HTN - Kirila Flashcards
CKD - estimated GFR
CKD - estimated GFR
CKD - urine Albumin:Cr ratio
> 30
Diagnostic test for CKD
Renal sonography
Clinical clues to renovascular disease
- New increased Cr
- Increased Cr w/ ACEI or ARB
- Drug-resistant HTN
- Flash pulmonary edema
- Abdominal/flank bruit
Diagnostic tests for renovascular disease
Renal sonography, CT/MR angiography, invasive angiography
Clinical clues to coarctation of aorta
Arm pulses > leg pulses
Arm BP > leg BP
Chest bruits
Rib notching on radiography
Diagnostic tests for coarctation of aorta
MR angiography, TEE, invasive angiography
Clinical clues to primary aldosteronism
Hypokalemia, drug-resistant HTN
Diagnostic tests for primary aldosteronism
- Plasma renin and aldosterone
- 24 hr urin aldosterone and potassium after salt loading - - Adrenal vein sampling
Clinical clues for cushing syndrome
Trucal obesity, wide and blanching purple striae, muscle weakness
Diagnostic tests for cushing syndrome
- 1 mg Dexamethasone-suppression test
- Urinary cortisol after dex.
- Adrenal CT
Clinical clues for pheocromocytoma
- Paroxysms of HTN
- Palpitations
- Perspiration
- Pallor
- Diabetes
Diagnostic tests for pheocromocytoma
- Plasma metanephrines
- 24 hr urine metan. and catech.
- Abdominal CT or MR
Clinical clues for obstructive sleep apnea
- Loud snoring
- Large neck
- Somnolence
Diagnostic test for obstructive sleep apnea
Polysonography
CKD - urine Albumin:Cr ratio
> 30
Diagnostic test for CKD
Renal sonography
Clinical clues to renovascular disease
- New increased Cr
- Increased Cr w/ ACEI or ARB
- Drug-resistant HTN
- Flash pulmonary edema
- Abdominal/flank bruit
Diagnostic tests for renovascular disease
Renal sonography, CT/MR angiography, invasive angiography
Clinical clues to coarctation of aorta
Arm pulses > leg pulses
Arm BP > leg BP
Chest bruits
Rib notching on radiography
Diagnostic tests for coarctation of aorta
MR angiography, TEE, invasive angiography
Clinical clues to primary aldosteronism
Hypokalemia, drug-resistant HTN
Diagnostic tests for primary aldosteronism
- Plasma renin and aldosterone
- 24 hr urin aldosterone and potassium after salt loading - - Adrenal vein sampling
Clinical clues for cushing syndrome
Trucal obesity, wide and blanching purple striae, muscle weakness
Diagnostic tests for cushing syndrome
- 1 mg Dexamethasone-suppression test
- Urinary cortisol after dex.
- Adrenal CT
Clinical clues for pheocromocytoma
- Paroxysms of HTN
- Palpitations
- Perspiration
- Pallor
- Diabetes
Diagnostic tests for pheocromocytoma
- Plasma metanephrines
- 24 hr urine metan. and catech.
- Abdominal CT or MR
Clinical clues for obstructive sleep apnea
- Loud snoring
- Large neck
- Somnolence
Diagnostic test for obstructive sleep apnea
Polysonography
Hypertensive crisis w/ retinopathy, microangiopathy, or acute renal insufficiency:
Timeline?
Target BP?
First-line therapy?
Alternate therapies?
Several hours
20-25% decrease
Labetalol
Nitroprusside, Nicardipine
Hypertensive encephalopathy:
Timeline?
Target BP?
First-line therapy?
Alternate therapies?
Immediate
20-25% decrease
Labetalol
Nicardipine, Nitroprusside
Acute aortic dissection:
Timeline?
Target-BP?
First-line therapy?
Alternate therapies?
Immediate
Systolic
Acute pulmonary edema:
Timeline?
Target-BP?
First-line therapy?
Alternate therapies?
Immediate
60-100
Nitroprusside + loop diuretic
Nitroglycerine
Acute coronary syndrome:
Timeline?
Target-BP?
First-line therapy?
Alternate therapies?
a