT or MR imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Obstructive sleep apnea

clinical clues

diagnostic testing

A

Loud snoring, large neck, obesity,
somnolence

Polysonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diet for Htn

A
  1. Adopt a diet that is:
    • High in vegetables, nuts, fruits, grains, low-fat dairy products, fish, poultry, etc.
    • Low in sweets, sugar-sweetened beverages, and red meats
    Adapt this dietary pattern to calorie requirements, personal/cultural food preferences, and
    medical conditions such as diabetes.
  2. Lower sodium intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physical activity for Htn

A
  1. Engage in three to four 40-minute sessions of moderate-to-intense aerobic physical
    activity per week.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

thiazide contraindication

A

gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

loop diuretics contraindications

A

hepatic coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

potassium sparing diuretics contraindications

A

Serum potassium
concentration > 5.5”mEq/L
GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ACE inhibitor contraindication

A

pregnancy
bilatereral renal artery stenosis
hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dihydropyridine CCB contraindication

A

as monotherapy in chronic kidney disease with proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

nonidhydropyridine CCB contraindication

A

heart block

Systolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ARBs, DRI contraindications

A

Pregnancy

bilateral renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

B adrenergic blockers contraindications

A

heart block
asthma
depression
cocaine and meth abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A adrenergic blockers Contraindication

A

orthostatic hypotension
systolic heart failure
left ventricular dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Central sympatholytics contraindications

A

orthostatic hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
directi vasodilators contraindication
orthostatic hypotension
26
thiazide side effects
Insulin resistance, new-onset type 2 diabetes Hypokalemia, hyponatremia Hypertriglyceridemia Hyperuricemia, precipitation of gout Erectile dysfunction (more than other drug classes) Potentiate nondepolarizing muscle relaxants Photosensitivity dermatitis
27
Loop diuretics side effects
Interstitial nephritis Hypokalemia Potentiate succinylcholine Potentiate aminoglycoside ototoxicity
28
K sparing diuretics side effects
Hyperkalemia
29
ACE inhibitor side effects
``` Cough Hyperkalemia Angioedema Leukopenia Fetal toxicity Cholestatic jaundice (rare fulminant hepatic necrosis if the drug is not discontinued) ```
30
Dihydropyridine CCB side effects
``` Headaches Flushing Ankle edema Heart failure Gingival hyperplasia Esophageal reflux ```
31
Nondihydropytidine CCB Side effects
Bradycardia, AV block (especially with verapamil) Constipation (often severe with verapamil) Worsening of systolic function, heart failure Gingival edema or hypertrophy Increase cyclosporine blood levels
32
ARBs, DRI side effects
hyperkalemia | angioedema (rare)
33
B adrenergic blockers side effects
New-onset type 2 diabetes (especially in combination with a thiazide) Heart block, acute decompensated heart failure Bronchospasm Depression, nightmares, fatigue Cold extremities, claudication (β 2 effect) Stevens-Johnson syndrome Agranulocytosis
34
A adrenergic blockers side effects
Orthostatic hypotension Drug tolerance (in the absence of diuretic therapy) Ankle edema Heart failure First-dose effect (acute hypotension) Potentiate hypotension with PDE-5 inhibitors (e.g., sildenafil)
35
central sympatholytics side effects
Depression, dry mouth, lethargy Erectile dysfunction (dose dependent) Rebound hypertension with clonidine withdrawal Coombs test–positive hemolytic anemia and elevated liver enzymes with α-methyldopa
36
Direct Vasodilators side effects
Reflex tachycardia Fluid retention Hirsutism, pericardial effusion with minoxidil Lupus with hydralazine
37
Blood pressure treatment goals
38
Preferred first-line htn treatment
Three choices: calcium channel blocker, ACE inhibitor or ARB, or thiazide diuretic (chlorthalidone preferred)
39
Combination treatment htn
Good option for stage 1 hypertension | ACE inhibitor + calcium channel blocker preferred over an ACE inhibitor + thiazide-type diuretic
40
prehypertenstion
ARB
41
htn in general
CCB, ACE-I or ARB, D
42
htn in elderly pts
CCB, ACE-I or ARB, D
43
HTN WITH LEFT VENTRICULAR HYPERTROPHY
ARB, D, CCB
44
htn in pts with dibatees mellitus
CCB, ACE-I or ARB, D
45
htn in pts with diabetic nephropathy
ARB, D
46
htn in nondiabetic chornic keney disease
ACE-I or ARB, BB, D
47
bp reduction for secondary prevention of coronary events
ACE-I, CCB, BB, D
48
BP recution for secondary prevention of stroke
ACE-I + D, CCB
49
bp management for patient with heart failure
D, BB, ACE-I or ARB, aldosterone antagonist
50
``` Gestational hypertension (stage 2, without preeclampsia) ```
Labetalol, nifedipine, methyldopa
51
thoracic aortic aneurysm
BB, ACE-I or ARB, D
52
Atrial fibrillation (ventricular rate control)
BB, nondihydropyridine CCB
53
psuedoresistant htn
``` Inadequate medical regimen Pressor substances (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs], calcineurin inhibitors such as cyclosporine or tacrolimus, or sympathomimetics such as cocaine or methamphetamine) White coat reaction, improper blood pressure measurement Medication nonadherence ```
54
Truly resistant htn
``` Chronic kidney disease Primary aldosteronism Other secondary hypertension (e.g., pheochromocytoma, Cushing syndrome, atherosclerotic renal artery stenosis, fibromuscular renal artery stenosis, Takayasu arteritis, coarctation of the aorta, hyperthyroidism, hypothyroidism, hyperparathyroidism) Difficult primary hypertension ```
55
Hypertensive crisis with retinopathy, microangiopathy, or acute renal insufficiency
Labetalol
56
Hypertensive | encephalopathy
Labetalol
57
Acute aortic dissection
Nitroprusside plus | metoprolol
58
Acute pulmonary edema
Nitroprusside with loop | diuretic
59
Acute coronary syndrome
Nitroglycerine
60
Acute ischemic stroke and | BP > 220/120"mm"Hg
Labetalol
61
Cerebral hemorrhage and Systolic BP > 180"mm"Hg or MAP > 130"mm"Hg
Labetalol
62
Acute ischemic stroke with indication for thrombolytic therapy and BP > 185/110"mm"Hg
Labetalol
63
Cocaine/XTC intoxication
Phentolamine (after | benzodiazepines)
64
Pheochromocytoma crisis
Phentolamine
65
Perioperative hypertension during or after CABG
Nicardipine
66
During or after craniotomy
Nicardipine
67
Severe | preeclampsia/eclampsia
``` Labetalol (plus MgSO 4 and oral antihypertensive medication such as nifedipine with or without methyldopa) ```
68
Contraindications and side effects Labetalol
Second- or third-degree AV block; systolic heart failure, COPD (relative); bradycardia
69
Contraindications and side effects nicardipine
Liver failure
70
Contraindications and side effects nitroprusside
Liver/kidney failure (relative), cyanide toxicity
71
Contraindications and side effects nitroglycerine
none
72
Contraindications and side effects Urapadil
none
73
Contraindications and side effects Esmolol
Second- or third-degree AV block, systolic heart failure, COPD (relative); bradycardia
74
Contraindications and side effects Phentolamine
Tachyarrhythmia, | angina pectoris
75
Health system
* Standardized medication intensification protocol * Team-based approach involving clinical pharmacists * Pay providers for performance
76
Drug Treatment
* Low-dose combination therapy * Best-tolerated drug classes * Fixed-dose single pill combinations * Long-acting once daily drugs * Low-cost generics
77
Patient Engagement
* Low-dose combination therapy * Best-tolerated drug classes * Fixed-dose single pill combinations * Long-acting once daily drugs * Low-cost generics

Renal Exam III (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions