Htn

Question 0

PTA of the renals

Answer 0

5-10% people
Indicated for >75% bilateral disease
Improves BP in 60-70% usually fibromuscular.. Do not stent fibromuscular cases

Question 1

BP increase in 20 mm systolic and 10 mm diastolic

Answer 1

Will double mortality

Question 2

Coarctation

Answer 2

6-8% of the cases2-5x more in men
Increase in turners
Notching of the ribs 3 sign
Stent with 20 mm gradient 
Restenosis ?

Question 3

Pheo

Answer 3

Best test 24 hour urine catecholamines and metanephrines positive test 2 fold normal 
10% malignant
10% extra abdominal 
10% multiple
MRI T2

Question 4

Pheo treatment

Answer 4

Block alpha first phenoxy benzamine

Then beta blockers

Question 5

Primary Aldo

Answer 5

Low plasma renin
PAC/PRA 30-40 for the diagnosis 
PAC>10 ng/dl
Treatment 
Spironolactone and eplerenone

Question 6

Adrenergic system

Answer 6

Alpha1- vein constriction
Aloha2 venodation
Beta 1 increase ionotropy
Beta2 vaso dilation

Question 7

Salt restriction

Answer 7

2-4 gm a day

Question 8

Dash diet

Answer 8

Fruits and vegetables

Question 9

Hyper tension trials

Answer 9

ALLHAT chlorthalidone, acei and ca blockers .. Alpha blockers were dropped due to CHF
SHEP trial low stroke rate chlorthalidone

Question 10

Atenolol studies

Answer 10

Life study atenolol with lasartan
More strokes and death with atenolol
Ascot trial more deaths with atenolol than Norvasc

Question 11

Accomplish trial

Answer 11

Amlodipine/ benazapril vs benazapril/hctz.. Amlodipine group did better and the study was stopped

Question 12

Acei

Answer 12

30% increase in creatinine is ok
Reduces intra glomerular pressure
Adverse conditions
Hypovolemia and CHF bilateral renal stenosis

Question 13

At2 receptor blockers

Answer 13

Not much better

Question 14

Calcium blockers

Answer 14

Blacks diabetes elderly
Superior stroke reduction 
Diastolic dysfunction 
Metabolically neutral
BP lowering not effected by sodium or NSAIDs

Question 15

Clonidine

Answer 15

Need bid dose
Rebound HTN
Depression

Question 16

Direct vasodilators

Hydralazine

Answer 16

Adjuvant 
Lupus 
Does not regress LVH
eDRF dependent 
Need to add diuretics

Question 17

HTN

Answer 17

Hypertensive urgencies no end organ damage
Hypertensive emergencies end organ damage
Labetalol
Nipride
Nicardipine

Question 18

Resistant HTN

Answer 18

Smoking
Non compliance 
Salt intake 
Obesity 
Alcohol 
Sleep apnea 
Pain,NSAIDs

Question 19

Pregnancy

Answer 19

BP should go down not up
No nipride
Labetalol , methyl dopa ca blockers
Don’t use acei and ARB also no atenolol acebutalol no hydralazine

Question 20

Black patients

Answer 20

Over all mortality in all races is dropping
Black men more likely to have mi
Black woman more likely to have HTN