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Cardiology > HTN > Flashcards

HTN Flashcards

1
Q

Who gets HTN?

A
  • african americans
  • females after 50-60 yo (d/t hormonal changes)
  • sensitive to salt diet
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2
Q

What is HTN?

A

the most imp modifier risk factor for CD, stroke, HF, ESRD (diastolic and systolic d/t low perfusion HF), peripheral vascular dz
prevent HTN to prevent other dz

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3
Q

What are the classification of blood pressure?

A

Normal: <80
PreHTN: 139/90
Stage 1: 159/99
Stage 2: 160/100

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4
Q

What if pt is older than 80yo?

A

systolic up to 150

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5
Q

What are the classification of cxs of HTN?

A

1) essential/primary HTN:
- unable to ID therefore irreversible
2) secondary HTN:
- able to ID, REVERSIBLE

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6
Q

Examples of secondary HTN?

A
  • chronic renal: polycysitc kidney, urinary tract obstruction, renin producing tumor
  • renovascular HTN
  • vascular
  • endocrine: hyperaldosteronism (low K)
  • adrenal: Cushing syndrome
  • pregnancy
  • drug and toxins: ETOH
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7
Q

What is arterial blood pressure?

A

cardiac output (SV, preload, afterload) X systemic vascular resistance (tota peripheral resistance)

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8
Q

What are suspected factors of HTN?

A
  • genetics

- vascular endothelium

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9
Q

What types of organ damage can arise from HTN?

A
  • cardiovascular (HF, Atheroscleortic cardiovascular dz, Left vent. hypertrophy, cardiac arrhythmias)
  • CNS
  • chronic renal dz
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10
Q

How to assess for pt’s cardiovascular risk status?

A
  • age/gender
  • family hx
  • DM
  • hypercholesterolemia
  • smoke
  • abdominal obesity
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11
Q

How to assess for pt’s secondary cx of HTN?

A
  • meds/drugs
  • sweating
  • lack of energy (thyroid disorder)
  • renal calculi (d/t hyperparathyroidsm)
  • day time sleepiness (sleep apnea)
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12
Q

PE of HTN?

A
  • BP on BOTH ARMS
  • fundoscopic (AV NICKING, cotton wool exudates)
  • peripheral pulses
  • BRUITS (esp renal artery bruit = renal dz = HTN)
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13
Q

Labs for HTN?

A
  • routine –> secondary cx suspicion? –> SPECIFIC studies
  • UA microalbuminuria: FOR diabetes I (early indication for ESRD)
  • plasma renin (hyperaldosteronism)
  • UA VMA
  • thyroid fxn test
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14
Q

Tx for HTN

A
  • pre: lifestyle changes
  • stage 1: life style changes + thiazide diuretic/ACE inhibitors; ARB beta blocker, CCB
  • stage 2: life style changes + 2 drug combo
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15
Q

What kind of life style changes?

A
  • wt loss
  • no drinking
  • more exercise
  • low Na intake
  • no smoking
  • K, Ca, Mg
  • low fat, cholesterol intake
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16
Q

How to tx diabetes w/ HTN?

A

ARB/ACE
b/c you have to protect the kidneys
but in AA: CCB or thiazide

17
Q

How to tx CAD w/ HTN?

A

B blocker + ACE or ARB

18
Q

How to tx chronic kidney dz w/ HTN?

A

ARB or ACE

AA: ACE

19
Q

How to tx HF w/ HTN?

A

ARB or ACE + B blocker + spironolactone + diuretics

20
Q

When do you NOT use diuretics?

A
  • gout
  • renal insufficiency
  • dyslipidema
21
Q

When do you NOT use B adrenergic antagonist?

A
  • asthma

- peripheral vascular dz

22
Q

When do you NOT use ACE inhibitors?

A
  • bilateral renovascular dz

- pregnancy

23
Q

When do you NOT use Angiotensin II antgonists?

A
  • bilateral renovascular dz

- pregnancy

24
Q

When do you NOT use CCB?

A
  • heart block

- heart failure

25
Q

When do you NOT use alpha adrenergic antagonists/central acting agents?

A

autonomic dysfunction

26
Q

What should be considered in pts with resistant HTN?

A
  • inadequate dose
  • may have high Na diet
  • poor compliance
  • may be using other DI
  • secondary HTN (need to tx underlying dz)
  • white coat HTN
27
Q

What to do with pts with resistant HTN?

A
  • reassess for secondary missed cx of HTN

- referral

28
Q

What are HTN emergencies?

A
  • some pts are asymptomatic - BE ON THE LOOKOUT (>220/125)
    • Tx: SLOWLY bring BP down (not suddenly) d/t organ damage (ischemia of heart, brian, kidney, placenta
  • encephalopathy (severe headache, confusion, coma, PAILLEDEMA)
  • cardiac decompensation: CHF, angina, MI
  • nephropathy: proteinuria
  • malignant HTN: encephalopathy, nephropathy, papilledema
29
Q

How to tx MI w/ HTN?

A

Bet blocker + ACE/ARB

30
Q

How to tx Stroke w/ HTN?

A

ACE/ARB

Cardiology (10 decks)

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