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Flashcards in Hypertension Deck (16)
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1

what are the signs of grade 1 hypertensive retinopathy?

silver wiring

2

what are the signs of grade 2 hypertensive retinopathy?

AV nipping (vein becomes compressed by arteries)

3

what are the signs of grade 3 hypertensive retinopathy?

flame haemorrhages

4

what are the signs of grade 4 hypertensive retinopathy?

- flame haemorrhages
- hard exudates
- papilloedema
- cotton wool spots

5

what are other hypertensive signs?

- L ventricular hypertrophy
- heaving
- S4 heart sounds (made by atria contracting forcefully to overcome a stiff ventricle)
- bruits

6

when is S3 sound heard?

volume overload (heart failure)

7

what are the causes of hypertension?

- phaeochromocytoma
- Cushing's
- Conn's
- acromegaly
- renal artery stenosis
- co-arctation of aorta

8

what are the basic investigations you should do in hypertension?

- FBC (check for polycythaemia)
- U&Es (K may be low, renal function affected)
- ECG (LVH)
- urinalysis (nephritis, renal disease)
- fasting glucose (diabetes)
- lipids

9

what are the investigations done for determining secondary causes of hypertension?

- renin levels
- aldosterone levels
- 24hr urine catecholamine levels
- 24hr urine cortisol
- glucose tolerance test if suspected acromegalic

10

what would the investigations show in Conn's?

- renin low
- aldosterone high

11

what would the investigations show in renal artery stenosis?

- Renin HIGH
- Aldosterone HIGH
- Pressure in renal artery is low so activates RAS
- High renin causes raised aldosterone

12

what are the clinical features of phaeochromocytoma?

- nervousness
- sweating
- palpitations
- episodic severe HTN
- necrotic bowel

13

what is the treatment of a phaeochromocytoma?

- rehydrate if dehydrated (are very vasoconstricted)
- alpha blockade
- beta blockade
- localise lesion and surgery

14

what is is when the BP remains high after treatment of the phaeo?

essential HTN

15

what is the normal treatment regime for HTN?

- intensive lifestyle medication
- aspirin
- high dose statin
- optimal BP control
- assessment for probable T2DM

16

what is the purpose of PCSK9 inhibition?

- PCSK9 digest LDL receptors
- regulates the levels of the LDL receptor
- Loss of function mutations lead to higher levels of the LDL receptor, lower LDL cholesterol levels and protection from coronary heart disease
- Evolocumab – PCSK9 monoclonal