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Flashcards in Hypertension Deck (57)
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1

How is hypertension defined.

Defined as blood pressure > 140/90mmHg.

2

What are the two main categories of hypertension. (2)

Essential hypertension.
Secondary hypertension.

3

What is essential hypertension.

Arterial hypertension with no specific cause.

4

What percentage of cases of hypertension are due to essential hypertension.

>90%

5

What are the causes of secondary hypertension. (5)

Endocrine causes.
Renal disease.
Acute porphyria.
Coarctation of the aorta.
Iatrogenic.

6

What are the endocrine causes of hypertension. (5)

Cushing's syndrome.
Phaeochromocytoma.
Acromegaly.
Conn's syndrome.
Thyrotoxicosis.

7

What are the renal causes of hypertension. (2)

Chronic renal failure.
Renal artery stenosis.

8

What are the iatrogenic causes of hypertension. (3)

Ciclosporin.
Contraceptives.
Steroids.

9

What are the risk factors for hypertension. (5)

Obesity.
Increased salt intake.
Alcohol.
Diabetes mellitus.
Genetic inheritance.

10

What are the symptoms of hypertension. (9)

Asymptomatic unless malignant.
Headaches.
Dizziness.
Blurred vision.
Epistaxis.
Angina.
Syncope.
Signs of heart failure.
And symptoms related to the underlying cause.

11

What are the signs of hypertension. (6)

LV heave.
4th heart sound.
3rd heart sound.
Hypertensive retinopathy.
Carotid/renal bruits.
Proteinuria.

12

What investigations should be carried out in a patient with hypertension. (9)

FBC.
UandEs.
Fasting glucose.
Lipid profile.
Haemoglobin A1c (HbA1c).
Urine for sugar/protein/blood/creatinine clearance.
ECG (for LV hypertrophy and strain).
CXR.
Other investigations to rule out secondary causes.

13

What tests should you do to rule out Cushing's as a cause of hypertension. (4)

Calcium.
TFTs.
Cortisol.
Dexamethasone suppression test.

14

What test should you do to rule out a phaeochromocytoma as a cause of hypertension.

24 hour urine for catecholamines.

15

What test should you do to rule out a renal carcinoid as a cause of hypertension.

24 hour urine for hydroxyindoleacetic acid (HIAA).

16

What test should you do to rule out Conn's as a cause of hypertension.

Aldosterone:renin ration.

17

What tests should you do to rule out renal artery stenosis as a cause of hypertension. (2)

Renal Doppler flow studies.
Renal MRA.

18

What are the complications of hypertension. (5)

Atherosclerosis.
Heart failure.
Cerebral infarct.
Cerebral haemorrhage.
Renal impairment.

19

What are the main aspects of treatment of hypertension. (2)

Lifestyle changes.
Medical treatment.

20

What aspects of a patient's lifestyle should be changed if they have hypertension. (5)

Stop smoking.
Weight loss.
Salt restriction.
Reduce alcohol intake.
Optimize glycaemic control.

21

What are the medical therapies for patient with hypertension. (7)

Diuretics (thiazide).
ACE inhibitors (Lisinopril).
Angiotensin receptor blockers (candesartan).
Calcium channel blockers (nifedipine).
Beta blockers (bisoprolol).
Aspirin when BP controlled if age>55.
Statin.

22

What is malignant hypertension considered.

A medical emergency.

23

What is malignant hypertension.

Fibrinoid necrosis of small arteries/arterioles and dilatation of cerebral arteries.

24

Who is most affected by malignant hypertension.

Men more than women.
Usually in the 5th decade.

25

What are the clinical signs of malignant hypertension. (5)

Headache.
Vomiting.
Visual disturbances.
Convulsions.
Papilloedema.

26

What is the treatment of malignant hypertension. (2)

IV labetalol/GTN.
Slow reduction of blood pressure.

27

What are the complications of malignant hypertension. (7)

Microangiopathic haemolytic anaemia.
Acute renal failure.
Cerebral haemorrhage.
Heart failure.
Encephalopathy.
Coma.
Death.

28

Who gets treatment for hypertension.

Everyone above 160/100.
For those with BP 140/90, the decision to treat depends on the risk of coronary events, presence of diabetes or end-organ damage.

29

What did the HYVET study show.

That there is a substantial benefit in treating those with hypertension over 80s.

30

What is isolated systolic hypertension.

It is the most common form of hypertension in the UK.