HTN/Hypotension

Question 1

Ventricular septal rupture PA sat

Answer 1

elevated due to left to right shunt

Question 2

hypokalemia at the time of diagnosis and difficult-to-control hypertension

Answer 2

primary hyperaldosteronism, will have metabolic alkalosis too. A ratio ≥70 with a PAC of ≥15 ng/dL and a PRA ≤1 ng/mL/hour

Question 3

Initial BP >140/90

Answer 3

No time for lifestyle changes, straight to meds (2 meds.) Reassess in 1 month.

Question 4

Biggest risk factor for HFpEF

Answer 4

HTN

Question 5

Aging BP

Answer 5

Increased SBP, decreased DBP, increased pulse pressure, increased aortic pulse wave velocity due to increased resistance, decreased NO release.

Question 6

Autonomic neuropathy

Answer 6

drop in BP without a compensatory rise in heart rate.

Question 7

Cardiodepressor syncope

Answer 7

marked drop in heart rate followed by a drop in blood pressure.

Question 8

POTS

Answer 8

modest drop in blood pressure accompanied by an extreme rise in heart rate

Question 9

normal orthostatic response

Answer 9

5-10 mm Hg drop in SBP, 5-10 mm Hg increase in DBP, and increased heart rate (10-25 bpm)

Question 10

meds that cause HTN

Answer 10

NSAID, oral contraceptives, stimulants (such as cocaine or amphetamines), antidepressants, and glucocorticoids

Question 11

aortic dissection, severe pre-eclampsia or eclampsia, and pheochromocytoma

Answer 11

reduce BP to <140 in first hour of treatment. Use labetalol.

Question 12

Elevated RA pressure
Elevated PCWP

Answer 12

> 10.
15.

Question 13

African American antihypertensive even if diabetic

Answer 13

thiazide diuretics or calcium channel blocker

Question 14

ARNI NYHA

Answer 14

Class II-III

Question 15

Newly diagnosed HTN, Get.

Answer 15

EKG to look for left ventricular hypertrophy, rhythm disturbances, and myocardial infarction

Question 16

Resistant htn

Answer 16

can get sleep study as part of workup

Question 17

expected change in creatinine with ACEI/ARB

Answer 17

30% increase, keep going

Question 18

cardiogenic shock MI PCI

Answer 18

Only culprit lesion (100% occlusion)

Question 19

Droxidopa causes fewer HF exacerbations than

Answer 19

midodrine

Question 20

drugs that cause orthostatic hypotension

Answer 20

terazosin, tizanidine (muscle relaxant), trazodone (and other antipsychotic/antidepressant medications), and carvedilol (with its alpha-blocking properties

Question 21

bilateral alveolar infiltrates

Answer 21

pulmonary edema

Question 22

Inotropy.
Cardiogenic shock with preserved BP.
Reduced BP.

Answer 22

Dobutamine.
Norepi.

Question 23

stage 1 htn

Answer 23

130-139/80-89.
treat with lifestyle interventions and reassessment of blood pressure in 3-6 months.

Question 24

treat fibromuscular dysplasia with

Answer 24

antihypertensive therapy including ACEI/ARB-> percutaneous balloon angioplasty

Question 25

hypertensive emergency treatment

Answer 25

lower <25% in hour 1,
160/100 mm Hg next 2-6 hours, and then eventually to normal over the next 24-48 hours.
Acute HF: IV nitrog/nitrop.
Nicardipine (do not use in AS)

Question 26

relationship between hypertension and cardiovascular disease risk

Answer 26

log-linear. A 20 mm Hg higher SBP and 10 mm Hg higher DBP= 2x MACE

Question 27

Preggo htn

Answer 27

Assess for proteinuria to diagnose pre-eclampsia.