HTN

Question 1

HTN definition?

Answer 1

elevated systolic and/or diastolic BP

Question 2

Sxs of 2º causes of HTN? (6)

Answer 2

mm weakness
tachycardia
sweating
tremors
thinning skin
flank pain

Question 3

Signs of sleep apnea? (4)

Answer 3

morning HA
daytime sleepiness
loud snoring
erratic sleep

Question 4

During physical exam of pts w/ HTN, look for what?

Answer 4

signs of target organ failure

Question 5

Signs of target organ failure in general physical exam? (4)

Answer 5

body fat distribution
skin lesions
mm weakness
impaired alertness

Question 6

Signs of target organ failure in eye exam? (3)

Answer 6

hemorrhage
papilledema
cotton wool spots

Question 7

Signs of target organ failure in neck exam? (2)

Answer 7

abn carotid pulse

abn thyroid

Question 8

Signs of target organ failure in respiratory exam? (2)

Answer 8

rhonchi

rales

Question 9

Signs of target organ failure in cardiac exam? (3)

Answer 9

abn size, rhythm, sounds
dyspnea
claudication

Question 10

Signs of target organ failure in abdominal exam? (3)

Answer 10

renal masses
renal bruits
abn femoral pulses

Question 11

Signs of target organ failure in neuro exam? (3)

Answer 11

visual disturbances
focal weakness
confusion
HA

Question 12

HTN screening guidelines for adults?

Answer 12

every 2 yrs

or annually if pre-HTN

Question 13

Diagnosing HTN?

Answer 13

average of >=2 seated BP readings

during >=2 office visits

Question 14

BP classifications:
normal?
pre?
stage 1?
stage 2?

Answer 14

Normal: SBP < 120 and DBP < 80

Pre: SBP 120-139,or DBP 80-89

Stage 1: SBP 140-159, or DBP 90-99

Stage 2: SBP >=160, or DBP >=100

Question 15

Pt’s w/ Masked HTN (normal in office, high everywhere else) have increased what?

Answer 15

cardiovascular risks

Question 16

Home BP monitoring goal?

Answer 16

<135/85

Question 17

BP goal for pts w/ DM?

Answer 17

<130

Question 18

Standard tests to run?

Answer 18

HCT
UA
blood chemistry
lipid panel
EKG

Question 19

HTN tx?

Answer 19

lifestyle intervention

meds

Question 20

Central α Agonists:

MOA

SE

Cautions

Answer 20

MOA: stim α2 receptors -> ↓ SNS

SE: anticholinergic sxs

Avoid abrupt cessation

Question 21

α blockers (-zosin):

MOA

SE

Cautions

Answer 21

MOA: block α1 receptors in smooth mm -> vasodilation

SE: orthostatic hypotension

combo drug

Question 22

β blocker (-lol):

MOA

2 types

SE

Cautions

Answer 22

MOA: block β receptors -> ↓ CO

Types: cardioselective (β1), noncardioselective (β1, β2: heart and lungs)

SE: slows everything down

Not for Unstable HF

Question 23

Diuretics:

MOA

Answer 23

MOA: inhibit Na reabsorb

Question 24

Thiazide Diuretics:

SE

Cautions

Answer 24

(Hydrochlorothiazide)
SE: low K+, Na, Mg; high Ca2+

sulfa allergies
DM possibly hyperglycemia

Question 25

Loop Diuretics: SE

Answer 25

(Furosemide) | SE: low K+, Mg

Question 26

Potassium Sparing Diuretics: SE

Answer 26

(Trimterene) | SE: hyperkalemia

Question 27

Aldosterone Antagonists: SE

Answer 27

(Spironolactone) | SE: hyperkalemia, gynecomastia

Question 28

Ca2+ Channel Blockers (-dipine): MOA 2 types SE

Answer 28

MOA: ↓ Ca2+ influx -> ↓ vascular resistance Types: Dihydropyidine (less card depressant), Non-dihydro (more card depressant) SE: HA, peripheral edema

Question 29

ACE Inhib (-pril): MOA SE

Answer 29

MOA: inhib RAAS, stim bardykinin SE: cough, hyperkalemia, acute renal failure

Question 30

Angiotensin Receptor Blocker (-sartan): MOA SE

Answer 30

MOA: inhib RAAS SE: cough, hyperkalemia, acute renal failure

Question 31

Direct Renin Inhib: MOA SE Cautions

Answer 31

MOA: inhib renin SE: cough, hyperkalemia, acute renal failure Use w/ ACE or ARB in DM

Question 32

Resistant HTN definition?

Answer 32

failure to hit goal BP w/ full-dose tx of 3 drugs including thiazide diuretic

Question 33

Most common cause of resistant HTN?

Answer 33

volume overload

Question 34

HTNsive Urgency is?

Answer 34

Asymp sever HTN | SBP >=180 and/or DBP >=120

Question 35

HTNsive Urgency etiology?

Answer 35

(U) non-adherence to meds and lifestyle ∆

Question 36

HTNsive Urgency tx?

Answer 36

Gradual ↓ of BP: rest adjust meds - avoid β block, ACE, ARB

Question 37

HTNsive Emergency is?

Answer 37

SBP >= 180 abd/or DBP >= 120 | a/w acute end-organ damage

Question 38

HTNsive Emergency tx?

Answer 38

ICU | careful, controlled reduction in BP over 48 hrs