HTN, Cerebrovascular, Parkinson's, polymyalgia rheu review

Question 1

common form of HTN in the elderly, is defined as sys BP >140 and diastolic BP <90

Answer 1

isolated systolic hypertension

Question 2

First line pharm therapy for HTN in elderly

Answer 2

thiazide diuretic 12.5 mg

Question 3

When does SBP more important than DBP as CVD risk factor?

Answer 3

50+

Question 4

Benefits of lowering BP

Answer 4

decreased stroke, MI, heart failure

Question 5

Independent risk factor for CVD

Answer 5

LVH

Question 6

What are thiazides also good for in addition to BP control?

Answer 6

osteopenia/osteoporosis

Question 7

What are CCBs also good for in addition to BP control?

Answer 7

Raynaud’s syndrome

Question 8

CI to thiazides

Answer 8

gout or h/o hyponatremia

Question 9

CI to BBs

Answer 9

2nd/3rd degree heart block

Question 10

CI in pregnancy for HTN

Answer 10

ACEI/ARB

Question 11

caused primarily by an increase in arterial stiffness due to increased collagen deposition and cross linking, degeneration of elastin fibers, atherosclerotic changes, and age-related endothelial dysfunction

Answer 11

isolated systolic hypertension

Question 12

BP readings may be falsely elevated in some elderly patients with very stiff, calcified arteries

Answer 12

pseudohypertension

Question 13

Two classifications of stroke

Answer 13

ischemic (75%) or hemorrhagic

Question 14

Brief episodes of focal neurological deficits lasting 2-3 minutes to at most a few hours but no longer than 24 hours leaving no residual deficits with complete functional recovery

Answer 14

TIA

Question 15

Acute, sustained functional neurological deficit lasting from days to permanent. There is neuronal necrosis or infarction

Answer 15

complete stroke

Question 16

Small, deep infarcts caused by occlusion of the small arteries that penetrate deeper brain structures. Subtle symptoms

Answer 16

lacunar

Question 17

stroke present seriously ill. Deteriorate more rapidly and have HA, N/V, and decreased consciousness as prominent signs

Answer 17

hemorrhagic stroke

Question 18

Rupture of an artery with bleeding onto the surface of the brain

Answer 18

subarachnoid

Question 19

Cause of subarachnoid hemorrhage

Answer 19

aneursym (85% Berry)

Question 20

“Worst headache ever” in the patients life radiates to face and neck. Phonophobia or photophobia

Answer 20

subarachnoid hemorrhage

Question 21

Cause of intracerebral hemorrhage

Answer 21

HTN

Question 22

Rupture of an artery with bleeding into the brain parenchyma

Answer 22

intracerebral

Question 23

Treatment of ischemic stroke

Answer 23

fibrinolytic therapy (tPA)

Question 24

Timeframe for administration of tPA

Answer 24

within 3 hours of onset of signs and symptoms

Question 25

Characteristics of parkinsons

Answer 25

resting tremor, muscular rigidity, bradykinesia

Question 26

Initial drug treatment for Parkinsons

Answer 26

carbidopa/levodopa or dopamine agonists

Question 27

characterised by severe bilateral pain and morning stiffness of the shoulder, neck and pelvic girdle

Answer 27

polymyalgia rheumatica

Question 28

Most useful lab test for PMR

Answer 28

ESR

Question 29

Patient presents with new HA, jaw claudication, or visual disturbance. h/o of PMR

Answer 29

giant cell arteritis

Question 30

Treatment for PMR

Answer 30

prednisone 15mg/day for 18-24 months