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#passmed 2022 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What BP is the NICE guidelines diagnosis BP for HTN?

A

140/90 – clinic

135/85 – ambulatory / home

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2
Q

What are the risk factors for HTN? (7 things)

A
  1. Male
  2. Age
  3. FHx
  4. Smoking / Alcohol
  5. Obesity
  6. High Na diet
  7. Physical inactivity
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3
Q

What are the causes of secondary HTN? (4 things)

A
  1. R – Renal disease
  2. O – Obesity
  3. P – Pregnancy induced HTN / Pre-eclampsia
  4. E – Endocrine

ROPE

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4
Q

What Renal disease causes secondary HTN?

A

Renal artery stenosis

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5
Q

What is the most common Endocrine cause of secondary HTN?

A

Hyperaldosteronism

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6
Q

How do you check if Hyperaldosteronism is the cause of the secondary HTN?

A

Renin:aldosterone ratio blood test

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7
Q

How do you confirm the diagnosis of HTN of a patient with clinic BP between 140/90 – 180/120?

A

24 hour ambulatory BP / home reading

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8
Q

What are the Clinic and Ambulatory/Home readings for Stage 1 HTN?

A 
Clinic = >140/90
Ambulatory/Home = >135/85
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9
Q

What are the Clinic and Ambulatory/Home readings for Stage 2 HTN?

A 
Clinic = >160/100
Ambulatory/Home = >150/95
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10
Q

What is the reading for Stage 3 HTN?

A

180/120+

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11
Q

What investigations should be done to check for End Organ Damage for newly diagnosed HTN patients? (5 things)

A
  1. Urine albumin:creatinine ratio
  2. Urine dipstick
  3. Bloods
  4. Fundus examination
  5. ECG
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12
Q

What are you checking for in Urine albumin:creatinine ratio for newly diagnosed HTN patients?

A

Proteinuria

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13
Q

What are you checking for in Urine dipstick for newly diagnosed HTN patients? (2 things)

A
  1. Haematuria

2. Kidney damage

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14
Q

What are you checking for in Bloods for newly diagnosed HTN patients? (3 things)

A
  1. HbA1c
  2. Renal function
  3. Lipids
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15
Q

What are you checking for in Fundus examination for newly diagnosed HTN patients?

A

Hypertensive retinopathy

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16
Q

What are you checking for in ECG for newly diagnosed HTN patients?

A

Cardiac abnormalities

17
Q

What are all the medications used for HTN? (5 things)

A
  1. A – ACE inhibitors (e.g. Ramipril 1.25 – 10mg once daily)
  2. B – Beta blockers (e.g Bisoprolol 5 – 20mg once daily)
  3. C – Calcium channel blocker (e.g Amlodipine 5 – 10mg once daily)
  4. D – Thiazide-like Diuretic (e.g Indapamide 2.5mg once daily)
  5. ARB – Angiotensin II Receptor Blocker (e.g Candesartan 8 – 32mg once daily)
18
Q

When are ARBs used in HTN?

A

Instead of ACE inhibitor if patient: nigga or doesn’t tolerate ACE inhibitors
ACE inhibitors and ARBs are NOT used together

19
Q

What is the initial management of HTN? (3 things)

A
  1. Establish diagnosis
  2. Investigate for Causes + End Organ Damage
  3. Lifestyle advice
20
Q

Who is offered MEDICAL management for HTN? (2 things)

A
  1. Under 80 yrs w Stage 1 HTN + Q-risk score 10+% / DM / Renal/CVS Disease / End Organ Damage
  2. All Stage 2 HTN patients
21
Q

What is the step wise approach to HTN medication? (4 steps)

A

Step 1: A (less than 55yrs + white) / C (55+ / nigga)
Step 2: A + C (white) / ARB + C (nigga)
Step 3: A + C + D

Step 4:
Serum K less than 4.5 = A + C + D + Spironolactone (K sparing diuretic)
Serum K more than 4.5 = A + B/alpha blocker + C + D

22
Q

What is a complication of Spironolactone?

A

Hyperkalaemia

23
Q

What is a complication of ACE inhibitors?

A

Hyperkalaemia

24
Q

What is a complication of Thiazide-like diuretics?

A

Electrolyte disturbances

25
Q

What should you monitor when using ACE inhibitors and diuretics on HTN patients?

A

U&Es regularly

26
Q

What is the treatment target for a HTN patient who is younger than 80?

A

Less than 140/90

27
Q

What is the treatment target for a HTN patient who is older than 80?

A

Less than 150/90

28
Q

What are the complications of HTN? (5 things)

A
  1. Ischaemic heart disease
  2. HF
  3. Stroke / brain haemorrhage
  4. Hypertensive retinopathy
  5. Hypertensive nephropathy

#passmed 2022 (27 decks)

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