CPRS Case 4: Hypertension Flashcards Preview

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Flashcards in CPRS Case 4: Hypertension Deck (12)
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Pathophysiology of raised blood pressure

See lecture notes Pathology of hypertension


Differentiate between primary and secondary hypertension

See lecture

2 factors: CO and TPR

CO by 2 factors:
- cardiac: HR, contractility
- non-cardiac: blood volume, salt intake, mineralcorticoid level


Different classes of antihypertensive

See lecture

Patient <55: ACE inhibitor —> + ARB —> + CCB —> + thiazide
Patient >55 / African-Caribbean: CCB —> CCB + thiazide —> + ACE/ARB


Mechanism of action of thiazide diuretics in treatment of hypertension

See lecture


Mechanism of action of CCB in treatment of hypertension

See lecture


Mechanism of action of ACE inhibitors in treatment of hypertension

See lecture


Complications of uncontrolled hypertension

Heart: Left ventricular hypertrophy
Large vessels: Atherosclerosis
Small vessels: Hypertrophy, fibrinoid necrosis, aneurysm
Brain: harmorrhage, infarction
Kidneys: nephrosclerosis


Factors influencing patient’s compliance to long term medication

1. Poverty
2. Misunderstanding instructions
3. Complex regimens
4. Forgetfulness
5. Feeling stigmatised
6. Improvement in symptoms
7. Not effective from previous treatment


Issues of patient’s confidentiality

Obtain consent before disclosure of medical information to third party

1. disclosure in public interest
2. disclosure in individual’s interest (because failing to disclose would exposure the patient / someone else to risk of deaths / serious harm)
3. when required by law

Personal data ordinance: patient’s right of access / correction of information in medical record and circumstances in which right may be refused


Information needed in a medical report

1. Personal information of deceased
2. Past medical history
- physical findings
- duration
- diagnosis
- treatment
3. Death
- date amen time
- place
- cause
4. Risk factors that predispose to death
5. Copy of post-morgen examination report


Attitudes of society towards death and autopsies

Traditional Chinese culture


Attitudes of doctors towards death and death investigation