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My Clin Med 4 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Primary (essential) HTN

A

elevated systolic/diastolic BP as defined w/out a defined etiology

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2
Q

secondary HTN

A

elevated BP with an identified cause

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3
Q

resistant HTN

A

BP uncontrolled despite adherence to an appropriate 3 drug regimen, where all drugs are >50% recommended dose

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4
Q

Refractory HTN

A

patient w/ resistant HTN, who cannot be controlled on >4 meds

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5
Q

Masked HTN

A

bp consistently elevated out of offive , but does not met criteria for HTN in office

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6
Q

MAP

A

Normal range 70-110 (<60 concern for insufficient perfusion through organs)

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7
Q

HTN Urgency

A

severe HTN (>120 DBP) in asymptomatic pt

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8
Q

HTN Emergency

A

Severe HTN (>120DBP) with acute end-organ damage

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9
Q

HTN complications Brain

A

Brain:

Stroke, hemorrhage, cerebral atrophy and dementia

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10
Q

HTN risk factors

A 
Age 
obesity
family history
race
high NA+ diet
alcohol abuse
physical inactivity
diabetes
dyslipidemia
Hostility/rage
depression
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11
Q

Secondary HTN (common cause)

A 
#1 Chronic Kidney Disease
Renovascular disease/ renal artery stenosis
Mineralocorticoid excess
Sleep apnea / breathing disorders
Medications
     Steroids
     birth control (High Estrogen)
     NSAIDS
     SSRI
    Sudafed
    Cocaine/amphetamines
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12
Q

Secondary HTN (Uncommon causes)

A

Pheochromocytoma
endocrine disorders
Coarctation of aorta

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13
Q

Renovascular HTN (cause)

A

Older pt: atherosclerosis

Younger: Fibromuscular dysplasia

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14
Q

HTN complications Eyes

A

Retinopathy, vitrious hemorrhage, imparred vision and blindness

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15
Q

HTN complications Kidneys

A

CKD,

End stage renal disease

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16
Q

HTN complications Cardiac

A 
Coronary heart disease,
ischemic heart disease
Lft ventricular hypertrophy
heart failure
Acute Aortic Dissection
Arterial aneurism
Hypertensive emergency
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17
Q

HTN Diagnosis

A

BP readings > 2 office visits, must be weeks or months apart
Home BP readings >130/80 mmHh
daytime <135/85 mmHg
Nighttime <120/70 mmHg

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18
Q

Normal BP

A

<120/80

19
Q

Prehypertension (BP)

A

<139/89

20
Q

Stage 1 HTN (BP)

A

<159/99

21
Q

Stage 2 HTN (BP)

A

> 160/100

22
Q

Isolated systolic HTN

A

Systolic >140

23
Q

Isolated Diastolic HTN

A

Diastolic >90

24
Q

Key factors in PMH to indicate HTN

A 
H/o HTN
Stroke
TIA
CAD
Heart failure
CKD
Peripheral Artery Disease
Diabetes/ dyslypidemia
25
Q

Key factors in Family History to indicate HTN

A

HTN
Diabetes
Dyslipidemia

26
Q

Key factors in Medication History to indicate HTN

A 
Nsaids
stimulants
antidepressants
high dose OCP
cold remedies
glucocorticoids
Folk remedies/ OTC herbals
27
Q

Key factors in Social History to indicate HTN

A 
Smoking
alcohol
illicit drugs
work/life stress
exercise
diet
sleep habits
28
Q

HTN initial symptoms - may indicate HTN emergency

A 
headaches, 
dizziness,
weakness, 
vision changes, 
SOB
Chest Pain
Claudication
Palpitations
fatigue
Weight gain
29
Q

Evaluation HTN - Physical Exam

A 
BP, Pulse
BMI
Waist circumference
eyes
neck - bruits
Cardiac exam
Lung exam
abdominal exam
extremities
neuro exam
30
Q

Secondary HTN S&S

A 
Age >30
Stage 2 HTN - unresponsive to Tx
Episodic
Morbid obesity- Snoring 
pallor, edema
31
Q

HTN Diagnostic labs

A 
BMP +LFT or CMPFasting Lipids
H-crit
Urinanalysis
ECG - see previous MI, arrhythmia
Urine Albumin to creatinine ratio
32
Q

Pre-HTN and HTN non-pharmalogical treatment

A 
Weight loss
Decrease Dietary NA+
increase Physical Activity
Moderation of alcohol
(smoking cessation for decreased CVD)
33
Q

HTN treatment Pharmacological

A

Diuretics, CCB, ACE, ARB

BB (No longer used)

34
Q

Therapy recommendation for PreHTN

A

Non-pharmacological only

35
Q

Therapy recommendation for CKD or diabetes at any age

A

Pharmacologic treatment at BP 140/90

36
Q

Therapy recommendation for <60 but not with CKD or diabetes

A

Pharmacologic treatment at BP 140/90

37
Q

Therapy recommendation for >60 and not with CKD or diabetes

A

Initiate Pharmacologic treatment at BP 150/90

38
Q

CKD+HTN treatment

A

ACE or ARB

39
Q

> 18 yo Black with HTN therapy

A

Thiazide or CCB

40
Q

> 18 non black non CKD with HTN therapy

A

Thiazaide, CCB, ACE, or ARB

41
Q

HTN Follow up

A

With initiation - monitior every 2-4 weeks until BP is achieved
Once stable - every 6 months, monitor K+ and Creatinine

42
Q

Resistant Hypertension Treatment

A

refer to HTN specialist

add on a 4th agent

43
Q

HTN Urgency Management

A 
Lower BP over hours to days
Goal of <160/100 or no more than 25-30% of baseline BP
Furosemide - if not volume depleted
Oral clonidine
oral captopril- if not volume overloaded
44
Q

HTN Emergency Management

A 
Immediate but careful reduction of BP
Excessive hypotension may lead to ischemic complications
IV Agents:
Nitroprusside,
nitroglycerin,
Nicardipine
labetolol
esmolol
hydralazine

My Clin Med 4 (4 decks)

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