hypertension

Question 1

what is the normal BP

Answer 1

120/80

Question 2

what are the values for hypertension

Answer 2

140/90

Question 3

what can high BP cause

Answer 3

haemorrhage, atheroma, renal failure, cardiac death

Question 4

what is the equation for BP

Answer 4

BP = CO (HR x SV) x SVR

Question 5

describe the RAAS system

Answer 5

reduced blood flow to kidneys causes the release of renin. coverting angiotensinogen –> angiotensin I. ACE in lungs converts ANGT 1 –> ANGT 2. ANGT 2 causes vasoconstriction and release of aldosterone from adrenal medulla.

Question 6

what is primary hypertension

Answer 6

no obvious cause, vast majority of cases. Nothing ‘wrong’ with body by itself

Question 7

what is secondary hypertension

Answer 7

has an underlying cause such as renal disease, endocrine disease, drug therapy and aortic disease

Question 8

how can renal disease cause hypertension

Answer 8

reduced flow to kidneys causes more renin to be released which causes fluid and salt retention

Question 9

name 2 endocrine syndromes and what they produce

Answer 9

Conn’s syndrome = excess aldosterone

Cushing’s = excess corticosteroid

Question 10

what is benign hypertension

Answer 10

usually asymptomatic, may lead to more serious factors in the future

Question 11

for every ___ mmHg over diastolic ___ mmHg the risk of ___ doubles

Answer 11

10, 85, MI

Question 12

for every ___ mmHg over diastolic ___ mmHg the risk of ___ doubles

Answer 12

8, 85, stroke

Question 13

what is malignant hypertension

Answer 13

life threatening condition where diastolic is over 130

Question 14

what changes take place in arteries due to hypertension

Answer 14

tunic media thickens and arteries become hard

Question 15

how do you diagnose using ABPM

Answer 15

at least 2 measurements per hour in a waking day

Question 16

how do you diagnose using HBPM

Answer 16

2 measurements 1 minute apart twice a day. record for 4-7 days and discard first day, then take average

Question 17

what is the white coat effect

Answer 17

higher BP in clinical setting

Question 18

what are the values for stage 1 hypertension

Answer 18

clinical: 140/90

ABPM/ HBPM: 135/85

Question 19

what are the values for stage 2 hypertension

Answer 19

clinical: 160/100

ABPM/ HBPM: 150/95

Question 20

what are the values for sever hypertension

Answer 20

systole over 180
or
diastole over 110

Question 21

what tests can be done to test CVD risk/ damage

Answer 21

urine (for proteins), blood (for glucose, electrolytes), fundi (retina) and ECG

Question 22

for patients under 80 what is drug target BP

Answer 22

under 140/90

Question 23

for patients over 80 what is drug target BP

Answer 23

under 150/90

Question 24

what is the drug algorithm for hypertension

Answer 24

A/C
A + C
A + C + D
A + C + D (+ spirolactone or a blocker or B blocker)

Question 25

in first line who should be prescribed ACEi and who should be prescribed Ca++ blockers

Answer 25

``` ACEi = under 55 Ca++ = black or over 55 ```

Question 26

when would ARB's be prescribed first over ACEi

Answer 26

if ACEi had caused a cough

Question 27

give an example of an ACEi

Answer 27

lisinopril

Question 28

give an example of an ARB

Answer 28

losartan

Question 29

give an example of a Ca++ antagonist, what side effect can occur

Answer 29

verapamil (ankle oedema)

Question 30

give an example of a diuretic

Answer 30

thiazide diuretic

Question 31

what type of drug is spirolactone, when may you not prescribe it

Answer 31

aldosterone blocker, diabetes

Question 32

give an example of a beta blocker, when would you not prescribe it

Answer 32

bisoprolol, asthma and not with beta

Question 33

give an example of an alpha blocker, when would you not prescribe it

Answer 33

doxazosin, not with beta

Question 34

what would you prescribe in women trying to have children

Answer 34

beta blockers (others can harm fetus)