hypertension

Question 0

HTN findings on physical exam?

Answer 0

fundoscopy: hemorrhage, papilledema, cotton wool spots
rhonchi, rales
renal masses, bruits

Question 1

clinical presentation of secondary hypertension (symptoms)

Answer 1

muscle weakness, tachycardia, sweating, tremor, thinning of the skin, flank pain, confusion

Question 2

rx management of HTN? (8)

Answer 2

diuretics, Ca2+ channel blockers, ACE inhibitors/ARB, B-blockers, direct renin inhibitor, central a-agonists, a-blockers

Question 3

thiazide diuretic electrolyte effects

Answer 3

decrease K+, Mg2+, Na+

increase Ca2+

Question 4

thiazide diuretic contraindication

Answer 4

sensitivity to sulfonamide-derived drugs

Question 5

loop diuretic?

and the risk?

Answer 5

furosemide

hypokalemia- supplement K+

Question 6

K+ sparing diuretic?
tx guidelines?
contraindications?

Answer 6

Triamterene
Weak anti-HTN, used w/ thiazide
Contraindicated in hepatic disease, renal failure, hyperkalemia

Question 7

aldosterone antagonist?

side effects?

Answer 7

spironolactone

gynecomastia & hyperkalemia

Question 8

aldosterone antagonist contraindications? (3)

Answer 8

renal impairment
DM w/ proteinuria
hyperkalemia

Question 9

Ca2+ channel blocker? MOA?

Answer 9

-dipine

inhibition of Ca2+ influx into myocardial & vascular smooth muscle cells, decreasing resistance, causing vasodilation

Question 10

Ca2+ channel blocker contraindication?

Answer 10

acute MI
acute HTN- nifedipine
heart conditions: AV block, cardiogenic shock, heart failure, ventricular tachycardia, etc

Question 11

ACE inhibitors? MOA?

Answer 11

-pril

inhibit the RAAS & stimulate bradykinin –> vasodilator effect

Question 12

ACE inhibitor indication? (4)

Answer 12

chronic kidney disease
DM
heart failure
post-MI

Question 13

ACE inhibitor side effects? (4)

Answer 13

cough
hyperkalemia
angioedema
acute renal failure

Question 14

ACE inhibitor contraindications? (3)

Answer 14

pregnancy
angioedema
renal a. stenosis

Question 15

ARBs? MOA?

Answer 15

-sartan

inhibit the RAAS system

Question 16

ARB side effects? (3)

Answer 16

hyperkalemia
angioedema
acute renal failure

Question 17

ARB contraindications? (2)

Answer 17

pregnancy

renal aa. stenosis

Question 18

direct renin inhibitor?

Answer 18

Aliskiren (Tekturna)

Question 19

direct renin inhibitor side effects? (3)

Answer 19

hyperkalemia
renal impairment
hypersensitivity reactions

Question 20

direct renin inhibitor contraindications (2)

Answer 20

use w/ ACE-I or ARB in diabetics

pregnancy

Question 21

central alpha agonists (2)

Answer 21

clonidine

methyldopa

Question 22

central alpha agonist side effects? (3)

Answer 22

anticholinergic side effects: dry mouth, hot red skin, urinary retention
bradycardia
orthostatic hypotension

Question 23

methyldopa contraindication & ok?

Answer 23

ok for pregnancy

not for liver disease

Question 24

alpha blockers? and usage guidelines?

Answer 24

-zosin | use in mild to moderate HTN & not for monotherapy

Question 25

B-blockers? | effects?

Answer 25

-lol | decreased CO, PVR, renin activity

Question 26

B-blockers cautions (3) & contraindications (4)?

Answer 26

caution: asthma/COPD, DM, depression contraindications: AV block, cardiogenic shock, CHF, hypotension

Question 27

hypertensive urgency?

Answer 27

180/120 | asymptomatic- usually due to treatment non-adherence

Question 28

hypertensive emergency?

Answer 28

180/120 | associated w/ acute end-organ damage

Question 29

ocular damage, encephalopathy, brain infarct, hemorrhage, aortic dissection, LV failure, MI, acute glomerulonephritis are signs of?

Answer 29

end-stage organ damage secondary to HTN

Question 30

failure to achieve a BP goal in a patient adhering to a full dose tx of a 3 drug regimen, incl HCTZ?

Answer 30

resistant HTN

Question 31

resistant HTN causes? (5)

Answer 31

``` improper BP measurement volume overload/retention medication/drug induced obesity excess EtOH ```

Question 32

requirements for resistant HTN? (3)

Answer 32

3 dose regimen full doses including HCTZ

Question 33

hypertensive urgency tx (3)

Answer 33

gradual reduction to < 160/100 Rest, increase doses of meds, Sodium reduction SL nifedipine is contraindicated

Question 34

HTN emergency tx? (3)

Answer 34

hospitalized in ICU BP goal of 160/100 over 2-6h. IV Nitro

Question 35

when end organ damage hits the eye

Answer 35

malignant HTN

Question 36

marked HTN w/ retinal hemorrhages, exudates, or papilledema

Answer 36

malignant HTN

Question 37

HCTZ is a?

Answer 37

thiazide diuretic

Question 38

furosemide is a?

Answer 38

loop diuretic

Question 39

Triamterene is?

Answer 39

K+ sparing diuretic

Question 40

Spironolactone?

Answer 40

aldosterone antagonist

Question 41

-dipine

Answer 41

Ca2+ channel blockers

Question 42

-pril

Answer 42

ACE inhibitor

Question 43

-sartan

Answer 43

ARBs

Question 44

Aliskiren (Tekturna)

Answer 44

direct renin inhibitor

Question 45

clonidine, methyldopa

Answer 45

Central Alpha Agonists

Question 46

-zosin

Answer 46

Alpha blockers

Question 47

-lol

Answer 47

B-blockers