cardiovascular disease and drugs Flashcards
1
Q
hypertension
- _____ cause of cardiovascular disease
- blood pressure: _____ = normal
- _____ or _____ hypertension - unknown >95%
- _____ hypertension - result of other diseases
- _____
- renovascular disease (_____)
- _____
- contraction of the _____
A
#1 120/80 primary essential secondary pheochromocytoma renal artery stenosis aldosteronism aorta
2
Q
2017 new guidelines for hypertension
-high blood pressure should be treated earlier with _____ changes and in some patients with _____ - at _____ mm Hg rather than _____ mm Hg - based on new ACC and American Heart Association (AHA) guidelines
blood pressure categories in the new guidelines are:
- normal: less than _____ mm Hg
- elevated: systolic between _____ and diastolic less than _____
- stage 1: systolic between _____ or diastolic between _____
- stage 2: systolic at least _____ or diastolic at least _____
- hypertensive crisis: systolic over _____ and/or diastolic over _____
A
lifestyle medication 130/80 140/90 120/80 120-129 80 130-139 80-89 140 90 180 120
3
Q
2017 new guidelines for hypertension
- only prescribing medication for stage 1 hypertension if a patient has had a _____ event (_____ or _____)
- patient at high risk of _____ or _____ based on _____
- presence of _____, _____ or _____ risk (high cholesterol)
- patients may need _____ or more types of medications
- _____: multiple medications combined into single pill
- identifying _____ status and psychosocial _____ as risk factors for high blood pressure
A
cardiovascular MI CVA MI stroke age diabetes mellitus chronic kidney disease atherosclerotic two compliance socioeconomic stress
4
Q
isolated systolic hypertension
- not distinguished as a separate entity for BP management
- _____ should be primarily considered during treatment and not just _____ BP
- _____ is a cardiovascular risk factor after age 50
- _____ is more important before age 50
A
SBP
diastolic
systolic BP
diastolic BP
5
Q
secondary HTN- clues on Exam
- _____, _____, other signs of _____ disease
- _____ especially with a diastolic component (_____)
- _____, purple _____, buffalo hump (_____)
laboratory tests: -increased \_\_\_\_\_, abnormal \_\_\_\_\_ (renovascular and renal parenchymal disease) -unexplained \_\_\_\_\_ (hyperaldosteronism) -impaired blood glucose (\_\_\_\_\_) impaired \_\_\_\_\_ (hypo-/hyperthyroidism)
A
pallor edema renal abdominal bruit renovascular truncal obesity striae hypercortisolism creatinine urinalysis hypokalemia hypercortisolism TFT
6
Q
target organ damage
- heart
- _____
- MI
- prior coronary revascularization _____
- heart failure
- brain: _____ or _____ attacks
- chronic _____ disease
- peripheral _____ disease
- _____
A
left ventricular CABG stroke transient ischemic kidney arterial retinopathy
7
Q
hypertensive crisis
- acute elevation of BP associated with end _____ damage
- potentially _____!
- hypertensive crisis/ hypertensive emergency/ malignant hypertension
- BP = _____ mm Hg x _____ consecutive readings
- damage to _____ tissue, _____ end arteries, and _____ arteries as well as ischemia to the _____
- hypertensive _____
- acute _____
- acute _____
- acute _____ (_____)
A
organ fatal 180/120 2 nervous renal retinal mural cardiac musculature encephalopathy aortic dissection MI CVA cerebrovascular accident
8
Q
common causes:
- antihypertensive drug withdrawal (_____)
- autonomic hyperactivity (_____)
- collagen vascular disease (such as _____)
- renal disease (name one _____)
- trauma to the _____
- neoplasia (example _____)
- pre-eclampsia (leading to _____)
- recreational drugs (such as _____)
A
clonidine Adrenergic SLE systemic lupus renal stenosis, acute tubular necrosis head pheochromocytoma convulsions during pregnancy heroin, LSD, cocaine, cannabis
9
Q
evaluation of a patient
- _____ history of the patient
- _____ history past and present
- _____ history of patient
- _____ of all peripheral pulses/ _____
- _____/ _____/ BUN/ creat/ _____
- chest Xray/ _____/ _____ head
drugs commonly used:
- _____/ nifedipine
- _____/ _____
- _____/ _____
A
BP cardiovascular medication palpation fundoscopy CBC electrolytes urinalysis EKG CT sodium nitroprusside labetalol esmolol diazoxide minoxidil
10
Q
major cardiovascular risk factors
- _____
- _____
- _____ (BMI >30 kg/m2)
- physical _____
- _____
- _____
- _____ or estimated GFR <60 mL/min
- age (older than _____ for men, _____ for women)
- family history of premature cardiovascular disease
A
hypertension cigarette smoking obesity inactivity dyslipidemia diabetes mellitus microalbuminuria 55 65
11
Q
identifiable causes of hypertension
- sleep apnea
- _____-induced or related causes
- chronic _____ disease
- primary _____
- _____ disease
- chronic _____ therapy and _____ syndrome
- _____
- contraction of the _____
- _____ or _____ disease
A
drug kidney aldosteronism renovascular steroid cushings pheochromocytoma aorta thyroid parathyroid
12
Q
blood pressure = _____ x _____
A
cardiac output
peripheral vascular resistance
13
Q
antihypertensive drugs
- _____
- _____ (_____) inhibitors
- _____ receptor blockers
- _____ blockers
- _____ (_____) blockers
- _____ (_____) blockers
- centrally acting _____
- _____
A
diuretics angiotensin converting enzyme ACE angiotensin beta B alpha a antihypertensives vasodilators
14
Q
control of blood pressure
- _____ reflexes modulate the sympathetic stimulation of _____ and _____ and adjust BP in response to _____ changes and altered physical activity
- -provide short term regulation of BP via the _____ nervous system
- kidney: regulation of _____, and the _____ axis
- -provide _____-term control of BP
- both mechanisms ensure BP remains in a narrow range
A
baroreceptor CO PR postural sympathetic plasma volume renin-angiotensin-aldosterone long
15
Q
diuretics
- diuretics act at various sites in the _____ to increase _____ production
- inhibit _____ from the _____ into circulation
- -causing an increase in _____ of _____ in _____
A
nephron urine sodium nephron excretion sodium urine
