CVD - Hypertension

Question 1

Stage 1 Hypertension? Clinical and home values?

Answer 1

Clinical: 140/90 or higher

Home: 135/85 or higher

Question 2

Stage 2 Hypertension? Clinical and home values?

Answer 2

Clinical: 160/100 or higher

Home: 150/95 or higher

Question 3

Stage 3 Hypertension? Clinical and home values?

Answer 3

Greater than 180/120 mmHg

MEDICAL EMERGENCY

Question 4

What BP value and stage is considered medical emergency?

Answer 4

Stage 3 & over 180/120mmHg

Question 5

How long should antihypertensives be taken before seeing effectiveness?

Answer 5

4 weeks

Question 6

Hypertension treatment for under 55 year olds?

Answer 6

1) ACE or ARB

2) ACE or ARB + CCB/Thiazide

3) ACE/ARB + CCB + Thiazide

4) if potassium lower 4.5: + low dose Spironlactone

If potassium higher 4.5: + Alpha/Beta blocker

Question 7

Hypertension treatment over 55 years or any age AFRICAN/CARRIBEAN?

Answer 7

1) CCB

2) CCB + ACE/ARB or Thiazides

3) CCB + ARB/ACE + Thiazides

4) If less than 4.5mmol/L -> Low dose Spironlactone

If over than 4.5mmol/L -> Alpha/Beta blocker

Question 8

BP target 80+ pt? Clinical and Home values?

Answer 8

Clinical: 150/90 mmhg

Home: 145/85 mmhg or lower

Question 9

Isolated systolic hypertension is common in?

Answer 9

60 Years +

Question 10

ACE side effects?

Answer 10

C - Cough
H - Hyperkalaemia
H - Hepatic Failure
A - Angioedema
R - Renal Impairment
D - Dizziness/ Headache

ARB is the same but no cough/Angioedema

Question 11

Diabetic BP target?

Answer 11

Below 140/80 mmHg

Question 12

Diabetic BP range if Kidney, eye or cerebrovascular disease present

Answer 12

130/80

Question 13

Diabetic Nephropathy Treatment?

Answer 13

ACE or ARB

Question 14

Antihypertensive in Pregnancy? 1st line? 2nd line? 3rd line?

Answer 14

1st line: Labetalol

2nd line: Nifidipine

3rd line: Methyldopa

Question 15

Methyldopa max dose?

Answer 15

3g adult max dose

Question 16

Monitoring of pregnancy antihypertensive?

Answer 16

Monitor FBC & LFT for 6-12 weeks
&
If there’s unexplained fever

Question 17

If Methyldopa is taken during pregnancy, why restart usual hypertensive med after birth? And when exactly?

Answer 17

Methyldopa can cause Depression

So within 2 days after birth start!!

Question 18

ACE interactions increased risk of?

Answer 18

Increase risk of Renal Failure

Increased Hyperkalaemia

Increased risk of Volume Depletion

Increased levels of Lithium

Question 19

Cardioselective Beta blockers?

Answer 19

Bisoprolol
ATenolol
Metoprolol
Acebutanol
Nebivolol

BATMAN

Question 20

Water soluble beta blockers?

Answer 20

Celiprolol
Atenolol
Nadolol
Sotalol

water CANS

Question 21

What Betablockers given if pt is experiencing nightmares? And why?

Answer 21

Celiprolol
Atenolol
Nadolol
Sotalol

Reason is it less likely to cross BBB

Question 22

Where are water soluble Betablockers excreted?

Answer 22

Kidneys

Question 23

Intrinsic sympathetic beta blockers or COLD EXTREMETIES ONES?

Answer 23

Ice

Pindolol
Acebutolol
Celiprolol
Oxyprenolol

ICE PACO

Question 24

Betablocker side effects?

Answer 24

• Bradycardia or HF
• Masks signs of Hypoglycaemia
• Can cause hyperglycaemia
• Bronchospasms

Question 25

CCB Side effects?

Answer 25

- Dizziness - Ginger Hyperplasia - Vasodilatory effects (Typical ccbs) - Av Blocks (Rlccb)

Question 26

Why are Rate limiting CCB not given in QT prolongation?

Answer 26

Cause AV blocks

Question 27

Pre-eclampsia - What should be used?

Answer 27

Aspirin from Week 12 Till birth

Question 28

WHAT Bp is classed as pre eclampsia?

Answer 28

Greater than 140/90

Question 29

Bp target for pre eclampsia?

Answer 29

135/85mmHg

Question 30

What is pre eclampsia?

Answer 30

Either - New onset of BP over 140/90 & Co-existing condition: CKS, diabetes, autoimmune, chronic BP Or Two or more moderate factors: First pregnancy, age 40+, pregnancy interval more than 10 years, BMI 35+, Family history, multiple pregnancies

Question 31

If a woman wishes to breastfeed postnatal period, which antihypertensive to take?

Answer 31

Enalapril

Question 32

If a BLACK woman wishes to breastfeed postnatal period, which antihypertensive to take?

Answer 32

Nifedipine Or Amlodopine (if they’ve had before)

Question 33

Advice breastfeeding while taking antihypertensive?

Answer 33

Monitor baby on: -Hypertension -Lethargy -Drowsy -Cold Peripheries -Poor feeding

Question 34

What is given to females with pre eclampsia where birth considered in 7 days?

Answer 34

IM Betamethasone for foetal maturation

Question 35

2 Side effects of Hydralazine HCL (alone)?

Answer 35

- Tachycardia - Fluid Retention

Question 36

Disadvantages of Clonidine HCL?

Answer 36

Sudden withdrawal can cause severe rebound hypertension

Question 37

ACE & NSAIDS together is there a problem?

Answer 37

Yes -> Renal Damage

Question 38

Which ACE to take BD?

Answer 38

Captopril

Question 39

Which ACE 30-60mins before food

Answer 39

Perindopril

Question 40

Betablocker side effects in Angina?

Answer 40

Sudden withdrawal -> Exacerbate angina Therefore gradual dose reduction required.

Question 41

Side effect of Sotalol?

Answer 41

QT Prolongation

Question 42

Betablocker stable in HF over 70 years?

Answer 42

Nebivolol

Question 43

Which 2 Betablockers reduce mortality in stable HF?

Answer 43

Bisoprolol & Carvedilol

Question 44

Which Betablocker can reverse symptoms clinical thyrotoxicosis in 4 days?

Answer 44

Propranalol

Question 45

Betablocker monitoring?

Answer 45

Lung function test

Question 46

Which CCB for anal fissure (chronic)?

Answer 46

Diltiazem HCL

Question 47

Overdose Diltiazem side effect?

Answer 47

Cardiac depressant -> Hypotension, Arrhythmias

Question 48

Diltiazem over 60mg prescribing info?

Answer 48

Brand Name needs to be prescribed over 60mg

Question 49

Which CCB can inhibit labour?

Answer 49

Lacidipine

Question 50

Nifedipine prescribed by?

Answer 50

Brand name

Question 51

Vasospastic Peripheral Vascular disease RAYNAUDS TREATMENT?

Answer 51

AVOID COLD & SMOKING & NIFEDIPINE !!!!