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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

type of hypertension whose etiology is unknown and accounts for 95% of all cases

A

primary hypertension

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2
Q

type of hypertension that has a definable cause and is usually associated with an underlying, treatable cause

A

secondary hypertension

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3
Q

which type of hypertension can be “cured”

A

secondary hypertension

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4
Q

what is considered elevated BP?

A

120-129/<80

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5
Q

what is stage I hypertension?

A

130-139/80-89

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6
Q

what is stage II hypertension?

A

> 140/>90

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7
Q

what does uncontrolled hypertension lead to?

A

heart failure

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8
Q

the pathogenesis of primary hypertension is sometimes _____

A

genetic

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9
Q

what are the 3 biggest risk factors associated with primary hypertension?

A
  1. obesity
  2. family history
  3. race
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10
Q

what can be a patient use to help me diagnose them with hypertension?

A

ambulatory BP monitoring

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11
Q

what kinds of patients are perfect for ambulatory BP monitoring?

A
  1. white coat hypertension + no end organ damage
  2. episodic hypertension
  3. hypotension symptoms while on HTN meds
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12
Q

a mean daytime BP >_____ systolic or > _____ diastolic is HTN

A

130;80

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13
Q

a patient who presents with a hypertensive urgency BP >_____ systolic or > _____ diastolic is HTN

A

180; 120

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14
Q

a patient with an initial BP > ____ systolic or > _____ diastolic and with known end-organ damage is HTN

A

160; 100

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15
Q

how often should a patient with normal BP be screened?

A

q 2 years

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16
Q

how often should a patient with BP of 120-139 systolic or 80-89 diastolic (prehypertension) be screened?

A

yearly

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17
Q

what is the physical exam like for a patient with suspected hypertension?

A

normal

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18
Q

what is metabolic syndrome?

A

hypertension, hyperlipidemia, and diabetes

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19
Q

what should I look for to diagnose hypertension, especially in patients with diabetes or renal disease?

A

microalbuminuria

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20
Q

what is the BP goal in patients 65 or older?

A

125-130/80

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21
Q

what is the BP goal in patients 65 or younger?

A

130-139/90

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22
Q

what is the BP goal for patients of all ages, that have diabetes, but no CKD?

A

125-130/80

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23
Q

what is the BP goal for patients of all ages, that have CKD, +/- diabetes

A

125-130/80

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24
Q

what 2 medications can I give a black patient with hypertension?

A
  1. thiazide diuretic
  2. calcium channel blocker
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25
Q

what 2 medications can I give any race that has hypertension and CKD?

A
  1. ACEI
  2. Angiotensin receptor blocker
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26
Q

how do thiazide diuretics decrease BP?

A

remove excess fluid from body

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27
Q

what are 3 thiazide diuretics?

A
  1. chlorthalidone
  2. hydrochlorothiazide
  3. indapamide
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28
Q

what are 2 ACE inhibitors?

A

1, benazepril
2. captopril

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29
Q

what are 2 angiotensin II receptor blockers (ARBs)?

A
  1. telmisartan
  2. losartan
30
Q

name a dihydropyridine calcium channel blocker

A

amlodipine

31
Q

name a nondihydropyridine calcium channel blocker

A

verapamil

32
Q

which 2 treatments should not be given to a pregnant patient for hypertension?

A
  1. ACE
  2. ARB
33
Q

what 4 medications are safe to give a pregnant patient for hypertension?

A
  1. labetalol
  2. hydralazine
  3. nifedipine ER
  4. methyldopa
34
Q

which 2 hypertension treatments should not be combined?

A

ACEI and ARB

35
Q

what kind of exercise produces small reductions in BP regardless of body mass, ethnic group, or age

A

aerobic

36
Q

in patients over 50 years, what is a risk factor for cardiovascular disease?

A

SBP greater than 140

37
Q

what is the usual nature of onset in patients with secondary hypertension?

A

abrupt

38
Q

what is the most common cause on secondary hypertension?

A

chronic kidney disease

39
Q

what is the 2nd most common cause of secondary hypertension?

A

primary hyperaldosteronism

40
Q

what are 4 things to check when screening for renovascular disease?

A
  1. GFR
  2. renal US
  3. elevated serum creatinine
  4. abnormal UA
41
Q

rare catecholamine-secreting tumor on the adrenal medulla that presents with triad of headache, palpitations, and sweating

A

pheochromocytoma

42
Q

what should we check for in a 24hr urine sample to screen for pheochromocytoma? (2)

A
  1. metanephrines
  2. catecholamines
43
Q

what should I check for in a 24hr urine sample to screen for hyperaldosteronism? (2)

A
  1. unexplained hypokalemia
  2. serum aldosterone : renin ratio
44
Q

what test should I do to screen for cushing’s syndrome to see an increase of cortisol?

A

dexamethasone suppression test

45
Q

what test confirms coarctation of the aorta?

A

CT angiography

46
Q

hypertension in the upper extremities, hypotension in the lower extremities, and differing BP between the arms indicates …

A

coarctation of aorta

47
Q

what would I check to screen for hypothyroidism?

A

TSH

48
Q

what would I check to screen for hyperparathyroidism? (2)

A
  1. serum PTH
  2. calcium
49
Q

what is the most common form of secondary hypertension?

A

renal parenchymal disease

50
Q

renal artery stenosis that is usually due to atherosclerosis or fibromuscular dysplasia

A

renovascular disease

51
Q

rare congenital narrowing of the proximal aorta near the origin of the left subclavian artery which may lead to hypertension

A

coarctation of aorta

52
Q

what is commonly seen on a CXR in a patient with coarctation of the aorta?

A

rib notching

53
Q

rare, excessive mineralocorticoid secretion of aldosterone from adrenal adenoma or bilateral hyperplasia

A

primary hyperaldosteronism

54
Q

rare, renin-secreting tumors that causes hypertension, that is mediated by increased Na+ retention due to excess aldosterone

A

secondary hyperaldosteronism

55
Q

rare cause of hypertension mediated by excess glucocorticoids (cortisol) that leads to increased B.V and renin production

A

cushing’s syndrome

56
Q

thyroid problem that is associated with systolic hypertension

A

hyperthyroidism

57
Q

thyroid problem that is associated with diastolic hypertension

A

hypothyroidism

58
Q

the number of calories you burn as your body performs basic life-sustaining functions

A

basal metabolic rate

59
Q

what increases HR, which in turn affects cardiac output?

A

increased basalmetabolic rate

60
Q

how does hypothyroidism increase BP?

A

fluid retention

61
Q

at what age should I start screening patients for hypertension?

A

18 years

62
Q

what 4 things should I test to screen a patient for secondary hypertension?

A
  1. potassium
  2. calcium
  3. creatinine
  4. UA
63
Q

what 2 causes of secondary hypertension can cause hypertension to persist even after treatment?

A
  1. coarctation of aorta
  2. hyperparathyroidism
64
Q

what are the 2 main causes of hypertensive crisis?

A
  1. uncontrolled primary hypertension
  2. secondary hypertension
65
Q

severely elevated BP without acute symptoms (often asymptomatic) or clinically-evident end-organ damage

A

hypertensive urgency

66
Q

severely elevated BP with evidence of impending or progressive targe organ damage

A

hypertensive emergency

67
Q

what are 5 evidence of impending or progressive target organ damage in a hypertensive crisis?

A
  1. headache/vision changes
  2. n/v
  3. chest pain
  4. cerebral infarction
  5. acute pulmonary edema
68
Q

what 4 tests NEED to be ordered in a hypertensive crisis?

A
  1. electrolytes
  2. renal function
  3. UA
  4. ECG
69
Q

what radiology should be ordered in a hypertensive crisis with suspected pulmonary edema or aortic aneurysm?

A

CXR

70
Q

what radiology should be ordered in a hypertensive crisis with headache, AMS, or other neurological symptoms?

A

CT scan

71
Q

therapeutic goals in a hypertensive crisis is prompt reduction of MAP by _____% and DBP below _____

A

20-25; 100

72
Q

what is something that patients with true hypertensive emergency require?

A

invasive BP monitoring (radial arterial line)

Cardiology (19 decks)

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