HTN

Question 1

common causes for secondary HTN

Answer 1

General/obese: OSA,

Renal causes:
Renal parenchymal disease, renal artery stenosis

Endo causes:
primary aldosteronism 
hyperthyroidism or hypothyroidism
cushing's disease
pheochromocytoma

structural: coarctation of aorta

Question 2

what are some possible end-organ damages/problems secondary to HTN emergency

Answer 2

brain: stroke, Hypertensive encephalopathy
heart: MI, Aortic dissection

Kidney: AKI

Eyes: retinal hemorrhage

Question 3

HTN drugs: Diuretics

Answer 3

Thiazides (hydrochlorothiazide)-first line

• Comfortable Tx, cheapest
• blocks NaCl symporter in Prox Convoluted Tubule

Loop diuretics (furosemide)

• Not first line, very powerful
• block NKCC transporter in Thick Ascending LOH

K+ sparing (Spironolactone)

Question 4

Does ARB (-sartan) also cause dry coughs?

Answer 4

nope, patient on ACEi who has dry cough issues can have a trial of switching to ARB

Question 5

two types of CCB?

Answer 5

1) dihydropyridines (DHP)- amlodipine (-ipine), act more on the vasculature than the heart. Vasodilation (1º)
Reduce contractility (2º)

2) Non-DHP (e.g., diltiazem, or verapamil), greater activity on the heart. Decreased HR
Decreased contractility
Vasodilation (2º). Cardiodepressent effect.

Question 6

B-blockers

Answer 6

B1 (cardioselective) blocker: metoprolol

B1/2 (non-cardioselective) blockers: propanalol, acebutalol