HTN

Question 1

if at the first visit, a clients BP is high normal, how often should their BP be recheck

Answer 1

yearly

Question 2

for patients with a normal BP, how often should their BP be rechecked

Answer 2

yearly

Question 3

for patients with high BP actively modifying health behaviors, how often should they follow up

Answer 3

3-6 months

Question 4

how often should you follow up with a patient receiving antihypertensive? when would this change?

Answer 4

every 1-2 months until 2 consecutive visits are at or below target then every 3-6 months

Question 5

what is the cut off to diagnose HTN for OBPM

Answer 5

> /= 140/90

Question 6

what is the cut off to diagnose HTN for ABPM or HBPM

Answer 6

> /= 135/85

Question 7

what standard testing should be preformed for all HTN patients

Answer 7

urinalysis, blood chem (K, Na, Cr), FBG or A1C, lipids, 12 lead

Question 8

when would you order an echocardiogram in a HTN patient

Answer 8

if you are concerned about LVH or coronary artery disease like those with evidence of HF

Question 9

what symptoms might suggest a secondary cause

Answer 9

sudden onset age >55 or <33
abdominal bruit
resistant to 3 drugs
increased Cr 30% with ACEI or ARB
pulmonary edema with HTN

Question 10

what is pheocromocytoma and when might you suspect is

Answer 10

adrenal gland tumor
Adrenal mass
labile or unexplained BP
HTN with anasethia or other meds
associated headaches, palpitations, sweating

Question 11

when might you start a statin without presence of DLD for HTN patients

Answer 11

HTN patients with at least 3 cardiovascular risk factors or established atherosclerotic disease

Question 12

what are the main classes of medication used to treat HTN

Answer 12

ACEI
ARB
CCB
thiazide like diuretics

Question 13

without any other indications, at what threshold should HTN medication be started for those without target organ damage or other risk factors and those with?

Answer 13

without: >/=160/100
With: >/= 140/90

Question 14

when is a beta blocker an appropriate first line monotherapy

Answer 14

patients younger than 60 with uncomplicated HTN and no other compelling factors

Question 15

what medication should not be started in black patients

Answer 15

ACEI

Question 16

what are adrenal causes of secondary hypertension

Answer 16

primary hyperaldosteronism
cushing syndrom
tumors (pheocrhomocytomas)

Question 17

paroxysmal HTN, headaches, palpitations, and sweating are signs of what?

Answer 17

pheochromocytomas

Question 18

what are renal causes of HTN

Answer 18

renal artery stenosis
diabetic nephropathy
glomerulonephritis
polycystic kidney disease

Question 19

a young individual with HTN and signs of decreased renal perfusion may have what?

Answer 19

renal artery stenosis

Question 20

unilateral or bilateral renal artery stenosis mya cause CKD?

Answer 20

Bilateral

Question 21

what anti hypertensive should not be given to patients with bilateral renal artery stenosis

Answer 21

ACE-I

Question 22

what is an aortic cause of secondary HTN

Answer 22

coarctation of aorta
isolated systolic HTN in elderly

Question 23

what are metabolic causes of secondary HTN

Answer 23

hyperthyroidism and hypothyroidism

Question 24

what medications may cause HTN

Answer 24

estrogen
cocaine
MAOIs with tyramine foods like cheese and wine

Question 25

what would your fundoscopic exam reveal with hypertensive retinopathies

Answer 25

dot and flame shaped hemorrhages AV nicking silver and copper wiring

Question 26

what are the main cardiac complications of HTN

Answer 26

LVH atherosclerosis leading to CAD aortic dissection

Question 27

true or false: properly managed HTN provides the greatest benefit in reducing risk of stroke

Answer 27

true

Question 28

what are the renal complications of HTN

Answer 28

renal failure

Question 29

what is the difference between HTN urgency and emergency

Answer 29

both with BP <180/120 but no evidence of end organ damage with urgency

Question 30

what are the neurological findings of acute end organ damage

Answer 30

headache altered LOC seizure papilledema stroke

Question 31

what are the cardiac manifestations of acute end organ damage

Answer 31

MI pulmonar edema aortic dissection

Question 32

what are the renal manifestations of acute end organ damage

Answer 32

increased BUN or Cr hematuria microalbuminuria

Question 33

what are the 4 main classes of HTN medication

Answer 33

ACE-I ARBs Thiazide diuretics long active CCB

Question 34

what classes of medication should be used to treat HTN with HF

Answer 34

ACE-I or ARBs Thiazide diuretics Aldosterone antagonists beta blockers

Question 35

Although any class can be used for HTN with diabetes, which class is protective against diabetic nephropathy

Answer 35

ACE-I or ARBs

Question 36

what medication should be avoided in patients with asthma

Answer 36

ACE-I

Question 37

hydrochlorothiazide is what class of medication

Answer 37

thiazide diuretic

Question 38

ramipril is what class of medication

Answer 38

ACE-I

Question 39

candesartan is what class of medication

Answer 39

ARB

Question 40

Amlodipine is what class of medication

Answer 40

CCB

Question 41

what labs should be monitored for patients on ACE-I

Answer 41

Electrolytes (K) Cr and GFR BUN

Question 42

what are risk factors for HTN

Answer 42

DM CKD poor diet sedentary behavior

Question 43

is ASA recommended for primary prevention in HTN management

Answer 43

no

Question 44

what is goal BP for patient with HTN and DM

Answer 44

<130/80