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Year 3 Medicine > Blood Pressure > Flashcards

Blood Pressure Flashcards

1
Q

How would you explain HTN to a pt?

A

Means high blood pressure which means the pressure of your blood going around your body is a bit high

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2
Q

Renal causes of secondary HTN (5)

A 
Renal artery stenosis
Chronic glomerulonephritis
Chronic pyelonephritis
PKD
Chronic renal failure
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3
Q

Give a pregnancy cause of HTN

A

Pre-eclampsia

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4
Q

How is acute malignant HTN managed? (4)

A
  • IV beta-blocker eg. esmolol
  • Labetalol
  • Hydralazine sodium nitroprusside
  • Avoid rapid lowering of BP b/c it can cause cerebral infarction
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5
Q

When are ACEi or ARBs first line? (4)

A

<55 yrs
Diabetic
Heart failure
LV dysfunction

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6
Q

How is severe HTN managed?

A

Atenolol

Nifedipine

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7
Q

What are the lifestyle recommendations for lowering BP?

A
  • Stop smoking
  • <14 units/week or <1-2 units/day of alcohol
  • Lose weight
  • 30+ mins of moderate exercise 5+ days / week

Diet:

  • Low caffeine
  • Low salt: try avoid salty foods like crisps; try cook meals at home from scratch instead of having takeaway or processed foods; don’t add table salt; use herbs and spices to flavour food instead of salt; try have foods which say low salt on the packaging
  • Avoid fatty or fried foods; use vegetable oil instead of animal fat
  • 2-3 portions of oily fish a week; lean meat like chicken instead of ham/steak
  • 5 a day
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8
Q

When may beta blockers be considered to treat HTN? (1)

A

Younger pts

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9
Q

Define Stage 1 HTN

A

SBP > 140 +/ DBP >90 on at least 2 separate occasions
AND
ABPM daytime average or HBPM average 138/85/+

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10
Q

When may alpha blockers be considered to treat HTN? (1)

A

Pts with prostate disease

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11
Q

What are the complications of HTN? (10)

A

CVS:

  • Heart failure
  • Coronary artery disease
  • PVD
  • Emboli

Neuro:

  • Cerebrovascular accidents
  • Hypertensive encephalopathy
  • Posterior reversible encephalopathy syndrome (PRES)

Eyes:
- Hypertensive retinopathy

Renal:
- Renal failure

Malignant hypertension

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12
Q

Endo causes of HTN (8)

A 
Diabetes mellitus  
Hyperthyroidism 
Cushing's syndrome  
Conn's syndrome  
Hyperparathyroidism 
Phaeochromocytoma 
Congenital adrenal hyperplasia  
Acromegaly
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13
Q

What is the target BP? (2)

A
  • Non-Diabetic: < 140/90 mm Hg
  • Diabetes without proteinuria: < 130/80 mm Hg
  • Diabetes WITH proteinuria: < 125/75 mm Hg
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14
Q

Alpha blocker ending

A

-azocin

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15
Q

Define severe HTN

A

SBP 180/+
OR
DBP 110/+

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16
Q

Keith-Wagner Classification of HTN retinopathy

A

i. Silver wiring
ii. As above + arteriovenous nipping
iii. As above + flame haemorrhages + cotton wood exudates
iv. As above + papilloedema

17
Q

CCB ending

A

-dipine

18
Q

ARB ending

A

-sartan

19
Q

Define malignant HTN

A

BP > 200/130

20
Q

What to ask in a HTN history?

A
  • What’s brought you in today? Any other presenting complaints?
  • Every had BP done before? Anyone ever said you have high BP? Do you take medications to lower your BP?
  • Do you take steroids or COCP?
  • Smoked / caffeine / exercise within ~ the last 2 hours?
  • Smoking history
  • Alcohol history
  • Diet history (breakfast, lunch, dinner, snacks and caffeine)
  • Have you had / anyone in your family had: HTN, stroke, high cholesterol, IHD, diabetes (well controlled?)
21
Q

When is medical Tx of HTN recommended?

A

SBP > 160 +/ DBP > 100

Or evidence of end-organ damage

22
Q

What are the risks of using beta blockers to treat HTN? (2)

A

Combining with thiazide diuretic increases risk of developing diabetes

May increase risk of heart failure

23
Q

Symptoms of accelerate or malignant HTN (6)

A 
Scotomas (visual field loss)  
Blurred vision  
Headache  
Seizures  
Nausea and vomiting  
Acute heart failure
24
Q

Drug causes of HTN (3)

A

Sympathomimetics
Corticosteroids
COCP

25
Q

Define Stage 2 HTN

A

BP 160/100/+
AND
ABPM daytime average or HBPM average 150/95/+

26
Q

What investigations would you like to do after taking the BP?

A
  • Lipid profile

Make sure it’s not secondary:

  • urine dipstick for blood and protein
  • U&Es, creatinine, eGFR
  • ECG
27
Q

Cardio causes of HTN (2)

A

Coarctation of the aorta

Increased intravascular volume

28
Q

ACEi ending

A

-pril

Year 3 Medicine (5 decks)

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