Hypertension

Question 1

What is blood pressure measured in?

Answer 1

mm Hg

Question 2

What is the systolic blood pressure?

Answer 2

The resistance of blood flowing in the blood vessels.

Question 3

What is the diastolic blood pressure?

Answer 3

The pressure of blood in the vessel when the heart is relaxing

Question 4

What is the range of normal blood pressure?

Answer 4

Between 90/60mmHg-120/80mmHg

Question 5

What is the range of BP for people who are at risk of developing HBP?

Answer 5

Between 120/80mmHg-140/90mmHg

Question 6

What is the range for high blood pressure?

Answer 6

140/90mmHg-150/90mmHg if over 80 years.

Question 7

What is the definition of essential hypertension?

Answer 7

high blood pressure that has no known cause.

Question 8

What % of case does essential hypertension account for?

Answer 8

95% of cases

Question 9

What is a major risk factor for developing essential hypertension?

Answer 9

CVD

Question 10

What is definition of secondary hypertension?

Answer 10

High blood pressure that is a result of a specific and potentially treatable cause

Question 11

What accounts for 80% os secondary hypertension?

Answer 11

Renal diseases such as diabetic nephropathy, glomerular nephritis and renovascular disease.

Question 12

What trimester is pre-eclampsia most likely to occur?

Answer 12

the 3rd trimester

Question 13

What is the definition of isolated systolic hypertension?

Answer 13

BP with a systolic pressure >140mmHg and diastolic BP <90mmHg.

Question 14

What age group does usually isolated systolic hypertension occur in?

Answer 14

The elderly.

Question 15

What can isolated systolic hypertension be an indicator of?

Answer 15

Hyperthyroidism and anaemia

Question 16

What is likely to be cause of isolated systolic hypertension?

Answer 16

devotion of calcium and remodelling of the vessel that result in arterial stiffness and reduced elasticity

Question 17

Whats causes increased systolic BP?

Answer 17

Increased pulse pressure and increased pulse velocity.

Question 18

What is iatrogenic hypertension?

Answer 18

High blood pressure that is a result of chemical substances/medicines.

Question 19

What are the 5 modifiable risk factors for hypertension?

Answer 19

1. Excess weight
2. High salt intake
3. Lack of physical activity
4. High salt intake
5. stress

Question 20

What are the 4 non-modifiable risk factors for hypertension?

Answer 20

1. Ageing
2. Family history
3. ethnicity
4. Gender

Question 21

What may patients with hypertension experience?

Answer 21

Generally symptomatic but patients may experience episodes of sweating and tachycardia

Question 22

When would you do a same day referral for a patient with hypertension?

Answer 22

Patient who has a blood pressure higher than 180/110mmHg without signs of accelerated hypertension or papillodema

Question 23

Why would you carry out a 12 lead ECG on a patient with suspected hypertension?

Answer 23

To assess cardiac function and left ventricular hypertrophy

Question 24

Why would you carry out a urine stick test on a patient suspected of hypertension?

Answer 24

To test for haematuria and renal disease.

Question 25

What is 1st line medication for hypertension in patient <55 yrs?

Answer 25

ACE inhibitor/ARB

Question 26

What do ACE inhibitors end in?

Answer 26

'pril'

Question 27

Give 3 examples of ACE inhibitors?

Answer 27

Ramapril, enalapril, perdinopril

Question 28

What is the primary action of ACE inhibitors and what dies it cause?

Answer 28

Prevent the conversion of angiotensin 1 to angiotensin 2 which reduces peripheral vascular resistance and therefore lowers BP

Question 29

What are 2 common side effects of ACE inhibitors?

Answer 29

Hypotension & dry cough

Question 30

Which side effect is associated with increased bradykinin production

Answer 30

dry cough

Question 31

Why arent ACE inhibitors good in pregnancy?

Answer 31

teratogenic effect effect development of foetus/embryo

Question 32

What is the GOLD standard test for investigating hypertension?

Answer 32

ambulatory BP monitoring

Question 33

What does ambulatory BP monitoring involve?

Answer 33

recording BP over 24 hr period

Question 34

How do you assess clinical hypertension?

Answer 34

record BP twice 5 mins apart and record the lowest

Question 35

Give an example of an ARB used to manage hypertension?

Answer 35

Losartan

Question 36

Whats antihypertensive is used 1st line to manage hypertension in patients >55yrs or Afro-Caribbean decent?

Answer 36

CCB

Question 37

Give an example of a CCB used for hypertension?

Answer 37

Amlodipine | Diltiazem

Question 38

What is 2nd line hypertension management?

Answer 38

ACR/ARB + CCB

Question 39

what is added as 3rd line hypertension management?

Answer 39

ACR/ARB + CCB + Thiazide like duiretic

Question 40

What investigation can be used to asses for hypertensive retinopathy?

Answer 40

Fundoscopy

Question 41

What assessment tool can be used to asses the risk of a patient having a cardiovascular event in the next 10 yrs?

Answer 41

QRISK3

Question 42

What is the target BP for a patient <80 yrs old?

Answer 42

<140/90

Question 43

What is the target BP for a patient >80yrs old?

Answer 43

<150/90

Question 44

what is a common side effect experienced by patients on ACE inhibitors

Answer 44

dry cough

Question 45

what is the pathophysiology behind a dry cough experienced in patients taking ACEi

Answer 45

increased bradykinin which causes bronchoconstriction