CCC - Hypertension Flashcards

1
Q

What is seen in stage 1 hypertension, retinopathy?

A

Silver wiring

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2
Q

What is seen in stage 2 hypertension, retinopathy?

A

AV nipping

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3
Q

What is seen in stage 3 hypertension, retinopathy?

A

Flame haemorrhage

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4
Q

What is seen in stage 4 hypertension, retinopathy?

A

Optic disc is flatten in papilloedema

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5
Q

Signs of hypertension other than retinopathy?

A

Left ventricular hypertrophy - may feel a heave or hear S4

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6
Q

Causes of hypertension?

A
Secondary -
Phaeochromocytoma 
Cushing's
Conn's
Acromegaly
Renal artery stenosis
Co-arctation of the aorta

Primary - essential HTN

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7
Q

Investigations for hypertension?

A
FBC - polycythaemia
U&Es - pot might be low in secondary causes e.g. phaeos
ECG - hypertrophy
Urinalysis - nephritis or renal disease
Fasting glucose - diabetes
Lipids
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8
Q

Special tests for secondary causes of HTN?

A
Renin
Aldosterone
24hr urine for catecholamines
24hr urine for cortisol and LDDST if cushingoid
Glucose test is acromegalic
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9
Q

How does conn’s cause HTN?

A

Adrenal tumour causes raised aldosterone
Raised BP

This high aldosterone suppresses renin so renin levels will be low on testing.

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10
Q

How does renal stenosis cause HTN?

A

Increases renal HTN
Renin high
Angiotensin high
Stimulates adrenal gland a lot which raises aldosterone again

(co-arctation of the aorta does the same thing)

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11
Q

How does a phaeochromocytoma cause HTN?

A

Adrenal medulla tumour
Increase catecholamines that increase stress
Adrenaline is suddenly pushed out all at once and binds to beta 1 receptors causing episodes of HTN

Renin, aldo, angio will all be normal though

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12
Q

How do phaeochromocytomas present?

A
Periods of 
Nervousness
Sweat over face
Palpitations
Episodic, severe HTN
Can even cause ischaemic bowel episodes.

Episodes can last a year or so as the tumour grows

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13
Q

Therapeutic steps in phaeo’s

A
  1. Alpha blockade (stay on this for future steps)
  2. Beta blockade
  3. Localise lesion
  4. Surgery
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14
Q

What are the grade of hypertension?

A

/

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15
Q

IMAGE

What is the pathway to treating hypertension?

A

/

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