HTN Flashcards
S4 gallop?
Atrial kick
Flame hemmorhages with what?
HTN, DM, central vein occlusion
ACEi is stopped when?
hyperkalemia
Renal artery stenosis less than 25 caused by what?
RAS over 50 is what?
Fibromuscular dysplasia of renal artery
Atherosclerosis
Renal artery stenosis findings?
Test for it?
HTN, bruit, HYPOKALEMIA b/c RENIN ANGIOTENSIN ANDROGEN SYSTEM
Dx for MRA
What can’t you give when bilateral renal stenosis?
ACEi b/c need distal construction to maintain GFR. Otherwise renal failure will happenq
Turner syndrome has what heart abnormality?
Coarctation (think a coarct looks like an X and turner is an X)
Hypertensive urgency?
180/120
No symptoms of end organ damage
IF end organ damage, it is an emergency!
Renal failure, papilledema, MI, dissection, pulm edema, angina
Tx of hypertensive emergency?
Only lower 25% of first 2 hours. But eventually getDBP to 100 otherwise can cause ischemia
Thiazides increase what?
Hyper GLUC
Glucose, lipids, urate, calcium
Loops lose calcium and potassium and sodium
What do thiazides lose?
K+ and H+
Alpha 1 blockers are what?
azosins
Use with other drugs, unless they have BPH
What causes first dose hypotension?
Azosins.
Also get rebound when you stop
Beta blockers that end in olol are blocking what? What if the end in something else?
If start with first half of alphabet they are B1, if second hal they are non selective
Labetalol and cavedilol are b1 and alpha1 selective (so can use in cocaine or pheo)
Dihidropiridines are what?
pines. HTN as a first line option
Use for prinzmetal
Esophageal spasm
Migraine
can cause constipation, reflux (makes sense, they are smooth muscle relaxers!)
Nitroprusside unique side effect?
Cyanide
Vasodilator concern for heart? Solution?
reflex tachy, meaning more O2 demand and adverse events
So combine with beta blocker
ACEi contraindication?
hyperkalemia (Think it causes worse renal insufficiency by decreasing GFR)
JNC8 if over 60 is bp of what?
less than 60?
Or if diabetes or CKD?
140/90 for everyone EXCEPT for otherwise healthy 60 or older (so no diabetes or CKD)
Anti htn in chronic kidney disease?
ACE/arb
HTN in black?
Thiazide or CCB. Works better
HTN in nonblack?
Thiazide, CCB, ACE, ARB
Diabetes should be on what?
ACE or arb
CHF HTN tx?
WHAT IS CONTRAINDICATED for htn med?
ACE, ARB
Aldosterone
Certain beta blockers (B,C Met)
Nondihydropyridine contraindicated b/c less cardiac ability. No Beta in acute setting
Post MI htn meds?
Beta blocker, ACE or ARB, Aldosterone antag
Osteoporosis ht. drug?
thiazide, retain calcium
contraindicated htn drug in COPD or asthma?
Nonselective beta blockers b/cbronchospasm
Gout contraindicated hth drug?
diuretics (remember the u in hyper GLUC)
Migraine patient with HTN?
beta blocker
HTN drugs that are sulfa?
Diuretics
SHOCK IS 5 star topic
oh my
Shock workup is shot gun approach
CBC, electrolytes, renal, liver, ABG, cardiac, coag, tox screen UA, lactic acid
Tx of cardiogenic shock?
Dobutamine (strict beta 1)
Intra-aortic balloon pump
PTCA if MI
Careful with fluids!!
Septic shock skin is what?
Tx?
war, vasodilation and loss of resistance causes it
Gram negative
DIC
Endotoxin
Tx: treat infection, IV FLUIDS and maybe vasopressor. NE is choice for vasopressor
Nuerogenic shock mechanism?
Tx?
Peripheral vasodilation and bradycardia
Tx with fluids, vasopressors, atropine
Swan ganz tells left atrial pressure
Left ventricular failure causes high atrial pressure
But if low fluids, low atrial fluid! helps figure out how to treat it
Capilarry wedge pressure in tampanade?
It is high b/c pressures normalize in all chamber of heart (b/c pushing in the sac)
Table on page 184!!
SUPER IMPORTANT
