Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > EXAM #2: HYPERTENSION > Flashcards

EXAM #2: HYPERTENSION Flashcards

1
Q

What is the life-time risk for a normotensive person at age 55 for developing HTN?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How much does an increase in 20 mmHg (systolic) or 10 mmHg diastolic increase the risk for CVD?

A

Doubles it for EACH increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much does HTN increase the risk for CVD in women?

A

Triples the risk

In men, closer to doubles the risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the general trend between HTN and mortality?

A

Increased HTN= increased mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Does JNC VIII define HTN?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does JNC VIII do?

A

Recommends BP levels to begin drug therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the determinants from JNC VIII that play into the decision of when to start drug therapy for HTN?

A

1) Age
2) Coexisting disease i.e.
- DM
- Chronic renal disease
3) Race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IF the BP cuff is too loose, what will happen to your reading?

A

Overestimation of the BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IF the BP cuff is too-narrow, what will happen to the BP reading?

A

Overestimate–it takes more pressure than usual to reach pressures that will occlude the artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the five Korotkoff sounds?

A

1) Tapping sounds when the brachial artery opens
2) Soft murmurs
3) Louder murmurs
4) Muffling
5) Disappearance

Note that you measure 1st and 5th sounds in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is borderline HTN?

A

BP occasionally exceeds normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is primary HTN?

A

Elevated BP without a known cause

*Note that 90% of HTN is PRIMARY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is secondary HTN?

A

Elevated BP WITH a known cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a HTN emergency?

A
  • Life-threatening circumstance
  • Focal/ generalized sx. of target-organ damage

*Requires rapid reduction of BP and typically involves a dBP greater than 120 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are signs of target-organ damage?

A

1) Retinal damage

2) CNS sx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is malignant HTN?

A

HTN retinopathy grade III and IV WITH severe BP elevation

*Evidence of ongoing target organ damage (to the brain b/c the retina is part of the brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is HTN encephalopathy?

A

Signs/sx. of cerebral edema caused by severe rise in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Outline the grading system for Hypertensive Retinopathy.

A

1) Arteriolar narrowing (take on a shiny copper appearance)
2) AV nicking
3) Hemorrhages and exudates
4) Papilledema

19
Q

What stages of Hypertensive Retinopathy are indicative of target-organ damage?

A

Grades 3 and 4

20
Q

How can you identify papilledema on fundoscopy if you’re unsure?

A

BVs look like they’re coming out of the side of the optic disc b/c it is pushed upward

21
Q

What are the possible CNS consequences of HTN?

A

1) Decreasing cognitive function
2) TIA
3) CVA

22
Q

What is the leading cause of end-stage renal disease?

A

Systemic arterial hypertension (SAH)

23
Q

What are the early effects of SAH on the heart?

A
  • Increased LV mass

- Consequent loss of LV compliance/ diastolic function (filling)

24
Q

What are the chronic effects of SAH on the heart?

A

LVH with LV dilation

*Leads to death

25
Q

What are the effects of SAH on the vascular system?

A

SAH is a major risk factor for:

1) ASCVD
2) MI
3) HF
4) Sudden cardiac death

26
Q

What are the major goals in evaluating systemic HTN?

A

1) Assess CV risk factors
2) Look for identifiable reasons for SAH e.g.
- Renal parenchymal disease
3) Determine target-organ damage

27
Q

List some of the common conditions that cause secondary HTN.

A
  • Chronic renal parenchymal disease
  • Primary aldosteronism
  • Renovascular disease
  • Cushing’s Syndrome
  • Pheochromocytoma
  • Coarctation of the aorta
  • Thyroid or PTH disease
  • Sleep apnea
  • Drug-induced or related causes
28
Q

What is the most common presentation of SAH?

A

Asymptomatic

29
Q

What is the most common form of target organ damage in SAH?

A

IHD

30
Q

What are the five diseases that require additional attention in SAH?

A

1) IHD
2) HF
3) DM
4) CKD
5) Cerebrovascular disease

31
Q

What part of the physical exam should never be omitted on a patient with HTN?

A

Fundoscopic exam

*B/c this is the only location in the body that you can look directly at the BVs

32
Q

What are the min. labs that should be ordered for patient with a new diagnosis of SAH?

A

1) Urine dipstick
2) Fasting glucose
3) Hematocrit
4) Serum creatinine
5) Serum Ca++ and K+
6) Lipid panel

*AND an ECG

33
Q

What is unprovoked hypokalemia a sign of?

A

Secondary HTN

34
Q

What is the utility of Echocardiogram in the diagnosis of SAH?

A

Determination of LV function

*Note that severe/ refractory HTN with NO LVH= v. recent onset or white coat syndrome

35
Q

What is the JNC VIII recommendation for a systolic BP in drug therapy?

A

sBP less than 140 mmHg

36
Q

What did the recent SPRINT trial show about drug therapy for HTN?

A

Intensive therapy i.e. a sBP less than 120 mmHg had fewer primary outcomes

37
Q

Reducing blood pressure reduces what complication the most?

A

CVA

38
Q

What are the non-drug therapies recommended for SAH?

A

1) DASH diet
2) Na+ restriction
3) Regular exercise
4) Maintain healthy weight
5) NO smoking

39
Q

Why should antacids be avoided in patients with SAH?

A

Some antacids contain high Na+

40
Q

According to the JNC VIII, what is the drug of choice for treating HTN?

A

Thiazide diuretics

41
Q

What is the JNC VIII recommendation on when to start drug therapy?

A 
sBP= 150 mmHg 
dBP= 90 mmHg
42
Q

What is the recommended initial anti-HTN therapy in the black population?

A

Thiazide diuretic or Ca++ blocker

43
Q

What is the first-line therapy for HTN in patients with CKD?

A

ACEI or ARB

44
Q

What is the most common adverse effect of ACEIs?

A

Chronic dry cough

Cardiovascular (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions