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Flashcards in MEERAN HTN Deck (15)
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1

Describe the sounds heard when S3 is present

Lub- de- dub
Ken-tuck-yyy

2

What does S3 indicate? When does this occur?

Rapid ventricular filling
Dilated ventricle e.g. HF, Athletes (increase in vol)

3

Describe the sounds heard when S4 is present

Le- Lub- Dub
Ten- nesss- seee

4

What does S4 indicate? When does this occur?

Turbulent flow from atria contracting against non compliant, thickened ventricle
= Stiff or hypertrophic ventricle
Hypertensive patients (Tall R on ECG)

5

List 3 signs that may be found in a hypertensive patient?

LV hypertrophy (Heave)
S4 heart sound
Hypertensive retinopathy

6

List 4 non modifiable cardiovascular risk factors

Male
Age
Ethnic background (Asian/ Afro-carribean)
FH

7

List 6 modifiable cardiovascular risk factors

Smoking
HTN
Obesity
Sedentary lifestyle
Diabetes
High cholesterol

8

What does presence of hypertensive retinopathy indicate?

HTN has been present for a long time

9

List 6 causes of HTN

Phaeochromocytoma
Cushings
Conns
Acromegaly
Renal Artery Stenosis
Co-arctation of the aorta

10

Which 2 diseases should not really be tested for unless visible clinical features are seen on examination?

Cushings
Acromegaly

11

How does RAS cause hypertension?

Low pressure reaching JGA means renin is high
Causes production of more A1, more A2 + more aldosterone
Constricts efferent arteriole to maintain GFR
Keep on peeing
High aldosterone which increases BP, but pressure does not get through stenotic vessel, pressure remains low, thus renin stays high

12

What condition would cause hypertension with high aldosterone and low renin?

Conn's tumour
(high aldosterone suppresses renin)

13

What condition would cause hypertension with high urine catecholamines?

Phaeochromocytoma

14

How do phaeos differ from conns tumours?

Phaeos:
Pulsatile blasts of adrenaline cause episodic HTN
Large on imaging
Conns:
Constant release of aldosterone causes constant HTN
Small on imaging

15

What drugs are used first line in phaeochromocytomas? Which drugs are given afterwards?

Alpha blockers to prevent vasoconstriction
B blockers secondary, as B2 receptors cause a bit of peripheral vasodilation thus blocking them can increase BP