HTN

Question 0

WHAT ARE SOME CAUSES OF SECONDARY HTN?

Answer 0

PHEOCHROMOCYTOMA, RENAL ARTERY STENOSIS, ALDOSTERONISM, COARCTATION OF THE AORTA

Question 1

WHAT IS CONSIDERED HTN?

Answer 1

140/90

Question 2

WHAT IS THE BIGGEST RISK FACTOR FOR CV DISEASE?

Answer 2

HTN

Question 3

IF YOU SEE SEVERE HTN IN A CHILD, WHAT SHOULD YOU BE THINKING? (DISEASE WISE)

Answer 3

ALDOSERONE INCREASE OR PHEOCHROMOCYTOMA

Question 4

WHAT IS HTN CRISIS?

Answer 4

ACUTE ELEVATION OF BP ASSOCIATED WITH END ORGAN DAMAGE. 190/100 X 2 CONSECUTIVE READINGS PERIOP.

Question 5

WHAT MARKS THE BEGINING OF CHRONIC HEART DISEASE?

Answer 5

ONCE YOU INJURE MUSCLE: MURAL CARDIAC MUSCULATURE

Question 6

WHAT CAN HAPPEN WITH SEVERE HTN?

Answer 6

MI, CVA, RENAL FAILURE, CHF, ENCEPHALOPATHY, AORTIC DISECTION…..ALL ACUTE.

Question 7

COMMON CAUSES OF SEVERE HTN?

Answer 7

WITHDRAWL OF ANTI-HTN IE CLONADINE NITROPRUSSIDE, SLE, REANAL ARTERY STENOSIS, NEOPLASM, PREECLAMPSIA, COCAINE.

Question 8

WHAT IS THE GOAL OF TREATMENT WITH HTN?

Answer 8

HALT VASCULAR DAMAGE BECAUSE THIS WILL BECOME IRREVERSABLE.

Question 9

HOW WILL PERIPHERAL PULSES FEEL IN A PT WITH COARCTATION OF AORTA?

Answer 9

DIFFERENT PERIPHERAL PULSE PALPATION.

Question 10

WHAT IS AN EXAMPLE OF A PURE ALPH BLOCKER AND WHAT IS IT USED FOR?

Answer 10

PHENTOLAMINE. USED FOR HTN CAUSED BY INCREASED CATACHOLAMINE RELEASE IE PHEOCHROMOCYTOMA.

Question 11

WHAT ARE THE 2 FACTORS THAT DETERMINE BP?

Answer 11

CO AND PVR.

BP= CO X PVR

Question 12

WHAT ARE THE SHORT TERM AND LONG TERM CONTROLS OF BP?

Answer 12

SHORT: BARORECEPTOR REFLEXES VIA SNS.
LONG: KIDNEY. REGULATE PLASMA VOL AND RENIN ANGIOTENSIN ALDOSTERONE AXIS.

Question 13

WHAT EFFECT DO DIURETICS HAVE ON SODIUM?

Answer 13

THEY INHIBIT NA REABSORPTION INTO CIRCULATION….NA STAYS IN THE NEPHRON, WHICH CAUSES AN INCREASED SECRETION OF NA IN URINE.

Question 14

WHERE DO LOOP DIURETICS WORK?

Answer 14

ACENDING LIMB OF HENLE BY INHIBITING NA,K, CL REABSORBTION. THESE ARE THE MOST EFFECTIVE DIURETICS.

Question 15

WHAT ARE LOOP DIURETIC SIDE EFFECTS?

Answer 15

HYPOKALEMIA, OTOTOXICITY, DEHYDRATION, HYPOTENSION

Question 16

WHAT ARE MAJOR DRUG INTERACTIONS WITH LASIX?

Answer 16

DIGOXIN, AMINOGLYCOSIDES, LITHIUM, POTASSIUM SPARING DIURETICS.

Question 17

HOW DO THIAZIDE DIURETICS WORK?

Answer 17

BLOCK REABSORPTION OF NA AND CL IN DISTAL CONVOLUTED TUBLE. WHICH INCREASES EXCRETION OF THESE LYTES PLUS WATER.

Question 18

WHAT ARE 2 MAIN CONSIDERATIONS WHEN USING THIAZIDE DIURETICS?

Answer 18

THEYRE NOT EFFECTIVE WHEN IMMEDIATE DIURESIS IS REQIRED. USE CAUTIOUSLY IN PT WITH SULFA DRUG ALLERGY.

Question 19

WHY ARE THIAZIDES NOT GOOD FOR DIABETICS OR PT WITH GOUT?

Answer 19

THIAZIDES ELEVATE PLASMA LEVELS OF URIC ACID AND GLUCOSE.

Question 20

CAN YOU USE THIAZIDE ON PT WITH KIDNEY FAILURE?

Answer 20

NO. EFFECTIVENESS IS DEPENDENT ON KIDNEY FUNCTION.

Question 21

WHAT ARE 3 MAJOR USES FOR THIAZIDES?

Answer 21

ESSENTIAL HTN, EDEMA, DI

Question 22

CAN YOU USE THIAZIDES DURING PREGNANCY?

Answer 22

NO

Question 23

WHAT IS A CONTRAINDICATION TO THIAZIDES?

Answer 23

HYPERSENSITIVITY TO THIAZIDES OR SULFONAMIDES (SULFA DRUGS)

Question 24

WHAT ARE ADVERSE EFFECTS OF THIAZIDES?

Answer 24

ELEVATED URIC ACID, LIPID LEVELS, BLOOD GLUCOSE.

Question 25

WHAT ARE THE 2 TYPES OF POTASSIUM SPARING DIURETICS?

Answer 25

EPITHELIAL SODIUM CHANNEL BLOCKERS AND ALDOSTERONE RECEPTOR ANTAGONISTS.

Question 26

WHAT WOULD YOU WANT TO AVOID IN PT TAKING POTASSIUM SPARING DIURETICS?

Answer 26

POTASSIUM SUPPLEMENTS AND ACE INHIBITORS.

Question 27

DO OSMOTIC DIURETICS HAVE A MOLECULAR TARGET?

Answer 27

NO....THATS UNIQUE CHARACTERISTIC. THEY INCREASE OSMOTIC PRESSURE OF TUBULE, WHICH REDUCES WATER REABSORPTION.

Question 28

WHAT EFFECT MAY HIGH POTASSIUM HAVE ON NMB?

Answer 28

HIGH POTASSIUM MAY PRODUCE METABOLIC ACIDOSIS WHICH WILL AFFECT DOA OF NMB.

Question 29

WHAT EFFECT DO HIGH DOSES OF LASIX HAVE ON NMB?

Answer 29

ANTAGONIZE NMB BY INHIBITING PHOSPHODIESTERASE, INCREASING CAMP, INCREASING MUSCLE CONTRACTION.

Question 30

WHAT IS A COMMON ANNOYING SIDE EFFECT OF LISINOPRIL?

Answer 30

COUGH. TAKES 4-6 WEEKS FOR COUGH TO DISAPPEAR.

Question 31

WHAT HAPPENS TO PRELOAD AND AFTERLOAD WHEN ON ACE INHIBITORS?

Answer 31

BOTH DECREASE. SO ITS GOOD FOR CARDIAC CONDITIONS TOO.

Question 32

WHAT EFFECT DO NSAIDS HAVE ON ACE INHIBITIORS?

Answer 32

DECREASE THE EFFECTIVENESS.

Question 33

WHAT EFFECT DO ANTACIDS HAVE ON CAPTOPRIL?

Answer 33

DECREASES THE ABSORPTION OF CAPTAPRIL.

Question 34

WHAT ARE THE EFFECTS OF ACE INHIBITORS ON POTASSIUM?

Answer 34

INCREASES POTASSIUM LEVELS. USE CAUTIOUSLY WITH K SUPPLEMENTS AND K SPARING DIURETICS.

Question 35

CONTRAINDICATIONS FOR ACE INHIBITORS?

Answer 35

PREGNANCY AND RENAL FAILURE.

Question 36

WHAT WOULD BE A GOOD ANTI HTN FOR PT WITH GOUT OR DM?

Answer 36

ANGIOTENSIN 2 RECEPTOR BLOCKERS. THEY DONT INCREASE GLUCOSE OR URIC ACID.

Question 37

WHAT POPULATION SHOUD YOU AVOID GIVING B BLOCKERS TO?

Answer 37

PT WITH ASTHMA OR DM.

Question 38

WHAT ARE THE CONTRAINDICATIONS FOR PROPRANALOL?

Answer 38

1ST DEGREE HEART BLOCK, CHF, CARDIOGENIC SHOCK, COPD, AND BRONCHIAL ASTHMA.

Question 39

WHY CAN YOU USE LOPRESSOR (METOPROLOL) IN PT WITH ASTHMA, DM?

Answer 39

ANTAGONIST AT B1 NOT B2.

Question 40

HOW SHOULD B BLOCKERS BE DISCONTINUED?

Answer 40

SLOWLY TAPERED DUE TO POSSIBLE REBOUND HTN AND TACHYCARDIA.

Question 41

WHAT EFFECTS AND SIDE EFFECTS OF B BLOCKERS WILL YOU SEE IN THE OR?

Answer 41

BRADYCARDIA ESP. WHEN NMB REVERSAL IS GIVEN. MASKS THE SIGNS OF HYPOGLYCEMAI AND HYPERTHYROIDISM.

Question 42

HOW DO CA CHANNEL BLOCKERS CAUSE THEIR EFFECTS?

Answer 42

THEY BLOCK THE CALCIUM ENTRY INTO THE CELL WHICH MEANS SMOOTH MUSCLE (IE: VESSELS) CANT CONTRACT. THEY ALSO BLOCK THE NODES OF THE HEART.

Question 43

WHAT IS CLEVIDIPINE?

Answer 43

A CALCIUM CHANNEL BLOCKER USED FOR PERI-OP HYPERTENSION.

Question 44

HOW DOES PSEUDOCHOLINESTERASE DEFICIENCY EFFECT CLIVIDIPINE?

Answer 44

IT SLOWS CLEARANCE OF CLEVIDIPINE.

Question 45

WHAT EFFECT DOES CARDIZEM HAVE ON BENZODIAZEPENES?

Answer 45

IT INCREASES BENZO'S SEDATIVE EFFECTS.

Question 46

CARIDIZEM AND BETA BLOCKERS USED TOGETHER INCREASES THE CHANCES OF WHAT?

Answer 46

BRADYARRYTHMIAS AND HYPOTENSION

Question 47

WHAT RESTRICTIONS ARE THERE FOR CHF?

Answer 47

WATER AND NA. LESS THAN 2 L AND 1-3G

Question 48

WHAT IS GOAL OF TREATMENT FOR CHF?

Answer 48

DELAY ONSET OF SYMPTOMS.

Question 49

WHAT DO CARDIAC GLYCOSIDES DO FOR CHF? (DIGOXIN)

Answer 49

DO NOT DECREASE MORTALITY BUT TREAT SYMPTOMS AND INCREASE QUALITY OF LIFE.

Question 50

WHAT HAS BEEN FOUND TO DECREASE THE MORTALITY FROM CHF?

Answer 50

COMBINED USE OF ACE INHIBITORS AND DIURETICS.

Question 51

WHAT DOES IT MEAN TO HAVE A POSITIVE IONOTROPIC AND NEGATIVE CHRONOTROPIC EFFECT.....LIKE DIGOXIN?

Answer 51

INCREASE SQUEEZE, DECREASE HR.

Question 52

WHAT DOES IONOTROPIC MEAN?

Answer 52

SQUEEZE OF HEART.

Question 53

WHAT TYPE OF RELATIONSHIP DO CA AND NA HAVE AT THE CARDIAC CELL?

Answer 53

INVERSE.

Question 54

WHAT ENZYME IS INHIBITED BY DIGOXIN?

Answer 54

NA/K ATPASE.

Question 55

HOW IS CALCIUM EFFECTED BY DIGOXIN?

Answer 55

IT INCREASES THE AMOUNT OF CALCIUM INTO THE CELL. AND IS RESERVED FOR PT WITH SYSTOLIC FUNCTION.

Question 56

WHAT ARE THINGS TO LOOK OUT FOR DURING SURGERY IF A PT IS ON DIGOXIN?

Answer 56

HYPOKALEMIA, ELECTROLYTE IMBALANCES, V FIB, AV BLOCK, SINUS BRADY.

Question 57

WHAT IS A COMMON TOXIC EFFECT OF DIGOXIN?

Answer 57

HALOS AND PHOTOPHOBIA.

Question 58

WHAT DO CARDIOSTIMULATORY DRUGS DO?

Answer 58

REDUCE AFTERLOAD OR ENHANCE MYOCARDIAL CONTRACTILITY.

Question 59

WHAT IS USED TO TREAT PULMONARY HTN?

Answer 59

ENDOTHELIN RECEPTOR AGONIST - BOSENTAN

Question 60

WHAT DOES ENDOTHELIN 1 DO?

Answer 60

PULMONARY VASOCONSTRICTION

Question 61

CAN AN ANGINA PT BE SYMPTOM FREE?

Answer 61

YES

Question 62

WHEN DO PTS BEGIN TO SHOW SYMPTOMS OF CHEST PAIN...IN TERMS OF CORONARY ARTERIES?

Answer 62

90%BLOCKED. DUE TO COLLATERAL SUPPLY.

Question 63

WHAT ARE A COMMON SIDE EFFECT OF NITRATES?

Answer 63

HEADACHES.

Question 64

HOW DO YOU PREVENT THE PATIENT FROM DEVELOPING TOLERANCE FROM NITRATE THERAPY?

Answer 64

NITRATE FREE PERIOD OF 10-12 HRS.

Question 65

WHAT ARE CLASS 1-4 ANTIARRHYTHMICS?

Answer 65

1 NA CHANNEL BLOCKERS 2 BETA BLOCKERS 3 POTASSIUM CHANNEL BLOCKERS 4 CALCIUM CHANNEL BLOCKERS.

Question 66

WHAT CLASS DOES LIDOCAINE FALL INTO?

Answer 66

SODIUM CHANNEL BLOCKER