Hypertension Flashcards
(134 cards)
1
Q
How is Cushing’s Syndrome related to secondary HTN?
A
2
Q
What drugs are used for Migraine prevention, even if a PT does not have HTN?
A
BB and CCB are first line therapy for migraine prevention (with/without HTN)
3
Q
Describe the Efficacy and ADRs for [Verapamil + diltiazem]
A
4
Q
What is phentolamine used to treat?
A
Sympathetic Overdrive but has rebound tachycardia
5
Q
Give the Tx and BP Goals for this Pregnancy-related-HTN
A
6
Q
What is MOA for all drugs that end with -sartan?
A
7
Q
Describe the MOA and efficacy for [Prazosin, terazosin, doxazosin]
A
8
Q
What does Chronic hypertension do to the baroreceptor reflex?
A
9
Q
What does this image of an arteriolar wall show?
A
10
Q
Describe the directed PE for HTN crisis
- BP measurements?
- Pulses
- Eye Exam?
- Other Exams
A
11
Q
What is the nocturnal dip?
What groups of people show a decreased nocturnal dip
A
12
Q
What is malignant hypertension and what is it associated with?
A
13
Q
Describe how α-Methyldopa works and its ADRs
A
14
Q
What is the amount of salt req. every day?
A
1500 mg but people on average have 3400 mg
15
Q
What kind of drug is Hydrochlorothiazide?
A
diuretic
16
Q
Describe the MOA and PK s for [Verapamil + diltiazem]
A
17
Q
If has a history of Gout and has HTN, what drugs do you not give them?
A
Diuretics
18
Q
Describe the MOA, Efficacy, and ADRs for Nifedipine
A
19
Q
If has a history of chronic kidney disease and has HTN, what drugs can you start them with?
A
ACE, ARB are 1st line therapy
20
Q
Describe how “Blood Cells” are related to secondary HTN
A
21
Q
Describe the MOA for Reserpine
A
22
Q
What is Sodium nitroprusside used for?
What does it do to afterload and preload?
A
23
Q
Describe how Angiotensin works
A
24
Q
Give the Tx and BP Goals for this Pregnancy-related-HTN
A
25
Concerning reasons for secondary HTN and the memory device "ABCD", what does D stand for?
* D
* Drugs
* Diet
* Dysfunctional Endocrine System
26
What are the ADRs/contraindications for Diuretics?
27
What group of drugs does the following describe?
28
What are the common reasons for HTN for the following age group?
Anyone over the age of 65
29
How do you confirm HTN?
30
Describe how α-Methyldopa works and its ADRs
31
What are the three main classes of Diuretics?
32
What are the pearls of HNT crisis Tx and what are the exceptions?
33
What percentage of HTN emergency is cardiac related and what percentage is cerebral related?
34
Describe the PKs and ADRs for propranolol
35
What is the major form of Peripheral resistance control?
36
What are the two types of HTN? Which is more common, what are the main causes of the more uncommon one?
37
Concerning reasons for secondary HTN and the memory device "ABCD", what does A stand for?
* A
* Accuracy of measurement
* Aldosteronism
* Apnea
38
What are the common reasons for HTN for the following age group?
0-18 year olds
39
Describe how "Bad Kidneys" are related to secondary HTN
40
Describe the MOA and for Efficacy propranolol
41
Describe the MOA and Efficacy for Clonidine
42
How do Natriuretic peptides work?
43
Give the Tx and BP Goals for this Pregnancy-related-HTN
44
Why were the classes of HTN changed in 2017?
45
List and describe the two major types of Hypertension
46
Give the Tx and BP Goals for this Pregnancy-related-HTN
47
What are the common reasons for HTN for the following age group?
40-64 year olds
48
How does Chronic HTN relate to pregnancy?
* tldr
* HTN Dx in 1st 20 weeks
* 5% of pregnancies
* Increased with older women
* Mild/Moderate: Do Not Treat
* Severe: Treat
* **Over 160 SBP or 110 DBP**
49
What are the Single-gene disorders associated with HTN?
50
How do Kidneys influence peripheral resistance and sodium
excretion/retention?
51
What are the Lifestyle (Non-Pharmacological) Modifications for Hypertension?
52
At what age do you treat pediatric HTN the same as adult HTN?
13
53
If you suspect an underlying cause of secondary HTN, what specific evaluations or labs do you want to find/conduct?
54
What are the benefits and ADRs for [Prazosin, terazosin, doxazosin]?
55
Describe the Tx plan for a Hemorrhagic stroke
56
* Which of the following is the best predictor of stress on arterial walls?
* Systolic BP
* Diastolic BpP
* Mean Arterial Pressure
MAP
57
If a PT has diabetes with no nephron disease, what drugs can you start them with?
* ACE, ARBs or CCBs
* **AVOID** **Diuretics**
* **_D_**iabties =/= **_D_**iuretics
58
Describe the efficacy and PKs for Reserpine
59
Describe what EDRF is and how it works
60
What are the hallmarks of Cushing's Syndrome?
61
What areas of America have the highest prevalence of HTN? What about the world?
Southeast USA
Russia + Africa
62
Describe how Aldosteronism can cause secondary HTN
* Excessive secretion of **aldosterone**.
* This disturbs the balance of sodium, potassium, and water in the blood and so leads to high blood pressure.
* Primary Hyperaldosteronism aka (Conn’s Syndrome)
* **low K+**
* Resistant HTN on **3 meds**
* Due to
* **solitary adrenal tumor**
* **bilateral adrenal hyperplasia**
63
What are the ADRs of Hydralazine?
64
Give the Tx and BP Goals for this Pregnancy-related-HTN
65
What type of HTN is necrotizing arteriolitis associated with?
Where does it occur?
66
What does this slide of a renal artery show?
67
What are the characters of Hyaline arteriolosclerosis
68
What are the general outcomes of hypertension?
69
Describe the leakage of plasma components in Hyaline arteriolosclerosis?
What occurs in the kidneys in this disease?
70
Give the Tx and BP Goals for this Pregnancy-related-HTN
71
Describe the PKs for ACE INHIBITORS
72
Explain the process of a Directed Physical Exam for HTN patients
73
Why has primary HTN increased in pediatric PTs and what would make you suspect secondary HTN in a pediatric PT?
74
Describe how Bruits is related to secondary HTN
* Bruit
* turbulent flow in peripheral vessels
* Suggested of Renal Artery Sclerosis
* Difficult to control HTN with 3 meds
* Older age with multiple risk factors for CAD
* ***_DO NOT GIVE PTs with Renal Artery Sclerosis an ACE inhibitor_***
* *_This will lead to kidney failure and will be seen as a 20% drop in eGFR or 30% rise in serum Cr_*
* Also suggestive of Fibromuscular dysplasia
* Seen in **young, healthy women.**
* **Fibrous changes in** **lumen****,** narrowing of renal arteries
* 2/3 of PTs have multiple arteries involved causing **arterial aneurysms/narrowing/ tortuosity**
* “**string of pearls**” appearance angiographically
* Fenetics (**PHACTR1** gene/**rs9349379** variant)
75
If has a history of coronary artery disease or an MI and has HTN, what drugs can you start them with?
* BBs are 1st line after MI
* **Met**oprolol, **n**adolol, **bis**oprolol, **propanol** or **tim**olol ONLY
* **ACE/ ARB**
* Use for stable **CAD or Left ventricular heart failure**
* Can add **thiazide diuretic or CCB** (**dihydropyridine** only) if BP goal is not reached
76
What are the uses of Minoxidil?
77
Besides Rx, what other things do you recommend a PT who has HTN do?
DASH-1 decreases Bp by 11, DASH-2 by 16
78
How does Diet cause secondary HTN?
79
What determines stroke volume and what determines Heart rate and myocardial contractility?
80
How do you treat HTN without Rx in pregnant women?
81
What are the 4 types of HTN that are related to pregnancy?
1. Chronic HTN
2. Pre-Eclampsia or Eclampsia
3. Pre-Eclampsia or Eclampsia + Chronic HTN
4. Gestational HTN
82
What are the common reasons for HTN for the following age group?
19-35 year olds
83
How does each of the following conditions relate to secondary HTN?
* End-stage renal disease (ESRD)
* Renal Artery Stenosis
* Pheochromocytoma (a rare tumor that usually starts in the cells of one of your adrenal glands)
84
Describe the Tolerance development seen in Hydralazine use?
85
Describe the general PKs of Diuretics
86
If a PT has diabetes with nephron disease, what drugs can you start them with?
ARBS, or ACEI
87
How does Pre-Eclampsia or Eclampsia relate to HTN during pregnancy?
* Multi-organ disease that may be related to the placenta and autoimmunity
* Need BP to be over 140/90 AND one of:
* Protein**uria**
* **Liver enzyme** elevations
* **Renal** insufficiency
* Visual/**Cerebral** changes
* Pulmonary **edema**
88
What are the three forms of HTN?
89
What are the benefits and ADRs for [Prazosin, terazosin, doxazosin]?
90
What are the ADRs for Angiotensin receptor blockers?
91
What is the MOA for Minoxidil?
92
What glaring statistic shows that age greatly influences HTN?
A healthy 65-year-old who has no sign of HTN has a 95% chance of developing HTN in 20 years.
93
* When do BPs in pregnant women drop and when do they return to normal?
* How is the prevalence of HTN-related pregnancy problems?
* When do you treat chronic HTN in pregnant women?
94
What are the safe options for Rx in pregnant women with HTN?
(Give the name of the drug as well as the class)
**Nice Meth Labs**
* Labetalol
* **First Choice**
* NS Beta blocker with alpha 1 activity
* Methyldopa
* Alpha 2 agonist
* Nifedipine
* CCB
95
Describe how the "Coarctation of the aorta" is related to secondary HTN
96
What kind of drug is **Chlorthalidone**?
Diuretic
97
What are the most common drugs that cause secondary HTN?
Tobacco, alcohol, anti-inflammatories
98
Concerning reasons for secondary HTN and the memory device "ABCD", what does B stand for?
* B
* Bruits (suggests RAS)
* Bad kidneys
* Blood Cells (Erythropoietin)
99
Describe how Apnea can cause secondary HTN
* Sleep apnea is the **most COMMON cause of resistant hypertension (64%).**
* Until addressed, BP’s will not reach ideal BPs
* **See nocturnal dip**
100
How do ACEI/ARB’s cause renal function to decline in RAS?
101
What are the current measurements for HTN stage 2?
What percentage of adults in America has HTN stage 2?
102
Describe the MOA, Efficacy, and ADRs for Nifedipine
103
* What is HELLP syndrome?
* How does it relate to HTN?
* How many PTs with HELLP die?
104
* What is hypertension defined as?
105
What is the first choice of drugs for HTN when a patient doesn't have any medical contraindications?
Which drug is usually started first and what other drug is commonly taken with it?
What is important to keep in mind when prescribing these drugs?
106
107
If a PT is African America, what is drugs do you avoid when starting Tx for HTN? What drugs do you start them with?
* African Americans
* less responsive to ACEI & ARB’s
* **_A_**frican **_A_**merican =/= **_A_**CEI or **_A_**RB
* Start with diuretics and CCB
108
What does this slide show?
109
When would you use Diuretics?
* Who do they work best on?
110
What are Eclampsia and Pre-Eclampsia?
* Eclampsia
* the onset of **seizures/convulsions** in a woman with pre-eclampsia.
* Pre-eclampsia
* a disorder of pregnancy in which there is **high blood pressure** and either **large amounts of protein in the urine or other organ dysfunction**. Onset may be before, during, or after delivery.
111
What particular group of people has the worst control of HTN? What group has the best control of HTN?
Worst: Asian men
Best: White women
112
* What are the diastolic pressures that indicate hypertension?
* What race has a high risk for hypertension?
* What occurs in untreated hypertension in about half of patients?
113
What happens to the vessels in Hyperplastic arteriolosclerosis?
114
What is Endothelin and how does it work?
115
Describe the Tx plan for an aortic dissection
116
Describe the Tx plan for an ischemic stroke
117
What are the ADR for Reserpine?
118
Describe the ADRs for ACE INHIBITORS
119
Describe how autoregulation and pH determine resistance in vessels?
120
When do you treat pre-eclampsia?
* Can use baby aspirin too
121
Describe how angiotensinogen eventually affects blood vessel size and aldosterone
122
What group of drugs does the following describe?
123
What drugs do you avoid when prescribing Rx for pregnant women with HTN?
Played on my **Ni**ntendo**-DS** while waiting for **AAA**
1. **A**CEI
2. **A**RBS
3. **A**tenolol
* Beta Blocker
4. **N**itroprusside
* Cyanide
5. **S**pironolactone
* Anti-androgenic
6. **D**ieretics
* Lowers placental perfussion
124
How does a **D**ysfunctional Endocrine cause secondary HTN?
125
* In HTN crisis, what is considered HTN Emergency?
* What symptoms are associated with it?
* What subset of HTN Emergency is associated with death if undiagnosed if not treated correctly/right away?
126
Describe the general mechanisms of Diuretics
127
Describe how "Catecholamines" are related to secondary HTN
128
What is the MOA and ADRs for Sodium nitroprusside?
129
What is Gestational HTN?
* HTN after 20 weeks
* 1/2 of women get it
* Usually resolves 6 weeks after birth
130
What labs do you consider when you find that a PT has HTN?
131
Describe how Aldosterone works
132
* In HTN crisis, what is considered HTN Urgency?
* Who does it affect most?
133
Concerning reasons for secondary HTN and the memory device "ABCD", what does C stand for?
* C
* Catecholamines
* Coarctation of aorta
* Cushing’s Syndrome
134
How do genetics play a part in HTN?
* Parental HTN increases the chance of HTN in children
* Chance increase more with age compared to others
* Anywhere between 65% to 27% of essential HTN due to genetics.
