Flashcards in Hypertension Deck (16)
what are the signs of grade 1 hypertensive retinopathy?
what are the signs of grade 2 hypertensive retinopathy?
AV nipping (vein becomes compressed by arteries)
what are the signs of grade 3 hypertensive retinopathy?
what are the signs of grade 4 hypertensive retinopathy?
- flame haemorrhages
- hard exudates
- cotton wool spots
what are other hypertensive signs?
- L ventricular hypertrophy
- S4 heart sounds (made by atria contracting forcefully to overcome a stiff ventricle)
when is S3 sound heard?
volume overload (heart failure)
what are the causes of hypertension?
- renal artery stenosis
- co-arctation of aorta
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)
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
what would the investigations show in Conn's?
- renin low
- aldosterone high
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
what are the clinical features of phaeochromocytoma?
- episodic severe HTN
- necrotic bowel
what is the treatment of a phaeochromocytoma?
- rehydrate if dehydrated (are very vasoconstricted)
- alpha blockade
- beta blockade
- localise lesion and surgery
what is is when the BP remains high after treatment of the phaeo?
what is the normal treatment regime for HTN?
- intensive lifestyle medication
- high dose statin
- optimal BP control
- assessment for probable T2DM