Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CVS > hypertension > Flashcards

hypertension Flashcards

1
Q

what are the 3 ways of measuring hypertension and which method is the BEST one?

A
  1. in a clinical setting [i.e by a doctor]
  2. ambulatory [24 hour monitoring device called ABPM] - MOST BEST
  3. home blood monitoring [HBPM]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 8 risk factors for hypertension?

A 
weight gain
smoking
ethnicity
age
salt
exercise
alcohol
caffeine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the SECONDARY causes of hypertension? [2]

A

renal diseases

endocrine disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

uncontrolled hypertension can cause target organ damage. what organs are affected?

A

brain
heart
kidneys
eye [retinopathy]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a healthy BP reading?

A

120/80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is an unhealthy BP that would be classed as hypertension?

what would the process be to this patient to confirm diagnosis and stage of hypertension?

A

over 140/90

first measure BP in clinical setting. then offer ambulatory blood pressure monitoring OR home BP monitoring kit if ABPM is unsuitable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the 3 stages of hypertension? what is the clinical and ambulatory/home BP for each stage?

A

stage 1: clinical BP >140/90 - 160/100. ambulatory/home: >135/85

stage 2: clinical BP: >160/100 - 180/120. ambulatory/home: >150/95

stage 3: clinical BP systolic >180. clinical BP diastolic >120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is malignant hypertension?

what BP measurement indicates malignant hypertension?

A

very high blood pressure that comes on suddenly and severely

over 180/120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what other symptoms occur with malignant hypertension?

A

target organ damage
retinal damage
papilloedema [optic nerve swelling]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what happens in clinic if a patients BP reads between 140/90 and 180/120?

A
  • the pt will be given an ambulatory bp to confirm diagnosis of hypertension. or a home kit if the ABPM is unsuitable
  • whilst waiting for results, investigate target organ damage to establish hypertension cause.
  • and cardiovascular risk assessment [QRISK2, JBS3]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pov: a pt had high clinic reading of bp and was given an ambulatory bp kit. she also had her target organ damage and cardiovascular risk assessment done on her.

her results reported NO hypertension but signs of target organ damage. what are the next steps?

A

investigate causes of target organ damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pov: a pt had high clinic reading of bp and was given an ambulatory bp kit. she also had her target organ damage and cardiovascular risk assessment done on her.

her results show NO hypertension and NO organ damage. what should be done?

A

measure clinic blood pressure every 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pov: a pt had high clinic reading of bp and was given an ambulatory bp kit. she also had her target organ damage and cardiovascular risk assessment done on her.

her results show she does have hypertension. what are the next steps?

A

offer urine/blood tests, lifestyle interventions and drug treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what would be the treatment type for patients UNDER 80 with none of the following [target organ damage, established CVD, renal disease, diabetes, 10 year risk of CVD greater than 10%]?

A

lifestyle advice and monitoring.

however if they develop one of those conditions then start medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which type of patients must be antihypertensive treatment be initiated following hypertension diganosis? [4]

A
  1. pt under 80 years with one of the following [10 yr CVD risk greater than 10%, diabetes, renal disease, established CVD, target organ damage]
  2. pt aged under 60 yo with 10 year CVD risk UNDER 10%
  3. pt over 80 with clinic BP of over 150/90
  4. pt under 40 with no target organ damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

who requires antihypertensive treatment for stage 2 hypertension following diagnosis?

A

all patients require drug treatment regardless of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the treatment of severe/stage 3 hypertension?

A

asap IV antihypertensives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

you must refer patients to specialist assessment on the SAME day if they have BP >180/120 and one of the following signs. which signs do these patients need to exhibit? [6]

A
  • retinal haemorrhage
  • papilloedema
  • life threatening symptoms [eg confusion, chest pain, AKI]
  • suspected phaeochromocytoma [eg postural hypotension, headache, palpitations]
  • if pt has severe hypertension but NO symptoms
  • if there is target organ damage [may need to be started on drugs asap]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what drugs are used in hypertension? in order?

A

ACDDB

ace/arb
calcium channel blocker
thiazide diuretic
low dose spironolactone
beta blockers/alpha blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. what must be done if a patient has severe hypertension but no symptoms, same day referral?
  2. what must you do if target organ damage is identified in this pt?
  3. what if no target organ damage was identified for this pt?
A
  1. carry out investigation on target organ damage
  2. start antihypertensive drugs asap
  3. repeat clinic blood pressure measurement within 7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the first line, 2nd, 3rd, and 4th line treatment for hypertension management in type 2 diabetes for all patients OR hypertension without type 2 diabetes in those aged 55 years or below and not of black African or African-Caribbean origin

A

step 1: add ACE or ARB
step 2: ADD on either a CCB OR thiazide like diuretic [if theres heart failure]
step 3: Ace/ ARB and CCB AND thiazide like diuretic
step 4: confirm clinic BP readings using ambulatory/home kits. consider ADDING low dose spironolactone [if K+ 4.5mmol or less] OR beta blocker/alpha blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the 1st, 2nd, 3rd or 4th line treatment for hypertension in..
Hypertension without type 2 diabetes in patients aged 55 and over, or all ages of black African or African-Caribbean origin patients without type 2 diabetes

A

step 1: offer CCB
step 2: ADD on either ACE/ARB OR thiazide like diuretic
step 3: ACE/ARB and CCB and thiazide like diuretic
step 4: confirm clinic BP reading using ambulatory or home kit. consider ADDING either low dose spironolactone OR alpha blocker/beta blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the clinic BP target reading for type 1 diabetics?

what is the clinic BP target reading for type 1 diabetics with signs of metabolic syndrome or albuminuria [albumin in urine]?

A
  • less than 135/85

- less than 130/80

24
Q

what is the 1st, 2nd, 3rd and 4th line for treatment of hypertension in type 1 diabetics?

A

step 1: ACE inhibitor [start with low dose then titrate upwards]
step 2: beta blockers
step 3: low dose thiazide diuretics WITH beta blockers
step 4: CCB [only the long acting ones eg MR nifedipine and MR amlodpine]

25
Q

what antihypertensive drugs should be offered to treat hypertension in all patients with diabetes. regardless of age or ethnicity?

A

ace or arbs

26
Q

which from either ACE or ARBs should be used for hypertension in black africans?

A

ARBs

27
Q

if CCBs are not tolerated in patients due to things like oedema or heart failure, what is the alternative antihypertensive that could be given instead?

A

thiazide like diuretics eg indapamide over bendroflumethiazide

28
Q

what are the 3 key side effects of ace inhibitors?

A

angioedema [swelling under skin]
DRY cough
hyperkalaemia

29
Q

in which patients should ACE inhibitors be avoided in? [4]

A

severe renal disease
afro caribbean
pregnancy/breastfeeding
concurrent use with aliskiren [another antihypertensive] with egfr less than 60 or angioedema

30
Q

what are the 2 main side effects of ARB inhibitors?

A

hyperkalaemia

angioedema

31
Q

in which patients should ARB inhibitors be avoided in? [3]

A

severe renal disease
pregnant women
aliskiren with egfr less than 60 or angioedema

32
Q

what is a key side effect of CCB?

A

oedema

33
Q

in which types of patients should CCBs be avoided in? [3]

A

odema
heart failure [except amlodipine]
unstable angina

34
Q

what are the 4 key side effects of thiazide diuretics?

A

hyponatraemia
hypokalaemia
hypercalcaemia
hyperuricaemia

35
Q

which types of patients should thiazide diuretics be avoided in? [4]

A

diabetes
gout
egfr under 30
addisons disease

36
Q

what are the 2 key side effects of spironolactone? [2]

A

hyperkalaemia

gynaecomastia [enlarged male breasts]

37
Q

in which patients should spironolactolone be avoided in [2]

A

hyperkalaemia

addisons disease

38
Q

what is one key side effect of beta blockers?

A

bradycardia [slow heart rate]

39
Q

in which patients should beta blockers be avoided in? [3]

A

asthmatics
COPD
unstable heart failure

40
Q

what is one key side effect of alpha blockers?

A

orthostatic hypotension [sudden drop of BP when you stand up from sitting down]

41
Q

in which patients should alpha blockers be avoided in? [1]

A

history of those who faint in those with BPH or postural hypotension

42
Q

what is the target clinic BP reading for patients with renal disease?

A

less than 140/90

43
Q

what antihypertensive drug must you use with CAUTION in patients with renal disease and why?

A

ACE inhibitors bc low crcl may cause hyperkalaemia

44
Q

what daily dosage is recommended when treating hypertension in patients with renal disease?

A

once daily medication if possible

45
Q

what is the clinical BP target for hypertension in pregnant women?
what is hypertension in pregnancy called?

A

pre eclampsia

target of less than 135/85

46
Q

what is the 1st line, 2nd line and 3rd line management of pre eclampsia?

what should be given in critical care or severe hypertension?

A

step 1: oral labetalol
Step 2: MR nifedipine [unlicensed]
step 3: methyldopa [unlicensed].

for critical care: iv magnesium sulfate

47
Q

when must methyldopa be discontinued in pregnant women?

A

2 days after giving birth and the continue regular antihypertensive treatment

48
Q

what is the INITIAL dose of labetalol in hypertension?

what is the USUAL/maintenance dose of labetalol in hypertension?

A

initial: 100mg twice daily, increase dose every 14 days
usual: 200mg twice daily. increased if needed to 800mg daily in 2 divided doses

49
Q

what is the cautionary labels for labetalol?

A

take WITH food

50
Q

what is the target clinical BP to start antihypertensive treatment for PREGNANCY?

A

below 135/85

51
Q

what is the target clinical BP to start antihypertensive treatment for RENAL DISEASE?

A

UNDER 140/90

52
Q

what is the target clinical BP to start antihypertensive treatment for RENAL DISEASE AND DIABETES or if urine albumin exceeds 70?

A

under 130/80

53
Q

what is the target clinical BP to start antihypertensive treatment for TYPE 1 DIABETES WITH albuminuria or features of metabolic syndrome

A

equal to or under 130/80

54
Q

what is the target clinical BP to start antihypertensive treatment for TYPE 1 diabetes with NO albuminuria or metabolic syndrome?

A

under 135/85

55
Q

what is the target clinical BP to start antihypertensive treatment for anyone who was referred to ‘same day specialist’ for things like retinal haemorrhage, life threatening symptoms etc

A

equal to or under 140/120

56
Q

what is the target clinical BP to start antihypertensive treatment for ANYONE UNDER 80?

A

equal to or under 140/90

57
Q

what is the target clinical BP to start antihypertensive treatment for ANYONE OVER 80?

A

equal to or under 150/90

CVS (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions