Fam Med Tut - HPT & CKD

Question 1

Definition of HPT:

Answer 1

1. BP > 140/90
2. On 3 separate occasions
3. With 2 occasions being > 24 hrs apart

Question 2

Def HPT Emergency:

Answer 2

BP > 180/110 with life threatening complications:

1. MI/ACS
2. CVA
3. Eclampsia/ seizures
4. Acute pul oedema
5. ARF
6. AAA/ dissection

Question 3

IV anti-HPT meds + indications:

Answer 3

Tridil - ACS/ pul oedema

Labetalol - good all indications but especially good for CVA

Question 4

Diff Dx to anasarca:

Answer 4

1. Cardiac
2. Renal
3. Liver

Question 5

Case: Fluid overloaded pt comes in with shock (hypotension). How to Rx with fluids?

Answer 5

1. Do leg raise test - bolus of 500 mls
2. Fluid responsive = 10% decrease HR; 10% increase MAP = can give fluids = 10 mls/kg bolus
3. No response to leg raise test = fluid unresponsive = start inotropes

Question 6

1st sign you’ve given too much fluids and fluid overloaded pt?

Answer 6

Bibasal creps

Question 7

How much to bolus fluid overloaded pt who is fluid responsive?

Answer 7

10 mls/kg IVI bolus

Question 8

Why do some patients keep coming in with fluid overload?

Answer 8

1. Increased water intake at home

2. Increased salt intake at home

Question 9

Advice to fluid overloaded patients to Mx fluid intake at home?

Answer 9

1. Limit fluids to 1L/ day (300 mls x 3)

2. Can use ice cubes to help with thirst