Htn Flashcards by Ali Atash

Blood pressure may be elevated in the office but not at home ? Is called?

White coat hypertension

How well did you know this?

Not at all

Perfectly

Essential (primary) HTN? With known cause or no unknow?

No specific cause.
Most cases with increase in PVR & CO

How well did you know this?

Not at all

Perfectly

Secondary HTN - Specific cause such as?

Renal artery construction
Contraction of aorta
Cushing disease ( ^^ cortisol )
Primary aldosteronism ( a cancer do na water retention)
Pheochromocytoma ( tumor in adrenal gland so ^^ catecholamine secretion NE/ E and do contraction)

How well did you know this?

Not at all

Perfectly

4 anatomical sites in the body regulare BP
Which one is incorrect?

a) heart
b) kidney
c) liver
d) capacitance vessels

C) liver

How well did you know this?

Not at all

Perfectly

4 anatomical sites in the body regulare BP
Which one is incorrect?

a) heart
b) kidney
c) arteriole
d) intestine

d) intestine

How well did you know this?

Not at all

Perfectly

Post-capillary venules is called also? Capacitance vessels or aorta

Capacitance vessels

How well did you know this?

Not at all

Perfectly

Local release of vasoactive substances from vascular endothelium involved in in the regulation of vascular resistance are?

Endothelin 1 —> vasoconstriction

Nitric oxide —> vasodilation

How well did you know this?

Not at all

Perfectly

Hydralazine is a vasodilatior - its MOA?

Dilates arterioles only (via NO)

How well did you know this?

Not at all

Perfectly

Most of vasodilators cause orthostatic hypotension and sexual dysfunction? Yes - no?

No. Incorrect. They don’t

How well did you know this?

Not at all

Perfectly

^^RAAS + reflex tachycardia when taking vasodilator like , hydralazine?

Yes

^^RAAS (Na/ water retention)
Treated by diuretic ( to deplete sodium and water)

Reflex tachycardia
Treated by b blockers

How well did you know this?

Not at all

Perfectly

Hydralazine taken alone do?

Tachyphylaxis = acute (sudden) decrease in drug response

How well did you know this?

Not at all

Perfectly

HTN and HF patients, who are african-american
Treated by? Hydralazine + nitrate. Or. Hydralazine +loop diuretic

Hydralazine + nitrate

How well did you know this?

Not at all

Perfectly

Hydralazine - PK
Hydralazine is metabolized by? Alkylation or acidification or acetylation ?

acetylation

How well did you know this?

Not at all

Perfectly

Does hydralazine to reflex tachycardia as a toxicity?

Yes

How well did you know this?

Not at all

Perfectly

Hydralazine:Patient with ischemic hear disease (IHD) -> reflex tachycardia and sympathetic stimulation —> provoke ?

Angina ? Yes or no
Ischemic arrhythmias? Yes or no
Edema? Yes or no
Palpitation ? Yes or no

Angina ? Yes
Ischemic arrhythmias? Yes
Edema? No
Palpitation ? No

How well did you know this?

Not at all

Perfectly

Lupus erythematosus is a toxicity of a drug called?
A. Minoxidil
B. Hydralazine
C. Nitroprusside
D. Fendolopam

B. Hydralazine ( release NO)

How well did you know this?

Not at all

Perfectly

Minoxidil is taken Iv? Yes or no

Dilate arteriole and vein?

No
Its taken ( orally )

Ooonly arteriole Nooo vein

How well did you know this?

Not at all

Perfectly

Minoxidil mechanism?
A. Release of nitric oxide
B. Activation of dopamine
C. Hyperpolarization of cell through opening of potassium channel
D. Reduction of calcium influx

D. Reduction of calcium influx

How well did you know this?

Not at all

Perfectly

Fenoldopam mechanism?
A. Release of nitric oxide
B. Activation of dopamine
C. Hyperpolarization of cell through opening of potassium channel
D. Reduction of calcium influx

B. Activation of dopamine

How well did you know this?

Not at all

Perfectly

Nitroprusside mechanism?

Release Nitric oxide

How well did you know this?

Not at all

Perfectly

MD k+ ? Minoxidil. Diazoxide. Open k channel

Open k channel
Minoxidil
Diazoxide

How well did you know this?

Not at all

Perfectly

Nifedipine mechanism?

Other drugs with the same mechanism?

Reduction of Ca influx

Other drugs: verapamil, diltiazem

How well did you know this?

Not at all

Perfectly

Minoxidil used in combination with?

B blocker & loop diuretic

How well did you know this?

Not at all

Perfectly

Toxicity of minoxidil when b blocker & diuretics are inadequate such as?

Tachycardia
Angina

**Edema
**Palpitation

How well did you know this?

Not at all

Perfectly

Side effect unique for minoxidil is? عرض جانبي مميز

Hypertrichosis

Hypertrichosis appear when taking?

Minoxidil

(?????) is a minoxidil used topically, it stimulate hair growth for baldness

Rogaine

Dilate both arterial and venous vessels? Mechanism: release N.O.

Sodium nitroprusside

Activates guanylyl cyclase —> ^^ c GMP —> release N.O. —>relax smooth muscle

Sodium Nitroprusside

Nitroprusside is metabolized releasing ? Nitric oxide and?

Cyanide

In the presence of sulphur, cyanide converts to less toxic compound Thiocyanate via?

Mitochondrial enzyme rhodanese

Sensitive to light. Must be made up fresh before administering?

Sodium Nitroprusside

Toxicity of sodium Nitroprusside. Acumulation of cyanide? Hydroxocobalamin? Methemoglobinemia?

Yes

Diazoxide like midoxidil MD Mechanism?

Potassium channel opening

Diazoxide مميز بشي Insulin

Inhibits insulin release form pancreas

Drug Used for case “ insulinoma” ?

Diazoxide

Drug used to treat Hypoglycemia caused by hyperinsulinism secondary to insulinoma?

Diazoxide

Verapamil and diltiazem belongs to? Potassium opening - calcium channel blocker Are they dihydropyridine or non-dihydropyridine?

calcium channel blocker Non-dihydropyridine

dihydropyridine and non-dihydropyridine are differently active in loweing blood pressure?

No. Incorrect “Equally” active

Sustained release calcium blocker with long half life for treatment of acute hypertension?

No “Chronic” HTN

Short acting nifedipine (ca blocker) increases risk of MI or mortality in patient with HTN.?

Yes

Ca blockers taken IV only? A. Clevidipine B. Amylodipine C. Felodipine D. Nisoldipine E. Nicardipine F. More than one answer

F. More than one answer ( A. Clevidipine + E. Nicardipine )

Niferdipine is long or short acting?

Short acting

Niferdipine is a short acting drug Taken Orally Used for?

Emergency management of severe HTN

Used in acute HTN occuring during surgery Its IV drug Clevidipine or nicardipine?

Clevidipine

Parenteral drugs when oral treatment of HTN are not feasible. List them

Clevidipine Nicardipine Verapamil Diltiazem

Clevidipine is a slow onset drug used to treat chronic HTN during surgery? Correct - incorrect

incorrect * rapid onset * acute HTN

S(-) non selective B blocking? A. Carvedilol B. Lebatalol C. Nebivolol

A. Carvedilol

S(-) R(+) isomers have equal B blocking in carvedilol? Yes or No

No In alpha blockers

(S,R) —> alpha A. Carvedilol B. Lebatalol C. Nebivolol

B. Lebatalol

(R,R) —> B blocking A. Carvedilol B. Lebatalol C. Nebivolol

B. Lebatalol

D- Nebivolol Selective or non selective B block Selevtive or non selective alpha

Selective or non selective B block Beta Beta Beta

L- Nebivolol do?

Vasodilation via endothelial release of NO

Vasodilator via endothelial release of NO? A. Nebivolol B. Carvedilol C. Levadolol D. Labitalol

A. Nebivolll

Nebivolol isomer that does vasodilation via NO release ? L-Nebivolol or D-Nebivolol

L-Nebivolol

Diuretics lower blood pressure primarly by?

Depleting body sodium stores So reducing BP by reducing B.V and CO

In diuretics PVR may increase due to reflex tachycardia , after how long cardiac output returns toward normal ?

6- 8 weeks

What type of diuretics is favourable in patients with HF? Why?

Aldosterone antagonist ( spironolactone, eplerenone, finerenone) They are cardio protective and prevent remodeling

Diuretics side effects Magnesium depletion ? Increase serum lipid concentration?

Yes

Diuretics side effects Impair glucose tolerance, how?

High glucose level because insulin is resistant due to hypokalaemia that cause hyperpolarization of B cells and decrease insulin secretion

Gynecomastia is a side effect of potassium sparing diuretics? A. Eplerenone B. Finerenone C. Spironolactone

C. Spironolactone

Minoxidil must not be in combination with loop diuretic & B blocker? Yer or no

No Its a must. To prevent reflex-tachycardia Its reflex is stronger than hydralazine

Hypertrichosis is a side effect of ? A. Hydralazine B. Fenoldopam C. Minoxidil D. Nifedipine

C. Minoxidil

Used as a stimulant to hair growth for correction of baldness?

Topical minoxidil ( e.g. Rogaine )

Drug x is metabolised by uptake into RBCs and release NO and cyanide? Drug x is called?

Sodium nitroprusside

Cyanide is converted into thiocyanate ( less toxic ) via?

Mitochondrial enzyme rhodanese

Accumulation of cyanide leads to metabolic alkalosis? Yes or no?

No. Incorrect Metabolic acidosis (True)

Treatments of cyanide toxicity: A) sodium thiosulfate B) Hydroxycobolamin C) A & B

C) A & B

Drug x cause hyperpolarization in smooth muscle cells and pancreatic B cells: A. Minoxidil B. Diazoxide

B. Diazoxide

Drug x has similar chemistry to thiazide diuretics by has nooooo diuretic activity? A) fendolopam B) minoxidil C) Hydralazine D) diazoxide

D) diazoxide

Drug x is metabolized by conjugation Increase IOP and should be avoided in patients with glaucoma Used for hypertensive emergencies and post-operative hypertension

Fenoldopam

Short acting CCB? A. verapamil B. Clevidipine C. Nifedipine D. Amlodipine

C. Nifedipine

The only drug used as IV in CCBs? A. Isradipinr B. Amlodipine C. Nifedipine D. Clevidipine

D. Clevidipine

Drug x has rapid onset and used for (acute) HTN occurring during surgery? A. Nifedipine B. Diltiazem C. Verapamil D. Clevidipine

D. Clevidipine (IV)

Drug x is used (orally), short acting that’s used for emergency management of severe hypertension? A. Clevidipine B. Diltiazem C. Nifedipine D. Verapamil

C. Nifedipine