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Paige: CARDIO > Exam 2 - HTN > Flashcards

Exam 2 - HTN Flashcards

1
Q

What BP is considered htn?

A

> 140/90

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2
Q

Why do we worry about HTN?

A

it can lead to stroke, HF, LVH

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3
Q

Which type of HTN has an unknown etiology, and is 2x greater in blacks?

A

essential (primary)

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4
Q

Which type of htn is from renal, endocrine, or congenital disease?

A

secondary

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5
Q

what factors can worsen htn?

A

fat

salty diet

cigs

nsaids

excess alcohol

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6
Q

what are the causes of htn?

A

genetics, enviro

inc SNS activity

inc RAA axis

high sodium

endocrine problem

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7
Q

does estrogen cause primary or secondary htn?

A

secondary

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8
Q

what can htn lead to in the heart?

A

chd, lvh, hf

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9
Q

what can htn lead to in the brain?

A

cerebrovascular disease

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10
Q

what else can htn lead to?

A

PAD

renal disease

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11
Q

which 3 things can cause kidney hypertension (a cause of 2ndary htn)?

A

renal artery stenosis

hyperplasia (FMH)

atherosclerosis

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12
Q

which comorbidity is associated with morbidity and mortality?

A

LVH

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13
Q

does LVH cause systolic or diastolic dysfunction?

A

diastolic

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14
Q

once you have LVH, can it regress?

A

YES with treatment

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15
Q

is cerebrovascular disease related to systolic or diastolic pressure?

A

systolic

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16
Q

what are the early symptoms of htn?

A

asx

morning headaches

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17
Q

what are late symptoms/findings of htn?

A

LVH causes SOB, DOE

Cerebral - TIA, stroke, hemorrhage

Heart - MI, angina, HF

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18
Q

What will you see in the retina on PE?

A

AV nicking

silver or copper wiring

hemorrhages or exudates

papilledema

19
Q

What two lab levels are you especially looking for in htn?

A

creatinine, BUN

for renal function

20
Q

What are treatment goals for someone over 60y?

A

bp < 150/90

Ideal goal is 140 systolic

21
Q

What are treatment goals for someone under 60y

A

bp < 140/90

22
Q

what are treatment goals for anyone over 18y with DM and CKD?

A

bp < 140/90

23
Q

What is ideal treatment for HTN in a non-black?

A

thiazide diuretic

CCB

ACE-I/ARB

24
Q

what is the ideal treatment for HTN in blacks?

A

thiazide diuretic

CCB

25
Q

What is ideal tx for someone 18+ with HTN and CKD?

A

ACE-I/ARB

26
Q

What is ideal tx for HTN after an MI?

A

add BB to whatever

27
Q

what is ideal treatment for HTN + HF?

A

ACEI

28
Q

ideal treatment for HTN + angina

A

CCB 1st line

BB 2nd line

29
Q

ideal treatment for HTN + DM?

A

ACEI/ARB

+/- thiazide diuretics or CCB

30
Q

How many meds is a hypertensive diabetic patient on on average?

A

3

31
Q

Ideal treatment for someone with HTN and trouble urinating?

A

alpha blockers

32
Q

What are the treatment guidelines for a person whose BP is >160 systolic or >100 diastolic?

A

start with 2 drugs

33
Q
A
34
Q

Non pharm treatment for HTN?

A

diet - low fat, low dairy, low ETOH, low Na

diet - high fruits, high veggies, high fiber

weight reduction

aerobic exercise

smoking cessation

35
Q

What’s the DOC in htn?

A

thiazide diuretics

(a part of ANY drug combo)

36
Q

what do thiazide diuretics decrease?

A

SVR

37
Q

who do thiazide diuretics work better in?

A

blacks, elderly

38
Q

which type of htn are thiazides best for?

A

isolated systolic htn

39
Q

Which drug is less effective in blacks and the elderly?

A

beta blockers

40
Q

which selective beta blocker is effective in HTN as well as HF and erectile dysfunction?

A

Nebivolol

41
Q

MOA of nebivolol?

A

vasodilates via nitric oxide

42
Q

are ACE-I useful as a primary med or as adjunct?

A

either but work best with diuretics

43
Q

are direct renin inhibitors like aliskeren better as monotherapy or adjunct?

A

either

44
Q

So CCBs are good for HTN but if a person has HF, you can’t give nondihydropyridines.

Why can’t you?

A

they’re inotropic and slow AV conduction

Paige: CARDIO (11 decks)

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