HTN lecture important stuff Flashcards
True or false: Amphetamines can cause secondary HTN
(important)
True
What determines BP classification?
(very important)
2 or more properly measured seated BP values from 2 or more clinical encounters.
-Out of office measurements should be used to confirm Dx
-If systolic and diastolic measurements are in different classes, use the highest category
RAAS: Where do the following act?
1) Renin
2) ACEis
3) ARBs
4) Beta blockers
(important)
1) Converts angiotensinogen
2) Angiotensin I
3) Angiotensin II
4) Heart (after angiotensin II), effects contractility and CO
This is a test question
Stage 2 HTN:
1) What is the BP of this stage?
2) What is the first step of Tx?
3) What is the next step? (2 options)
4) When should you reassess after the initiation of medication?
1) >/= 140/90 mmHg
2) ACEi or ARB with CCB
or
ACEi or ARB with thiazide
3) 1 month
Test question pt 1
List the most appropriate first-line medications for the following:
1) HF with reduced HF/EF
2) HF with preserved HF/EF
1) ACEi or ARB, then add beta blocker; diuretic if edema
2) Same as above
Test question pt 2/2
List the most appropriate first-line medications for the following:
1) Stable ischemic heart disease
2) DM
3) CKD
4) Secondary stroke prevention
1) Beta blocker, then add ACEi or ARB
2) ACEi, ARB, CCB, or thiazide
3) ACEi or ARB
4) Thiazide or thiazide with ACEi
Chronic HTN in pregnancy:
1) What 3 things are recommended as a first-line agents due to favorable safety profiles?
2) What 3 things are known teratogens and are absolutely contraindicated?
1) Labetalol, long-acting nifedipine, or methyldopa
2) ACEi, an ARB, and a direct renin inhibitors
Chronic HTN in pregnancy:
1) Instant-release nifedipine and atenolol are not acceptable agents due to what 2 things?
2) May see instant release ____________ use for acute hypertensive emergencies
1) Teratogenicity (ie, animal studies) and intrauterine growth retardation
2) nifedipine
What is a big SE of ACEis? Why?
1) Cough: May develop in up to 20% of patients
a) ACEi blocks degradation of bradykinin
b) Increased bradykinin enhances the BP-lowering effects of an ACEi,
When should you take diuretics?
In the morning
What is special abt methyldopa?
Used for pregnancy-induced HTN
What is a last-line Tx for HTN?
Direct arterial vasodilators (Hydralazine + minoxodil)
