Hypertension Flashcards

1
Q

What is the most likely complication to occur with chronic hypertension?

A

Stroke

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2
Q

What are the classifications of blood pressure?

A

Normal: <120/<80

Pre-Htn: 120-139/80-89

Stage 1: 140-159/90-99

Stage 2: >160/>100

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3
Q

What are the treatments for the stages of hypertension?

A

Normal/Pre Htn - Lifestyle modification (no drugs)

Stage 1 - LSM, Mono-combo

Stage 2 - LSM, Combo

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4
Q

Does lowering BP prevent strokes or MIs better?

A

Strokes

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5
Q

What are common indications of hypertension?

A

Heart Failure

Diabetes w/ proteinuria

CAD

Chronic Renal Insufficiency

CVA

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6
Q

What is necessary to produce sustained hypertension?

A

Renal involvement

An altered renal “set point” for sodium retention/excretion

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7
Q

What are the two best screening tests for renovascular hypertension?

A

Captopril renogram

Arteriorgram

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8
Q

How does hyperaldosteronism cause hypertension?

A

Autonomous aldosterone production leads to ecf expansion and increased BP

Very high BP, surpressed renin levels and nonstimulatable

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9
Q

What is pheochromocytoma?

A

Autonomous production of vasoconstrictors epinephrine and norepinephrine

Increaes in TPR define physiology, however catecholamines may blunt natriuresis so volume depletion is not sufficient to prevent hypertension

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10
Q

What is the majority cause of hypertension?

A

Essential (combination of genetics and environment)

Secondary causes (i.e. pathologies) much less common

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11
Q

What is malignant hypertension?

A

Medical emergency

Evidence for acute vascular injury in context of hypertension, usually found on retinal examination

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12
Q

Who should be evaluated for secondary hypertension?

A

Hypertension presenting early

Hypertension without a family history

Severe or difficult to control hypertension

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13
Q

What are the types of renovascular hypertension?

A

Fibromuscular dysplasia - familial, responds well to correction

Athermomatous - correlates with PVD

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14
Q

What are types of hyperaldosteronism?

A

Adrenal tumor (Conn’s syndrome)

Adrenal hyperplasia (Glucocorticoid sens/insens)

Pseudohyperaldosteronism (licorice/tobaccos, Liddle’s)

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15
Q

How is hyperaldosteronism evaluated?

A

Hypokalemia

Hypokalemia in the face of ACE inhibitor is a red flag

Goal is to demonstrate suppressed renin and non-suppressible aldosterone

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16
Q

What are the risk factors for atherosclerosis?

A

Smoking

Dyslipidemia

Age > 60

Male or postmenopausal female

Family history

17
Q

What drugs are recommended for uncomplicated hypertension?

A

Diuretics

18
Q

What drugs are recommended for diabetes with proteinuria?

A

ACE inhibitors or ARB

19
Q

What drugs are recommended for myocardial infarction?

A

Beta blockers

20
Q

What drugs are recommended for systolic heart failure?

A

ACE inhiibtors or ARB