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cardiology > HTN > Flashcards

HTN Flashcards

1
Q

What are the 3 factors need to maintain adequate pressure in the cardiovascular system

A
  1. Functioning pump
  2. Sufficient fluid volume
  3. Vascular resistance
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2
Q

Diagnostic Studies for HTN

A 
ECG: L Ventricular hypertrophy
Decreased H&H
Elevated BUN, creatinine, urine protein and glucose 
Serum K, Ca, and uric acid
Plasma aldosterone concentration
Lipid panel
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3
Q

After diagnosis, what is the treatment goal?

A

> 140/90

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4
Q

After diagnosis of HTN in pt with DM or CKD, what is treatment goal?

A

> 130/80

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5
Q

Nonpharmacologic therapies for HTN

A 
DASH
Exercise
Weight loss
Smoking cessation
ETOH decrease
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6
Q

Initiating pharmacologic therapies for HTN in pt with DM and CKD

A

Initiate drug therapy immediately if BP is > 140/90 at diagnosis along with lifestyle changes

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7
Q

How many drugs does stage 2 (>160 systolic or >100 diastolic) its require to lower BP?

A

2

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8
Q

What are the drugs available for HTN?

A 
Diuretics
B-adrenergic antagonists
Angiotensin-converting enzyme inhibitors
Angiotensin II Receptor Blockers
Calcium channel blockers
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9
Q

What drug is considered 1st line in treating Essential HTN?

A

Diuretics: Thiazides are consistently effective

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10
Q

How do diuretics work to treat HTN?

A

Initially reduce plasma volume & chronically reduce PVR

Potassium supplements may be needed

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11
Q

Who can use loop diuretics?

A

HTN pt with renal dysfunction

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12
Q

How do Beta Blockers work to treat HTN?

A

Decrease HR & CO

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13
Q

What pt population do BB work best in?

A

Young white adults

Reduce mortality after MI in pt with heart failure

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14
Q

What pt population must you be careful to use BB with when treating HTN?

A

Pt with pulmonary disease or DM

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15
Q

How do ACE-I work?

A

Inhibit bradykinin degradation (inflammatory mediator that vasodilate) (initiates cough)
Stimulate vasodilating prostaglandins (vasodilation)

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16
Q

What is the initial drug choice for HTN pt with BM & CKD

A

ACE-I: help preserve kidney function

17
Q

What pt population will benefit from ACE-I use?

A

Mild-Mod HTN
Younger whites
Use when diuretics are insufficient
Reduce mortality in PT with MI and heart failure

18
Q

How do ARBs work?

A

Block the interaction of angiotensin II on receptors

19
Q

What pt population with benefit from ARBs?

A

Pt with DM or CKD because they help preserve kindly function

Do not increase bradykinin = no cough

20
Q

What are other agents available to treat refractory HTN or other special cases?

A

Aldosterone receptor antagonists: combo with BB and ARBs after MI with heart failure

Alpha-blockers: BPH
Central Sympatholytics
Vasodilators
Aliskiren: renin inhibitor

21
Q

How do Calcium Channel Blockers works?

A

Peripheral vasodilation

22
Q

What pt population is CCB preferred?

A

Elderly & Black

23
Q

Drugs used in HTN emergencies

A
  • Nitroprusside
  • Nitroglycerin (if MI present)
  • B blocker
  • Fenoldopam
  • Hydralzine: pregnancy
  • Oral agents: Clonidine
24
Q

Classification of BP

A

Normal 160/ >100

25
Q

Causes of HTN

A 
Sleep apnea
Drugs
CKD
Primary aldosteronism
Reno vascular disease
Steroid or Cushing's
Pheochromocytoma
Coarctation
Thyroid/parathyroid disease
26
Q

HTN can cause target organ damage to which organs?

A 
Heart
Brain
Kidneys
Peripheral arterial disease
Retinopathy
27
Q

What is the JNC 8 goal & therapy for >60 yo

A
28
Q

What is the JNC 8 goal & treatment for

A
29
Q

What is the JNC 8 goal & treatment for diabetics with HTN

A
30
Q

What is the JNC 8 goal & treatment for CKD pt with HTN

A

ACE or ARB

31
Q

Thiazide use for osteoporosis

A

Favorable

32
Q

BB for arrhythmia migrant, thyrotoxicosis, and preoperative HTN

A

Favorable

33
Q

CCB in Raynaud’s and some arrhythmias

A

Favorable

34
Q

A-Blockers for BHP

A

Favorable

35
Q

ACE/ARB in LVH can prevent cardiac remodeling

A

Favorable

cardiology (11 decks)

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