Hipertensão no PS Flashcards
1
Q
What are common symptoms of a hypertensive emergency?
A
Severe headache, shortness of breath, chest pain, and visual disturbances.
2
Q
Multiple choice: Which of the following is a potential complication of a hypertensive emergency? A) Stroke B) Common cold C) Diabetes D) Allergies
A
A) Stroke
3
Q
What is the primary goal in treating a hypertensive emergency?
A
To lower blood pressure quickly but safely to prevent organ damage.
4
Q
True or False: Oral medications are the first line of treatment in a hypertensive emergency.
A
False
5
Q
What type of medications are typically used for immediate treatment of hypertensive emergencies?
A
Intravenous antihypertensives.
6
Q
Fill in the blank: In a hypertensive emergency, the blood pressure must be reduced by no more than ______ in the first hour.
A
25%
7
Q
Multiple choice: Which of the following is NOT a sign of hypertensive emergency? A) Nausea B) Blurred vision C) Fatigue D) Rash
A
D) Rash
8
Q
What is the difference between hypertensive urgency and hypertensive emergency?
A
Hypertensive urgency does not involve acute organ damage, while hypertensive emergency does.
9
Q
True or False: Patients with a history of hypertension are at risk for hypertensive emergencies.
A
True
10
Q
What organ systems can be affected by hypertensive emergencies?
A
Cardiovascular, neurological, renal, and ocular systems.
11
Q
Fill in the blank: A hypertensive emergency may lead to ______ if not treated promptly.
A
Organ failure
12
Q
Multiple choice: Which of the following conditions can trigger a hypertensive emergency? A) Acute kidney injury B) Asthma C) Diabetes D) Allergies
A
A) Acute kidney injury
13
Q
What diagnostic tests are commonly performed in suspected hypertensive emergencies?
A
Blood tests, urinalysis, chest X-ray, and ECG.
14
Q
True or False: Lifestyle changes can help prevent hypertensive emergencies.
A
True
15
Q
What lifestyle modifications are recommended to prevent hypertensive emergencies?
A
Dietary changes, regular exercise, and stress management.
16
Q
Fill in the blank: The presence of ______ is a common indicator of hypertensive emergency.
A
End-organ damage
17
Q
Multiple choice: Which of the following medications is often used in hypertensive emergencies? A) Aspirin B) Nitroprusside C) Metformin D) Ibuprofen
A
B) Nitroprusside
18
Q
What is the role of monitoring in the treatment of hypertensive emergencies?
A
To ensure blood pressure is reduced safely and to monitor for complications.
19
Q
True or False: Hypertensive emergencies can occur in pregnant women.
A
True
20
Q
What is the recommended follow-up care after a hypertensive emergency?
A
Regular blood pressure monitoring and adjustment of antihypertensive medications.
21
Q
Fill in the blank: A sudden spike in blood pressure can lead to ______ and should be treated immediately.
A
Hypertensive emergency
22
Q
Multiple choice: Which demographic is at higher risk for hypertensive emergencies? A) Young adults B) Elderly C) Children D) Pregnant women
A
B) Elderly
23
Q
What is the primary goal in treating hypertensive emergencies?
A
To rapidly reduce blood pressure to prevent target organ damage.
24
Q
True or False: Nitroprusside is an effective medication for hypertensive emergencies.
A
True
25
Fill in the blank: The typical initial dose of Nitroprusside is _____ mcg/kg/min.
0.5
26
What is the maximum dose of Labetalol for hypertensive emergencies?
300 mg
27
Which medication is commonly used for hypertensive emergencies in pregnant patients?
Methyldopa
28
True or False: Nicardipine can be administered as a continuous infusion for hypertensive emergencies.
True
29
What is the starting dose of Nicardipine for hypertensive emergencies?
5 mg/hour
30
Which class of drug does Esmolol belong to?
Beta-blockers
31
Multiple Choice: Which of the following is NOT a common medication for hypertensive emergencies? A) Nitroprusside B) Furosemide C) Labetalol D) Nicardipine
B) Furosemide
32
What is the mechanism of action of Nitroprusside?
It causes direct vasodilation by releasing nitric oxide.
33
True or False: Aortic dissection is a contraindication for the use of beta-blockers.
True
34
Fill in the blank: The target blood pressure reduction in hypertensive emergencies is usually _____ mmHg per hour.
25-30
35
What is the main risk associated with prolonged use of Nitroprusside?
Cyanide toxicity
36
Short Answer: Name one contraindication for using Labetalol.
Asthma
37
What is the preferred route of administration for Sodium Nitroprusside?
Intravenous
38
Multiple Choice: Which medication is preferred for patients with renal impairment? A) Nitroprusside B) Labetalol C) Fenoldopam D) Nicardipine
C) Fenoldopam
39
True or False: Rapid blood pressure reduction is always necessary in hypertensive emergencies.
False
40
What is the typical infusion rate for Esmolol in hypertensive emergencies?
0.1 to 0.5 mg/kg/min
41
Fill in the blank: The medication _____ is a selective alpha-2 agonist used in hypertensive emergencies.
Clonidine
42
Short Answer: What is the effect of Fenoldopam in hypertensive emergencies?
It dilates renal blood vessels and lowers blood pressure.
43
What is the initial dose of Clonidine for hypertensive emergencies?
0.1 mg orally or 0.2 mg transdermally
44
True or False: Dosing adjustments are not required for elderly patients in hypertensive emergencies.
False
45
What is the primary side effect of Nicardipine?
Hypotension
46
Fill in the blank: The systemic vascular resistance is decreased by _____ medications.
Vasodilator
47
Short Answer: Why is careful monitoring required during the administration of antihypertensive medications in emergencies?
To prevent rapid drops in blood pressure and potential complications.
48
What is the primary cause of hypertensive pulmonary edema?
Severe hypertension leading to increased pulmonary capillary pressure.
49
True or False: Hypertensive pulmonary edema can occur in patients without heart disease.
True.
50
Fill in the blank: The clinical presentation of acute pulmonary edema typically includes _______ breathing.
labored.
51
What are common symptoms of acute pulmonary edema?
Shortness of breath, cough, and wheezing.
52
Which diagnostic tool is essential for confirming acute pulmonary edema?
Chest X-ray.
53
What is the role of diuretics in the treatment of hypertensive pulmonary edema?
To reduce fluid overload and decrease pulmonary congestion.
54
Multiple Choice: Which medication is commonly used to lower blood pressure in hypertensive pulmonary edema? A) Furosemide B) Nitroglycerin C) Both A and B
C) Both A and B.
55
What is a potential complication of untreated hypertensive pulmonary edema?
Respiratory failure.
56
True or False: Oxygen therapy is not beneficial in the management of acute pulmonary edema.
False.
57
What is the first-line treatment for acute pulmonary edema?
Oxygen supplementation and diuretics.
58
Fill in the blank: Patients with hypertensive pulmonary edema may present with _______ on auscultation.
crackles.
59
What is the significance of using morphine in the treatment of pulmonary edema?
It can help relieve anxiety and decrease respiratory drive.
60
Which underlying condition is commonly associated with hypertensive pulmonary edema?
Chronic kidney disease.
61
What is the target blood pressure range for patients experiencing hypertensive pulmonary edema?
Generally, less than 130/80 mmHg.
62
Multiple Choice: Which of the following is NOT a treatment for acute pulmonary edema? A) Beta-blockers B) Diuretics C) Vasodilators
A) Beta-blockers.
63
What should be monitored closely in patients treated for hypertensive pulmonary edema?
Vital signs and fluid balance.
64
True or False: Hypertensive pulmonary edema requires immediate medical intervention.
True.
65
What is the impact of left ventricular failure on pulmonary edema?
It can exacerbate fluid accumulation in the lungs.
66
Fill in the blank: The use of _______ can help improve cardiac output in pulmonary edema patients.
inotropes.
67
What lifestyle modifications can help prevent hypertensive pulmonary edema?
Dietary changes, regular exercise, and adherence to antihypertensive medications.
68
What is the purpose of nitrates in the management of acute pulmonary edema?
To reduce preload and improve pulmonary circulation.
69
True or False: Acute pulmonary edema can be a life-threatening condition.
True.
70
What is the typical patient position to relieve symptoms of pulmonary edema?
Sitting up or in an upright position.
71
Which lab test is useful for assessing heart failure in cases of pulmonary edema?
B-type natriuretic peptide (BNP) level.
72
What is the expected outcome with appropriate treatment of hypertensive pulmonary edema?
Resolution of symptoms and stabilization of respiratory function.
73
Fill in the blank: Continuous _______ monitoring is crucial during the treatment of acute pulmonary edema.
cardiac.
74
Fill in the blank: The preferred initial treatment for hypertensive emergencies is ___________.
Intravenous antihypertensive medications.
75
What class of medications is commonly used in hypertensive emergencies?
Vasodilators.
76
True or False: Dialysis patients are at higher risk for hypertensive emergencies.
True.
77
What role does dialysis play in managing hypertensive emergencies?
It helps remove excess fluid and toxins that can contribute to hypertension.
78
Short answer: Why is gradual blood pressure reduction important in chronic kidney disease?
To avoid acute kidney injury.
79
True or False: Oral antihypertensives are preferred for immediate management of hypertensive emergencies.
False.
80
What other condition should be considered when treating hypertensive emergencies in dialysis patients?
Underlying cardiovascular disease.
81
Short answer: What is the relationship between fluid overload and hypertension in chronic kidney disease?
Fluid overload can exacerbate hypertension.
82
Which lab tests are essential to monitor in patients with hypertensive emergencies?
Electrolytes, creatinine, and urine output.
83
Fill in the blank: In chronic kidney disease, ___________ must be carefully managed to prevent exacerbating hypertension.
Electrolyte imbalances.
84
True or False: A single antihypertensive agent is usually sufficient for treating hypertensive emergencies.
False.
85
What is the recommended approach to managing hypertension post-dialysis?
Regular monitoring and adjustment of antihypertensive medications.
86
What lifestyle modification can help manage hypertension in patients with chronic kidney disease?
Adopting a low-sodium diet.
87
What is the role of diuretics in managing hypertensive emergencies?
To reduce fluid overload and lower blood pressure.
88
Fill in the blank: ___________ is a key indicator of kidney function that should be monitored.
Creatinine.
89
True or False: Rapid blood pressure reduction is always the best approach in hypertensive emergencies.
False.
90
What are the potential complications of untreated hypertensive emergencies?
Stroke, myocardial infarction, and acute kidney injury.
91
Short answer: What is the importance of individualized treatment plans in hypertensive emergencies?
To address specific patient needs and risks.
92
Fill in the blank: The recommended initial dose of ___________ for hypertensive emergencies is typically 5-10 mcg/min.
Nitroglycerin
93
Which medication is contraindicated in patients with aortic dissection?
Sodium Nitroprusside
94
What is the typical dosing range for Labetalol in hypertensive emergencies?
20 mg IV, followed by 40 mg if needed, and then 80 mg every 10-15 minutes, up to 300 mg.
95
True or False: Clevidipine can be used for rapid blood pressure control.
True
96
What is the initial dose of Esmolol for hypertensive emergencies?
500 mcg/kg loading dose followed by 50 mcg/kg/min infusion.
97
Multiple Choice: Which of the following is a common side effect of Nitroprusside? A) Hypotension B) Hypertension C) Bradycardia D) Tachycardia
A) Hypotension
98
What is the maximum infusion rate for Clevidipine?
16 mg/hour
99
Fill in the blank: The use of ___________ is often preferred in patients with renal impairment.
Labetalol
100
What is the effect of rapid blood pressure reduction in hypertensive emergencies?
It can prevent or minimize organ damage.
101
True or False: Oral medications are the first choice in hypertensive emergencies.
False
102
What is the initial dose of Nicardipine for hypertensive emergencies?
5 mg/hour IV infusion.
103
Which class of medications does Fenoldopam belong to?
Dopamine receptor agonists.
104
Multiple Choice: Which medication is NOT typically used in hypertensive emergencies? A) Nitroglycerin B) Hydralazine C) Furosemide D) Aspirin
D) Aspirin
105
What is the target blood pressure reduction rate in hypertensive emergencies?
No more than 25% within the first hour.
106
Fill in the blank: ___________ is contraindicated in patients with acute heart failure.
Nitroglycerin
107
What is the role of diuretics in hypertensive emergencies?
They can help reduce fluid overload but are not first-line agents.
108
True or False: There is a single preferred agent for all hypertensive emergencies.
False
109
What is the primary consideration when choosing a medication for hypertensive emergencies?
The underlying cause of the hypertension.
110
What is the initial dose of Diltiazem for hypertensive emergencies?
0.25 mg/kg IV over 2 minutes.
111
Fill in the blank: Patients with ___________ should be closely monitored for hypotension when treated with Sodium Nitroprusside.
Cirrhosis
112
What is the duration of action for Labetalol?
3 to 6 hours.
113
Multiple Choice: Which medication is typically administered as a continuous infusion? A) Esmolol B) Metoprolol C) Amlodipine D) Hydrochlorothiazide
A) Esmolol
114
What is hypertensive encephalopathy?
A neurological disorder caused by severely elevated blood pressure leading to brain dysfunction.
115
True or False: Hypertensive encephalopathy is characterized by acute hypertension and cerebral edema.
True
116
What are common symptoms of hypertensive encephalopathy?
Headache, confusion, seizures, visual disturbances, and altered consciousness.
117
Fill in the blank: The primary treatment for hypertensive encephalopathy involves __________.
rapid reduction of blood pressure
118
Multiple Choice: Which of the following is NOT a typical symptom of hypertensive encephalopathy?
Shortness of breath
119
What imaging technique is often used to assess hypertensive encephalopathy?
CT or MRI of the brain
120
True or False: Hypertensive encephalopathy can lead to permanent neurological damage if not treated promptly.
True
121
What is the recommended initial target blood pressure reduction in a patient with hypertensive encephalopathy?
Reduce blood pressure by 20-25% within the first hour.
122
Name one common medication used to treat hypertensive encephalopathy.
Labetalol
123
What is the role of sodium nitroprusside in the treatment of hypertensive encephalopathy?
It is a potent vasodilator used for rapid blood pressure control.
124
Fill in the blank: Patients with hypertensive encephalopathy may exhibit __________ due to increased intracranial pressure.
papilledema
125
What is the significance of identifying the underlying cause of hypertension in patients with hypertensive encephalopathy?
To prevent recurrence and manage long-term blood pressure control.
126
True or False: Hypertensive encephalopathy can occur in patients with previously controlled hypertension.
True
127
What is a critical complication of untreated hypertensive encephalopathy?
Cerebral hemorrhage
128
What are the potential long-term effects of hypertensive encephalopathy?
Cognitive impairment and persistent neurological deficits.
129
Multiple Choice: Which of the following is a common diagnostic finding in hypertensive encephalopathy?
Cerebral edema
130
What lifestyle modifications can help prevent hypertensive encephalopathy?
Dietary changes, regular exercise, and medication adherence.
131
Fill in the blank: The __________ is crucial for monitoring patients during acute treatment of hypertensive encephalopathy.
blood pressure
132
Name one risk factor for developing hypertensive encephalopathy.
Chronic hypertension
133
True or False: Hypertensive encephalopathy only affects older adults.
False
134
What is the primary goal of treating hypertensive encephalopathy?
To stabilize blood pressure and prevent neurological damage.
135
What type of hypertension is most commonly associated with hypertensive encephalopathy?
Malignant hypertension
136
Fill in the blank: Early recognition and treatment of __________ is essential in hypertensive encephalopathy.
elevated blood pressure
137
What can be a potential consequence of overly aggressive blood pressure reduction in hypertensive encephalopathy?
Cerebral hypoperfusion
138
What is the function of diuretics in the management of hypertensive encephalopathy?
To reduce fluid overload and lower blood pressure.
139
What is acute aortic dissection?
Acute aortic dissection is a serious condition in which the inner layer of the aorta tears, allowing blood to flow between the layers of the aortic wall.
140
True or False: Acute aortic dissection is a common cardiovascular emergency.
True
141
What are the two main types of aortic dissection?
Type A and Type B.
142
Fill in the blank: The classic symptom of aortic dissection is ___________.
sudden, severe chest pain.
143
Which imaging modality is most commonly used to diagnose aortic dissection?
CT scan of the chest.
144
What is the primary treatment for Type A aortic dissection?
Surgical intervention.
145
What is a common cause of hypertensive emergencies?
Uncontrolled hypertension.
146
True or False: Hypertensive emergencies always present with symptoms.
False
147
What is the blood pressure threshold for a hypertensive emergency?
Systolic BP > 180 mmHg or diastolic BP > 120 mmHg.
148
What is the immediate management goal in a hypertensive emergency?
To lower blood pressure rapidly but safely.
149
Which class of medications is commonly used to treat hypertensive emergencies?
Intravenous antihypertensives.
150
What are potential complications of untreated aortic dissection?
Rupture, cardiac tamponade, and organ ischemia.
151
What is the role of beta-blockers in the management of aortic dissection?
To decrease heart rate and blood pressure, reducing stress on the aortic wall.
152
Fill in the blank: Aortic dissection can lead to ___________ if not treated promptly.
death.
153
What are the risk factors for aortic dissection?
Hypertension, connective tissue disorders, and a history of aortic surgery.
154
True or False: Patients with a history of Marfan syndrome are at increased risk for aortic dissection.
True
155
What is the significance of the Stanford classification in aortic dissection?
It helps determine the treatment approach based on the location of the dissection.
156
What is the most critical time frame for intervention in acute aortic dissection?
Within the first 24 hours.
157
What is the difference between Type A and Type B aortic dissections regarding treatment?
Type A usually requires surgical repair, while Type B may be managed medically.
158
What symptom can indicate a complication of aortic dissection?
Sudden onset of severe back pain.
159
Fill in the blank: A hypertensive emergency may lead to ___________ if not treated.
acute organ damage.
160
List one sign of aortic dissection.
Unequal blood pressures in the arms.
161
What is the first-line imaging test for suspected aortic dissection?
CT angiography.
162
What is the role of surgical intervention in Type B aortic dissection?
It is reserved for cases with complications such as rupture or malperfusion.
163
True or False: All patients with aortic dissection experience classic symptoms.
False
164
What is the primary goal of treatment in acute aortic dissection?
To stabilize the patient and prevent complications such as rupture.
165
True or False: Immediate surgical intervention is always required for all types of aortic dissection.
False.
166
Which medication class is commonly used to control blood pressure in acute aortic dissection?
Beta-blockers.
167
Fill in the blank: The initial dose of __________ is often 20 mg IV for beta-blockers in acute aortic dissection.
Esmolol
168
What is the recommended target systolic blood pressure in patients with acute aortic dissection?
100-120 mmHg.
169
Which imaging technique is preferred for diagnosing acute aortic dissection?
CT angiography.
170
True or False: Opioids are used for pain management in acute aortic dissection.
True.
171
What is the role of nitroprusside in the management of aortic dissection?
It is used as an adjunct to control blood pressure when beta-blockers alone are insufficient.
172
What is the initial bolus dose of nitroprusside in acute aortic dissection?
0.25-0.5 mcg/kg/min.
173
Which type of aortic dissection is classified as Type A?
Dissection involving the ascending aorta.
174
What is the first-line treatment for Type A aortic dissection?
Surgical intervention.
175
Fill in the blank: The Stanford classification system is used to categorize __________.
Aortic dissections.
176
What is the common symptom presentation of acute aortic dissection?
Sudden, severe chest or back pain.
177
True or False: Dissection of the descending aorta (Type B) typically requires surgical intervention.
False; it can often be managed medically.
178
What is an important consideration when managing blood pressure in aortic dissection?
Avoid rapid drops in blood pressure to prevent organ ischemia.
179
Which medication should be avoided in acute aortic dissection due to its potential to increase heart rate?
Hydralazine.
180
What is the role of imaging in the follow-up of aortic dissection patients?
To monitor for complications and assess the aorta.
181
Fill in the blank: __________ is a common complication of untreated aortic dissection.
Rupture.
182
What is the purpose of using calcium channel blockers in managing aortic dissection?
To assist in blood pressure control if beta-blockers are insufficient.
183
True or False: Long-term follow-up is unnecessary after an aortic dissection is treated.
False; long-term follow-up is essential.
184
What is the recommended monitoring for patients after surgical repair of aortic dissection?
Regular imaging and blood pressure monitoring.
185
Which patient demographic is at higher risk for aortic dissection?
Older adults with hypertension.
186
Fill in the blank: __________ can be a presenting symptom of aortic dissection in some patients.
Syncope.
187
What is the significance of a 'tearing' sensation in the context of aortic dissection?
It is a classic symptom indicating the onset of dissection.
188
Which laboratory tests are essential in the evaluation of aortic dissection?
Cardiac biomarkers and renal function tests.
189
What is the typical duration of hospital stay after surgical intervention for Type A dissection?
1 to 2 weeks.
190
What is malignant accelerated hypertension?
It is a severe form of hypertension characterized by extremely high blood pressure and evidence of acute target organ damage.
191
True or False: Malignant hypertension can occur without any symptoms.
False
192
What are common symptoms of malignant hypertension?
Symptoms may include severe headache, visual disturbances, chest pain, and neurological deficits.
193
Fill in the blank: Malignant hypertension is often associated with __________ damage.
target organ
194
What is the typical blood pressure reading for diagnosing malignant hypertension?
Blood pressure readings are usually greater than 180/120 mmHg.
195
Which organ is commonly affected by malignant hypertension?
The kidneys are commonly affected.
196
True or False: Malignant hypertension is a medical emergency.
True
197
What is the first-line treatment for malignant hypertension?
Intravenous antihypertensive agents are the first-line treatment.
198
Multiple Choice: Which of the following is NOT a typical treatment for malignant hypertension? A) Nitroprusside B) Labetalol C) Aspirin
C) Aspirin
199
What is the role of blood pressure monitoring in malignant hypertension?
Continuous blood pressure monitoring is crucial to assess response to treatment and avoid complications.
200
Fill in the blank: The goal of treatment in malignant hypertension is to reduce blood pressure by __________.
gradual means
201
True or False: Patients with malignant hypertension should be treated with oral medications first.
False
202
What is a potential complication of untreated malignant hypertension?
Complications can include stroke, heart failure, and renal failure.
203
Short Answer: What diagnostic tests are commonly used to evaluate malignant hypertension?
Tests may include blood tests, urinalysis, and imaging studies.
204
Multiple Choice: Which condition is often a cause of malignant hypertension? A) Diabetes B) Chronic Kidney Disease C) Both A and B
C) Both A and B
205
What is the significance of fundoscopic examination in patients with malignant hypertension?
It helps to assess for retinal damage, which indicates end-organ involvement.
206
True or False: Lifestyle changes are sufficient to treat malignant hypertension.
False
207
What is the recommended follow-up for patients treated for malignant hypertension?
Regular follow-up visits to monitor blood pressure and organ function are recommended.
208
Fill in the blank: Malignant hypertension often occurs in patients with __________ hypertension.
chronic
209
What is the primary goal in managing a patient with malignant hypertension?
The primary goal is to prevent further organ damage and stabilize blood pressure.
210
Short Answer: Name one intravenous drug used in the treatment of malignant hypertension.
Nitroprusside
211
Multiple Choice: Which of the following is a symptom of malignant hypertension? A) Nausea B) Lethargy C) All of the above
C) All of the above
212
What is the importance of identifying the underlying cause of malignant hypertension?
Identifying the cause is important for targeted treatment and long-term management.
213
True or False: Malignant hypertension can be cured completely with medication.
False
214
What is the expected time frame for blood pressure reduction in malignant hypertension management?
Blood pressure should be reduced within hours to days.
