HTN Renal Disease / Vasculitis Flashcards
What disease processes can result in renal HTN?
- Pheochromocytoma
- Primary Aldosteronism
- Artheroscelrosis
- Cushing’s
- Hypothyroidism and Hyperthyroidism
- Hyperparathyroidism
At what BP would you start to be concerned over Malignant HTN?
Is this often associated with hypertensive emergency or urgency?
> 180/120 mmHg
HTN Emergency
What are the retinal manifestations of Malignant HTN?
What about HTN Encephalopathy?
Retinal: Hemorrhages, Exudates, Papilledema
Encephalopathy: Cerebral Edema, SAH, Lacunar Infarctions
What may be present on UA in a patient with Malignant HTN?
Renal Biopsy?
UA: Hematuria, Proteinuria
Biopsy: Fibrinoid Fibrosis
How is Malignant HTN treated?
IV Labetalol
IV Nitroprusside
Nicardipine
__________ HTN is one of the most common causes of secondary HTN.
It can often present as an acute onset of severe resistant increase in BP at a young age, refractory HTN, flash pulmonary edema, or an increase in sCr after starting ACEi
Renovascular HTN
If on US you noticed a unilaterally smaller kidney, what underlying disorder (regarding BP) may be present?
Renovascular HTN
Are Doppler US, CTA, MRA, and Aortogram all viable imaging modalities for renovascular HTN work up?
What is most diagnostic and therapeutic if renal artery stenosis is involved?
Yes
Angiography
T/F: Medical Management (ie: anti-hypertensives) is given to all patients with renovascular HTN
True
Other than medical therapy, what additional treatment options are available for renovascular HTN?
Angioplasty with stenting
Surgical Revascularization
Nephrectomy (of the “pressor” kidney)
_________ disease results from cholesterol crystal break off from a plaque and embolize distally from their origin
Atheroembolic Disease
T/F: Atheroembolic Disease is typically Iatrogenic
True
What are examples of iatrogenic events that may result in atheroembolic disease?
Spontaneous?
Iatrogenic: Angiography, Cardiovascular Surgery, Anti-coagulation
Spontaneous: Hemodynamic Stress
What is the classic clinical triad of atheroembolic disease?
- Precipitating Event (Cardiac Procedure, Angiography, etc…)
- Subacute or AKI
- Blue Toe Syndrome / Livedo Reticularis
What may be seen on fundoscopy in a patient with atheroembolic disease?
Hollenhorst Plaque in a retinal artery