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Small Animal Medicine > Cardio - Systemic Hypertension > Flashcards

Cardio - Systemic Hypertension Flashcards

1
Q

How is BP measured?

A

Directly (intra-arterial) or indirectly (doppler/oscillometric)

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2
Q

What BP measurement is more accurate for smaller patients?

A

Doppler

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3
Q

Where should BP be measured in cats?

A

tail base

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4
Q

Where should BP be measured in dogs?

A

non-dependent limbs

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5
Q

How big should the BP cuff be in dogs vs. cats?

A

Dogs = 40% of circumference

Cats = 30-40% of circumference

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6
Q

What causes SHT in humans?

A

95% primary

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7
Q

What type of SHT do dogs and cats have?

A

secondary (esp. animals > 10 yo)

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8
Q

What diseases cmmonly have secondary SHT in dogs?

A

Hyperadrenocorticism, CKD

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9
Q

What diseases commonly have secondary SHT in cats?

A

hyperthyroidism, CKD

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10
Q

Heart disease _____ cause SHT, but SHT can _____ or _____ heart disease.

A

does not, cause, worsen

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11
Q

What organs are more prone to SHT?

A

Kidney, eye, brain, heart, blood vessels

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12
Q

What damage does SHT have on the kidneys?

A

Progression of CKD, proteinuria

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13
Q

What damage does SHT have on the eye?

A

Retinal hemorrhage and detachment

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14
Q

What damage does SHT have on the brain?

A

Hemorrhagic stroke

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15
Q

What damage does SHT have on the heart?

A

LV hypertrophy

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16
Q

What damage does SHT have on blood vessels?

A

hemorrhage

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17
Q

What clinical signs are associated with SHT and the kidney?

A

PU/PD

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18
Q

What clinical signs are associated with SHT and the eye?

A

acute blindness

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19
Q

What clinical signs are associated with SHT and the brain?

A

Forebrain signs, seizures

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20
Q

What clinical signs are associated with SHT and the heart?

A

heart murmur, S4 gallop, CHF

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21
Q

What clinical signs are associated with SHT and blood vessels?

A

Epistaxis

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22
Q

What diagnostic tests can be run when SHT is suspected to involve the kidney?

A

BUN/crea, U/A, UP:C

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23
Q

What diagnostic tests can be run when SHT is suspected to involve the eye?

A

fundic exam

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24
Q

What diagnostic tests can be run when SHT is suspected to involve the brain?

A

neuro exam, MRI

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25
Q

What diagnostic tests can be run when SHT is suspected to involve the heart?

A

Echo

26
Q

What diagnostic tests can be run when SHT is suspected to involve the blood vessels?

A

PE

27
Q

What is normal BP (systolic)?

A

120-130 mmHg

28
Q

What happens in “white coat” effect?

A

Situational hypertension, no official cutoff for high BP in a very stressed patient

29
Q

What is abnormal BP (systolic) AKA SHT?

A

>140 mmHg

30
Q

What BP range is considered pre-hypertensive?

What is the risk of future target organ damage?

A

140-159; mild

31
Q

What BP range is considered truly hypertensive?

What is the risk of future target organ damage?

A

160-179; moderate

32
Q

What BP range is considered severely hypertensive?

What is the risk of future target organ damage?

A

>180; severe

33
Q

What 4 types of patients should be screened for SHT?

A
  1. Those with evidence of target organ damage
  2. Those with diseases that cause secondary SHT
  3. Those receiving vasodilator therapy
  4. Those with diseases that are worsened by SHT (DMVD)
34
Q

When is routine BP screening recommended?

A

Dogs and cats >9 years

35
Q

A

A

Systolic BP >160 mmHg

36
Q

B

A

Evidence of TOD

37
Q

C

A

TREAT!

38
Q

D

A

No evidence of TOD

39
Q

E

A

BP 160-179 mmHg: repeat BP twice within 8 weeks

40
Q

F

A

<160 mmHg: recheck in 3-6 months

41
Q

G

A

>160 mmHg: TREAT

42
Q

H

A

BP > 180 mmHg: repeat BP twice within 2 weeks

43
Q

I

A

<160 mmHg: recheck in 3-6 months

44
Q

J

A

>180 mmHg: TREAT

45
Q

What are the 2 goals of SHT tx?

A

Control BP and treat underlying disease

46
Q

What do ACEi do to BP?

A

Decrease 10-15 mmHg

47
Q

What effect do ACEi have on the renal efferent arteriole?

A

Decrease glomerular hypertension and proteinuria

48
Q

What effect do ACEi have on RAAS?

A

inhibits

49
Q

What drug class is telmisartan?

A

AT receptor blocker

50
Q

What effect does telmisartan have on BP?

A

Decreases 20-25 mmHg

51
Q

What effect does telmisartan have on the renal efferent arteriole?

A

Decreased glomerular hypertension and proteinuria

52
Q

What effect does telmisartan have on RAAS?

A

inhibits

53
Q

What drug class is amlopidine?

A

Ca channel blocker

54
Q

What effect does amlopidine have on BP?

A

Decreases 30-60+ mmHg

55
Q

What effect does amlodipine have on the renal efferent arteriole?

A

No effect

56
Q

What effect does amlodipine have on RAAS?

A

activates

57
Q

When should BP be rechecked in non-emergent cases?

A

7-10d after starting an antihypertensive

58
Q

What should you do if you recheck a non-emergent BP and it is >140 mmHg?

A

Increase hypertensive dose or add 2nd agent

59
Q

What should you do if you recheck a non-emergent BP and it is hypotensive?

A

Decrease anti-hypertensive dose

60
Q

What should you do if you recheck a non-emergent BP and it is normotensive?

A

recheck again q 3-4 months

61
Q

What should be done in cases of emergent BP issues (i.e. retinal detachment)?

A

Hospitalization, amlodipine or hydralazine, recheck BP q 2 hours

Small Animal Medicine (100 decks)

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