HTN

Question 1

preHTN is systolic____ or diastolic____

Answer 1

120-139; 80-89

Question 2

stage 1 HTN is systolic____ or diastolic_____

Answer 2

140-159; 90-99

Question 3

stage 2 HTN is systolic____ or diastolic_____

Answer 3

> 160; >100

Question 4

HTN with no known cause

Answer 4

primary HTN

Question 5

bp that is consistently elevated by out of office measurements but does not meet the criteria in the office

Answer 5

masked HTN

Question 6

what bp defines hypertensive urgency

Answer 6

diastolic >120

Question 7

diastolic>120, end organ damage

Answer 7

hypertensive emergency

Question 8

HTN can be diagnosed after how many visits?

Answer 8

3

Question 9

take BP how many times at each visit

Answer 9

2

Question 10

when to repeat BP within office

Answer 10

when have BP difference >10 b/w repeats

Question 11

risk of stroke increases as bp >

Answer 11

110/75

Question 12

what grade of HTN retinopathy: generalized retinal arteriolar narrowing

Answer 12

grade 1

Question 13

more severe generalized narrowing, focal areas of arteriolar narrowing and AV nicking

Answer 13

grade 2

Question 14

retinal hemorrhages, microaneurysms, hard exudates, and cotton-wool spots

Answer 14

grade 3

Question 15

hypertensive retinopathy, grades 1-3 + optic disk swelling and macular edema

Answer 15

grade 4

Question 16

how to screen for peripheral arterial disease

Answer 16

ankle-brachial index

Question 17

ABI under___is specific/sensitive for PAD

Answer 17

under 0.9

Question 18

if you can get your middle aged patient to drop SBP by 10 and DBP by 5, can reduce stroke risk by____, MI risk by___, heart failure risk by____

Answer 18

35-40%; 20-25%; 50%

Question 19

isolated systolic HTN is more common in what age grp

Answer 19

elderly

Question 20

why does isolated systolic HTN occur?

Answer 20

diminished arterial compliance

Question 21

how to dx OSA

Answer 21

formal sleep study (polysomnography)

Question 22

hypokalemia in a patiet with HTN

Answer 22

primary aldosteronism

Question 23

best initial test for suspected primary aldosteronism

Answer 23

aldosterone:renin ratio

Question 24

high PAC: low PRA with ratio >___, is dx for____

Answer 24

> 30; primary hyperaldosteronism

Question 25

hig PRC:high PRA

Answer 25

secondary hyperaldosteronism

Question 26

low PAC: low PRA

Answer 26

alternate mineralocorticoid stimulation

Question 27

>30% jump in Cr after started ACEi or ARBs

Answer 27

bilateral renovascular disease

Question 28

screening for abdominal bruit?

Answer 28

duplex doppler ultrasonography

Question 29

duplex doppler ultrasonography considered positive when

Answer 29

50+

Question 30

f/u test for +duplex doppler ultrasonography

Answer 30

MR angiography or CT angiography

Question 31

gold standard for dx of abd bruit

Answer 31

renal arteriography

Question 32

string of beads appearance

Answer 32

fibromuscular dysplasia

Question 33

what is the most common cause of HTN in preadolescent kids

Answer 33

renal disease

Question 34

dx of renal parenchymal disease

Answer 34

elevated Cr, decr GFR

Question 35

tx of renal parenchymal disease

Answer 35

aggressive tx of HTN with ACEi

Question 36

2nd most common cause of HTN in kids

Answer 36

coarctation of aorta

Question 37

h/o HTN, SOB on exertion in kids

Answer 37

coarctation of aorta

Question 38

if >___systolc diffference, then send for____

Answer 38

>20; echo

Question 39

dx of pheo if low index of suspicion

Answer 39

24 hr urine metanephrines and catecholamines

Question 40

dx of pheo if high index of suspicion

Answer 40

plasma for fractionated metanephrines

Question 41

dx of HTN is based on elevated BP at how many visits?

Answer 41

3

Question 42

what should you set BP goals based on? (3)

Answer 42

1. age 2. diabetes 3. kidney disease

Question 43

age >60 w/o DM or CAD, BP goal is under____

Answer 43

150/90

Question 44

age under 60 w/o DM or CKD, BP goal is under____

Answer 44

140/90

Question 45

all ages with DM or CKD, BP goal is under____

Answer 45

140/90

Question 46

who is a candidate for lifestyle change trial as tx for HTN

Answer 46

BP under 160/100 with no evidence of target organ damage

Question 47

1st drug to start in Af Am without CKD

Answer 47

thiazide or CCB

Question 48

1st drug to start in non-Af Am without CKD

Answer 48

ACEi, ARB, thiazide, CCB

Question 49

1st drug to start in person with CKD

Answer 49

Acei, ARB

Question 50

what drug is good for an older woman with osteoporosis

Answer 50

thiazide

Question 51

what drug is good for someone with raynauds?

Answer 51

CCB

Question 52

what drug is good for someone with BPH?

Answer 52

alpha blocker

Question 53

what drugs are beneficial for recurrent stroke presentation

Answer 53

thiazide, ACEi

Question 54

when SBP >160/100, how to titrate drugs

Answer 54

titrate up to max dose until goal is achieved

Question 55

how should PAD be managed?

Answer 55

ASA

Question 56

maximum initial fall expected in tx of hypertensive emergencies

Answer 56

25%

Question 57

in stroke patient, who is eligible for lytic tx

Answer 57

BP under 185/110

Question 58

in an ischemic stroke patient, when to tx?

Answer 58

>220/120

Question 59

how often to f/u patients after dx

Answer 59

regularly until BP controlled, then every 3-4 months after dx

Question 60

how often to run ancillary studies after dx

Answer 60

yearly