HTN

Question 1

non-pharmacological for DM

Answer 1

sodium not more than 2.4g
weight reduction 
DASH eating (fruit, veg, low fat dairy) 
physical activity 
moderation of alcohol consumption

Question 2

Classification of hypertension 
High normal: 
grade 1: 
grade 2: 
grade 3: 
isolated systolic:

Answer 2

High normal: 130/85 - 139/89
grade 1: 140/90 - 159/99
grade 2: 160/100 - 179/109
grade 3: 180/110
isolated systolic: 140/90

Question 3

blood pressure targets for 82 year old man with no problems

Answer 3

<150/90

Question 4

45 year old man with ACR 4, PCR 12

Answer 4

130/80`

Question 5

72 man with DM

Answer 5

<140/80

Question 6

man 72 yo with no medicatl problems

Answer 6

140/80

Question 7

types of diuretics

Answer 7

`thiazide, loop, k sparring, aldosterone receptor blockers

Question 8

name 4 thiazide diuretics

Answer 8

chlorthialidone
hctz
indapamine
metolazone

Question 9

name 3 loop diuretics

Answer 9

bumetanide, frusemide, torsemide

Question 10

adr of thiazide diuretics

Answer 10

increased cholesterol and increased glucose 
decreased K, NA, Mg 
increased Ca, uric acid 
azotemia 
photosensitivity

Question 11

ADR of loop diuretics

Answer 11

decreased K, Ca, Mg, Na
azotemia
photosensitivity
tinnitus

Question 12

thiazide renal impairment

Answer 12

not to be used with GFR <30ml/min except metolazone

Question 13

thiazide small dose or large dose more effective

Answer 13

small dose

Question 14

loop diuretics small dose or large dose better?

Answer 14

large dose

Question 15

is loop or thiazide preferred in poor kidney function

Answer 15

loop

Question 16

is thiazide or loop first line in lowering bp

Answer 16

thiazide

Question 17

name 9 ACEI/ARB

Answer 17

banzepril 
captopril 
Enalapril 
fosinopril 
lisinopril
moexipril 
quinapril
ramipril 
trnadolapril

Question 18

name 4 ARBS

Answer 18

candesartan
irbesartan
losartan
valsartan

Question 19

ADR of ACE/ARB

Answer 19

hypotension 
dry cough (ace) 
hyperkalemia 
transient worsening of kidney function (need to monitor renal panel) 
angioedema (ACE >> ARB)

Question 20

counselling points for ACEI/ARB

Answer 20

hypotension, cough

Question 21

name the DHP CCB

Answer 21

nifedipine

amlodipine

Question 22

name the non-DHP CCB

Answer 22

diltiazem, verapamil

Question 23

ADR of DHP CCB

Answer 23

dizziness, headache, flushing, peripheral edema, tachycardia, gingival hyperplasia (nifedipine)

Question 24

is DHP or non-DHP CCB more potent

Answer 24

DHP

Question 25

DHP CCB ADR

Answer 25

bradycardia, heart block, constipation (verapamil more)

Question 26

why choose Non-DHP CCB

Answer 26

more cardiac selective | no need to do renal panel

Question 27

name the cardioselelctive BB (5)

Answer 27

atenolol, bisoprolol, metoprolol, betaxolol, acebutolol

Question 28

name the non-selective BB

Answer 28

propranolol, timolol, nadolol

Question 29

me the mixed blockage BB

Answer 29

carvedilol

Question 30

ADR of BB

Answer 30

bronchospasm, bradycardia, heart block, hypotension insomnia, depression, fatigue impotence, metabolic changes may mask the s/sx of hypoglycaemia

Question 31

contraindications off BB

Answer 31

asthma, 2nd or 3rd degree heart block, systolic HF (except bisoprolol, metoprolol and carvedilol)

Question 32

when is non-cardioselective BB preferred

Answer 32

its with non-CV indications like migraine prophylaxis or essential tremor

Question 33

compelling indications for BB

Answer 33

post MI tachyarrhythmias HF (carvedilol, bisoprolol, metoprolol XL)

Question 34

when is clonidine used

Answer 34

resistant HTN

Question 35

SE of clonidine

Answer 35

anticholinergic, CNS

Question 36

when is methyldopa used in HTN

Answer 36

pregnancy induced HTN

Question 37

when is methyldopa used in HTN

Answer 37

pregnancy induced HTN

Question 38

SE of methyldopa

Answer 38

transient elevation in LFT, CNS side effects, rarely hepatitis or haemolytic anemia

Question 39

name 3 alpha1 blockers

Answer 39

doxazosin prazosin terazosin

Question 40

alpha 1 blockers MOA

Answer 40

blocks peripheral alpha 1.postsynaptic receptors --> vasodilation of both arteries and veins prevent the uptake of catecholamines by the smooth muscles

Question 41

SE of alpha 1 blockers

Answer 41

orthostatic hypotension | reflex tachycardia

Question 42

compelling indication for alpha 1 blockers

Answer 42

BPH

Question 43

direct vasodilator name

Answer 43

hydrazine

Question 44

hydralazine MOA

Answer 44

direct relaxation of peripheral arterial smooth muscle --> decrease peripheral resistance

Question 45

disadvantage of hydralazine

Answer 45

may only be temporarily effective as BP lowering agents when used alone

Question 46

renin inhibitor name

Answer 46

aliskiren