Hypertension

Question 1

Normal BP category
SBP/DP

Answer 1

SBP <120 & DP < 80

Question 2

ELEVATED BP category

Answer 2

SBP 120-129
&
DB < 80

Question 3

stage 1 HTN parameters

Answer 3

SBP 130- 139
OR
DP 80-89

Question 4

stage 2 HTN category

Answer 4

SBP 140 or higher
OR
DP 90 or higher

Question 5

Hypertensive crisis BP Parameters

Answer 5

SBP > 180 and/or
DP > 120

Question 6

etiology of hypertensive crisis

Answer 6

• acute pain
• stroke
• renal failure
• non compliance with medication
• illicit drug use (cocaine, methamphetamines)
• HF

Question 7

ACEI side effects

Answer 7

• Dry cough
• dizziness
• hypotension
• increased BUN & Cr
• Hyperkalemia
• angioedema

Question 8

ARBS side effects

Answer 8

well tolerated
hypotension
less angioedema

Question 9

Thiazide side effects

Answer 9

Hypo NA+, K+, Mag
hypercalcemia gout
hyperglycemia
dizziness

Question 10

CCB (2 types) side effects

Answer 10

Dihydropyridines: dizziness, flushing, headache, edema

Non Hihydro: constipation, bradycardia, orthostatic hypotension

Question 11

Hypertensive emergency definition

Answer 11

Urgency + target end organ damage (Chest pain, ischemia, ARF, Neuro deficit, pulmonary edema, Ao dissection, Eclampsia)

Question 12

Hypertensive emergency treatment

Answer 12

Lower MAP 20-25 % in the first 1-2 hrs using a rapid acting and titratable agent (IV)

Question 13

Hypertensive urgency definition

Answer 13

SBP >180 or diastolic > 110

Question 14

Hypertensive urgency treatment

Answer 14

Lower BP over 24 - 48 hrs. Often can be done outpatient

Question 15

In HTN emergency what is the medication of choice and why?

Answer 15

IV nicardepene

prevents rebound HTN and less side effects

Question 16

Clevidipine

Answer 16

onest: 2 min
duration: 10 min

side effects: headache, reflex tachycardia

Question 17

Esmolol

Answer 17

onset: 1 min
duration: 3-6 hrs

contraindications: 2nd, 3rd AV block, systolic HF, asthma, bradycardia

Question 18

Labetolol

Answer 18

onset 5-10 min
duration 3 - 6 hrs

contraindications: 2nd, 3rd AV block, systolic HF, asthma, bradycardia

Question 19

Nicardipine

Answer 19

onset: 5- 15 min
duration 4 - 6 hrs

contraindications: Liver failure

side effects: Headache, reflex tachycardia

Question 20

Nitroglycerin

Answer 20

onset 1 - 5 min
duration 5 - 10 min

side effects: headache, reflex tachycardia

Question 21

IVP Labetolol is a

Answer 21

non selective beta blocker (alph1 alpha 2)

Question 22

Enalapril should not be given in patients with poor

Answer 22

renal function

Question 23

Ace inhibitors are contraindicated in patients with

Answer 23

Contraindicated in renal artery stenosis

Question 24

In African American adults with hypertension but without HF or CKD including those with DM what type of medication should be used?

Answer 24

thiazide diuretic or CCB or in combination should be used

Question 25

In patients with CKD, with or without DM they should be started on an

Answer 25

ACEI or ARB or in combination with other drug classes

Question 26

In non black patients with HTN they can be started on

Answer 26

a thiazide, an ACE, ARB, CCB alone or in combination.