Hypertension CIS Flashcards Preview

RENAL II Exam 3 > Hypertension CIS > Flashcards

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

coarctation of aorta

difference in BP arms to legs
-20mmHg

also - systolic ejection murmur

can cause secondary HTN

narrowing medial layer of aorta
-commonly at ligamentum arteriosum
-interrupted, preductal, postductal