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Flashcards in Renal hypertension II Deck (14):

what is seen on CXR in coarctation of the aorta?

notched ribs


what are the signs and symptoms of coarctation of the aorta?

- history of HTN
- SOB on exertion
- arm / leg BP greater than 20 systolic difference
- delayed pulses


how does a low sodium diet affect ACE / ARB therapy? why?

low sodium diet may make HTN more sensitive to treatment with ACE / ARB (increaes renin release and makes BP more angiotensin II dependent)


what tests are used to diagnose pheochromocytoma (low and high suspicion)?

- low index: 24 hour urine metanephrines and catecholamines

- high index: plasma for fractionated metanephrines


why do you not use a beta blocker first prior to pheo surgery?

unopposed alpha receptor stimulation


how does hypothyroidism cause HTN?

- decrease CO
- increase PVR
- increases DIASTOLIC BP


how does hyperthyroidism cause HTN?

- increase CO
- decreased vascular tone
- increased SYSTOLIC BP


steps to diagnosis of HTN

- step 1: accuracy (must have elevated BP on at least an initial screen and then 2 or more repeat visits)

- step 2: classification

- step 3: CVD risk factors

- step 4: target organ damage

- step 5: identifiable causes


how are steps 1, 2, and 3 done to assess for HTN?

- history
- physical
- ancillary studies


BP goals are set based on what criteria?

- age
- diabetes
- kidney disease status


goal BP for patients over 60 without DM / CKD

under 150/90


goal BP for patient under 60 without DM / CKD

under 140/90


goal BP for all ages WITH DM or CKD

under 140/90


a trial of lifestyle modifications is given to patients with what BP?

under 160/100 with no evidence of target organ damage