Car 15 - Hypertension Flashcards
What is hypertension?
BP greater or equal to 140/90.
What is Prehypertension?
BP greater or equal to 120/80.
What is a normal BP range?
BP less than 120/80.
What are the five major risk factors for HTN?
Age. Obesity. Smoking. Genetics. Race.
What is the cause of 90-95% of HTN?
Essential hypertension.
What is Hypertensive urgency?
BP greater or equal to 180/120. W/o evidence of end-organ damage (EKG changes, headache, vision abnormalities, chest pain, renal insuff, flash pulmonary edema).
What is Hypertensive emergency?
BP greater or equal to 180/120 WITH evidence of end-organ damage (EKG changes, headache, vision abnormalities, chest pain, renal insuff, flash pulmonary edema).
What is the difference b/w HTN urgency vs HTN emergency?
HTN urgency does NOT have end-organ damage while HTN emergency does.
What disease are caused by long term HTN?
Atherosclerosis. Renal insuff. Stroke (Thromboembolic or hemorrhagic stroke). Retinopathy. LVH and CHF. Aortic dissection.
Why is Left Ventricular hypertrophy bad?
Thickening of the LV wall (Not necessarily stronger like skeletal muscle). ^ myocardial oxygen demand. Stiffening of the LV (can cause S4). Encroachment upon the LV lumen.
What is Aortic Dissection?
Tear in the intima of the aorta, causing blood to dissect into the wall of the aorta, b/w layers of the media, forming a false lumen. Most common in ascending aorta. Causes a tearing chest pain that radiates to the back. Widening of mediastinum in CXR. 75% mortality.
What are the two classifications of Aortic dissection?
Standford A and B. A: any tear that involves the ascending aorta. B: descending aorta, distal to left subclavian artery. Type B is managed medically for the most part, type A can be mortal. [Type A involves the Ascending Aorta, type B occurs Beyond the Branches].
What is the drug of choice for aortic dissection?
Beta-blockers.
What would you most suspect the cause of HTN to be in a patient with: Paroxysms of increased sympathetic tone: anxiety, palpitations, diaphoresis.
Pheochromocytoma.
What would you most suspect the cause of HTN to be in a patient with: age of onset b/w 20 and 50.
Primary HTN.
What would you most suspect the cause of HTN to be in a patient with: Elevated serum creatinine and abnormal urinalysis.
Renal disease.
What would you most suspect the cause of HTN to be in a patient with: Abdominal bruit.
Renal artery stenosis.
What would you most suspect the cause of HTN to be in a patient with: Family history of HTN.
Primary HTN.
What would you most suspect the cause of HTN to be in a patient with: tachycardia, heat intolerance, diarrhea.
Hyperthyroidism.
What would you most suspect the cause of HTN to be in a patient with: Hyperkalemia.
Renal failure.
What would you most suspect the cause of HTN to be in a patient with: Episodic sweating and tachycardia.
Pheochromocytoma.
What would you most suspect the cause of HTN to be in a patient with: Abrupt onset in a patient younger than 20 or older than 50, and depressed serum K+ levels.
Hyperaldosteronemia.
What would you most suspect the cause of HTN to be in a patient with: central obesity, moon-shaped face, hirsutism.
Cushing syndrome.
What would you most suspect the cause of HTN to be in a patient with: Normal urinalysis and normal serum K+ levels.
Primary HTN.
What would you most suspect the cause of HTN to be in a patient with: young individual w/ acute onset tachycardia.
Cocaine or amphetamines.
What would you most suspect the cause of HTN to be in a patient with: Hypokalemia.
Renal artery stenosis.
What would you most suspect the cause of HTN to be in a patient with: Proteinuria.
Renal disease.
What CXR finding is possible sign for aortic dissection?
Widened mediastinum.
