Flashcards in Hypertension CIS Deck (33):
1
to diagnose hypertension
need TWO readings
2
essential HTN
no known cause - idiopathic
3
most likely cause of HTN
essential - no known cause
4
risk factors for essential HTN
obesity
high salt diet
hereditary
alcohol
age
5
headaches and HTN
don't treat to solve headache
6
HTN risk of what conditions
stroke
MI
heart failure
ESRD
aortic dissection
PVD
7
HTN in young**
increased peripheral vascular disease (vasospasm)
-level of small arterioles
-both systolic and diastolic elevated
8
HTN in old**
aorta stiff - collagen replaces elastin
-isolated systolic HTN**
9
recommended life-style modifications for patient
minimum 30 minutes most days of week
-HR elevation 70% (220-age)
DASH diet - fruit, veggies, low fat
moderation of alcohol - less than 2/day or 10/week
10
treat with drugs or wait for lifestyle mods?
drug.
11
intitial HTN med for non-black
ACE (-)
ARB
CCB
thiazide diuretics
12
initial HTN med for black
CCB
thiazide diuretics
13
cushings
-adrenal overactivity
-striae - fast weight gain
-cause of HTN
14
dexamethasone suppression test
cushing test
15
secondary HTN
-hard to control HTN
-compelling ginding
-atypical age
-absence of predisposing factors
16
renal artery stenosis
cause of secondary HTN
17
Dx for renovascular HTN
captopril
DSA
MRI - angiography
arteriography
renal vein renin ration
18
captopril
rise in renin and large fall in BP after administration
captopril - ACE (-)
-abnormal test - renovascular disease
-diagnosis - renal artery stenosis
19
two main causes of renal artery stenosis
-atherosclerosis
-fibromuscular dysplasia
20
careful with these meds with renal a. stenosis
ACE (-)
unilateral - BP falls
bilateral - unpredictable, may worsen HTN
one kidney - unpredicatble, may worsen HTN
21
fibromuscular dysplasia
young females
bilateral renal a stenosis
responds to angioplasty
22
atherosclerosis
older males
unilateral renal a stenosis
23
test for hyperthyroid
TSH
24
black with hyperthyroid meds for HTN
beta-blocker
-non-selective
-propanolol
25
HTN with low K
hyperaldosteronism
hypokalemia is the clue**
26
hypertensive urgency
systolic > 180
diastolic > 130
NO evidence of organ damage
27
hypertensive emergency
any BP - includes end organ damage
28
secondary hyperaldosteronism
diuretics
CHF
cirrhosis
ascites
nephrosis
etc
29
weak with hyperaldosteronism?
hypokalemia - muscle weakness
30
Tx for hyperaldosterone HTN
spironolactone
-aldosterone blocker**
31
adrenal conditions with 2nd HTN
cushings
hyperaldosteronism
pheochromocytoma
32
test for pheochromocytoma
VMA levels
33