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Sp: Coexisting I > 4. HTN > Flashcards

4. HTN Flashcards

1
Q

normal BP

A

120/8-0

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2
Q

elevated

A

120-129/80

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3
Q

stage 1 HTN bp

A

130-139/80-89

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4
Q

stage 2 HTN bp

A

> 140/90

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5
Q

HTN means we cannot

A

perfuse the heart as well

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6
Q

HTN causes

A

LV hypertrophy
coronary insufficiency
HF

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7
Q

baroreceptors: high pressure zone

A

sensitive > 60mmHg
aortic arch
carotid sinus

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8
Q

baroreceptors: low pressure zones

A

large veins
wall of atria

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9
Q

what regulates sympathetic changes

A

high pressure baroreceptors

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10
Q

what regulates blood volume

A

low pressure baroreceptors

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11
Q

what contributes to acute and long term volume control

A

RAAS

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12
Q

angiotensin 2

A

vasocontriction
incr aldosterone

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13
Q

aldosterone

A

incr Na+
incr H2O
exretes K+

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14
Q

ADH aka

A

vasopressing

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15
Q

ADH low doses

A

reabsoprtion of water

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16
Q

ADH high doses

A

vasoconstriction

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17
Q

endothelin

A

vasoconstriction

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18
Q

ANP is secreted by

A

atrial myocytes

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19
Q

ANP effects

A

incr GFR
incr Na+ excretion
incr H2O excretion

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20
Q

BNP secreted by

A

ventricular myocytes

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21
Q

BNP effects

A

vessel dilation

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22
Q

ANP/BNP prevent

A

myocardial remodeling/hypertophy

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23
Q

secondary HTN causes in kids

A

renal disease
coarctation of aorta

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24
Q

secondary HTN adolescnets

A

coarctation of aorta

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25
Q

secondary HTN young adults

A

thyroid
fibromuscular dysplasia
renal disease

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26
Q

secondary HTN mid age adults

A

hyperaldosteronism
thyroid
OSA
cushings
pheochromocytoma

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27
Q

secondary HTN elderly

A

renal artery stenosis
renal failure
hypothyroidism

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28
Q

HTN pathophysiological effects

A

vasculopathy
heart disease
cerebrovascular damage
nephropathy

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29
Q

HTN: initial treatment

A

lifestyle modification

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30
Q

1 kg weight loss =

A

1 mmHg BP reduction

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31
Q

alcohol BP effect

A

alcohol incr BP
inhibit ADH
incr renin
reduces med efficacy

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32
Q

HTN: primary line treatment (4)

A

thiazide diuretics
CCB
ACE inhibitors
ARBS

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33
Q

CCB

A

amlodipine
verapamil

(DIPINE)
(MIL)

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34
Q

ACE inhibitors

A

lisinopril

(PRIL)

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35
Q

ARBs

A

Losartan

(SARTAN)

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36
Q

HTN: secondary treatment
(8)

A

loop diuretics
aldo antagnoist
b blocker
a blocker
a/b blocker
clonidine
vasodilators
renin inhibitor

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37
Q

loop diuretic

A

furosemide

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38
Q

aldosterone antagonist

A

spironolactone

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39
Q

a blocker

A

zosin

40
Q

direct renin inhibitor

A

aliskiren

41
Q

more drugs means the pt has

A

less control

42
Q

drug for pheochromocytoma

A

a blocker
(ZOSIN(

43
Q

what drugs taken day of surgery have profound post-induction hyptension

A

ACE inhibitor (PRIL)
ARBs (SARTAN)

44
Q

what HTN drug is associated with sedation

A

clonidine

45
Q

secondary HTN pnemonic

A

Cushings
Hyperaldosteronism
Aortic coarctation
Pheochromocytoma
Stenosis of renal arteries

46
Q

day of surgery: ACE / ARBS

A

withhold for 10 hours prior

47
Q

day of surgery: b blocker

A

take as normal

48
Q

day of surgery: CCB

A

take as normal

49
Q

day of surgery: clonidine

A

take as normal

50
Q

which HTN drug has profound rebound if held

A

clonidine

51
Q

claudications

A

plaque build up

52
Q

carotid bruit indicates

A

atherosclerotic vascular disease

53
Q

which pt should you give a fluid bolus to for HTN

A

pts that took ACE/ARB before surgery

54
Q

pheochromocytoma signs

A

flushing
sweating
palpitations

55
Q

renal artery stenosis signs

A

renal bruit

56
Q

hyperaldosteronism sign

A

hypokalemia

57
Q

what BP indicates cancellectomy for elective procedures?

A

> 180/110

58
Q

HTN causes what risks in surgery

A

incr EBL
incr MI risk
incr hemodynamic volatility

59
Q

what should you consider perepping for surgery on HTN pt

A

additional PIV
type and match
preemptive art line

60
Q

what drugs help decr BP effects during induction and laryngoscopy

A

propofol
narcotics
VA
esmolol
phenylephrine

61
Q

pts with preoperative ______ are more likely to have intraoperative ______

A

pts with preoperative hyertension are more like to have intraoperative hypotension

62
Q

induction causes

A

hypotension

63
Q

laryngoscopy causes

A

hypertension

64
Q

best practice BP range off baseline

A

+/- 20% of baseline MAP

65
Q

hypertensive crisis

A

based on presence of end-organ damage symptoms

66
Q

hypertensive crisis treatment

A

sodium nitroprusside
nicardipine
clevidipine

67
Q

CNS end organ damage

A

encephalopathy
intracerebral hemorrhage
subarachnoid hemorrhage
acute stroke

68
Q

renal end organ damage

A

renal dysfunction

69
Q

CV end organ damage

A

unstable angina
MI
HF
aortic dissection

70
Q

NO prodrugs

A

NTG
nitroprusside

71
Q

nicardipine receptor

A

CCB - DHP

72
Q

hydralazine receptor

A

Ca2+ release from SR in arterioles

73
Q

NTG bolus

A

10-100 mcg

74
Q

nipride bolus

A

dont bolus

75
Q

nicardipine bolus

A

0.2-0.5 mg

76
Q

hydralazine bolus

A

5-10mg

77
Q

esmolol bolus

A

10-50mg

78
Q

esmolol infusion

A

25-200mcg/kg/min

79
Q

NTG infusion

A

0.1-2 mcg/kg/min

80
Q

nipride infusion

A

0.1-2 mcg/kg/min

81
Q

max NTG infusion

A

5 mcg/kg/min

82
Q

max nipride infusion

A

10 mcg/kg/min

83
Q

nicardipine infusion

A

5-15 mg/hr

84
Q

hydralizine infusion

A

dont infuse

85
Q

labetalol bolus

A

5 mg

86
Q

labetalol infusion

A

dont infuse

87
Q

which anti-HTN drug should you avoid in pts on PDE5 inhibitor

A

NTG

88
Q

which anti-HTN drug increases risk of methemoglobinemia

A

nipride

89
Q

which anti-HTN drug has reflex tachy?

A

nicardipine

90
Q

which anti-HTN drug is slow onset/long acting?

A

hydralazine

91
Q

which anti-HTN drug is very potent

A

hydralazine

92
Q

what indicates acute postop HTN

A

> 180/110

93
Q

what surgeries incr risk of acute postop HTN

A

carotid endarterectomy
abdominal aortic surgery
radical neck dissection
intracranial surgery

94
Q

common post op HTN symptoms

A

pain
anxiety
hypoxemia
hypercarbia
shivering
bladder distention

95
Q
A

Sp: Coexisting I (11 decks)

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