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Hypertension Flashcards

1
Q

type of hypertension whose etiology is unknown and accounts for 95% of all cases

A

primary hypertension

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2
Q

type of hypertension that has a definable cause and is usually associated with an underlying, treatable cause

A

secondary hypertension

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3
Q

which type of hypertension can be “cured”

A

secondary hypertension

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4
Q

what is considered elevated BP?

A

120-129/<80

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5
Q

what is stage I hypertension?

A

130-139/80-89

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6
Q

what is stage II hypertension?

A

> 140/>90

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7
Q

what does uncontrolled hypertension lead to?

A

heart failure

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8
Q

the pathogenesis of primary hypertension is sometimes _____

A

genetic

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9
Q

what are the 3 biggest risk factors associated with primary hypertension?

A
  1. obesity
  2. family history
  3. race
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10
Q

what can be a patient use to help me diagnose them with hypertension?

A

ambulatory BP monitoring

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11
Q

what kinds of patients are perfect for ambulatory BP monitoring?

A
  1. white coat hypertension + no end organ damage
  2. episodic hypertension
  3. hypotension symptoms while on HTN meds
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12
Q

a mean daytime BP >_____ systolic or > _____ diastolic is HTN

A

130;80

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13
Q

a patient who presents with a hypertensive urgency BP >_____ systolic or > _____ diastolic is HTN

A

180; 120

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14
Q

a patient with an initial BP > ____ systolic or > _____ diastolic and with known end-organ damage is HTN

A

160; 100

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15
Q

how often should a patient with normal BP be screened?

A

q 2 years

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16
Q

how often should a patient with BP of 120-139 systolic or 80-89 diastolic (prehypertension) be screened?

A

yearly

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17
Q

what is the physical exam like for a patient with suspected hypertension?

A

normal

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18
Q

what is metabolic syndrome?

A

hypertension, hyperlipidemia, and diabetes

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19
Q

what should I look for to diagnose hypertension, especially in patients with diabetes or renal disease?

A

microalbuminuria

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20
Q

what is the BP goal in patients 65 or older?

A

125-130/80

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21
Q

what is the BP goal in patients 65 or younger?

A

130-139/90

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22
Q

what is the BP goal for patients of all ages, that have diabetes, but no CKD?

A

125-130/80

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23
Q

what is the BP goal for patients of all ages, that have CKD, +/- diabetes

A

125-130/80

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24
Q

what 2 medications can I give a black patient with hypertension?

A
  1. thiazide diuretic
  2. calcium channel blocker
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25
what 2 medications can I give any race that has hypertension and CKD?
1. ACEI 2. Angiotensin receptor blocker
26
how do thiazide diuretics decrease BP?
remove excess fluid from body
27
what are 3 thiazide diuretics?
1. chlorthalidone 2. hydrochlorothiazide 3. indapamide
28
what are 2 ACE inhibitors?
1, benazepril 2. captopril
29
what are 2 angiotensin II receptor blockers (ARBs)?
1. telmisartan 2. losartan
30
name a dihydropyridine calcium channel blocker
amlodipine
31
name a nondihydropyridine calcium channel blocker
verapamil
32
which 2 treatments should not be given to a pregnant patient for hypertension?
1. ACE 2. ARB
33
what 4 medications are safe to give a pregnant patient for hypertension?
1. labetalol 2. hydralazine 3. nifedipine ER 4. methyldopa
34
which 2 hypertension treatments should not be combined?
ACEI and ARB
35
what kind of exercise produces small reductions in BP regardless of body mass, ethnic group, or age
aerobic
36
in patients over 50 years, what is a risk factor for cardiovascular disease?
SBP greater than 140
37
what is the usual nature of onset in patients with secondary hypertension?
abrupt
38
what is the most common cause on secondary hypertension?
chronic kidney disease
39
what is the 2nd most common cause of secondary hypertension?
primary hyperaldosteronism
40
what are 4 things to check when screening for renovascular disease?
1. GFR 2. renal US 3. elevated serum creatinine 4. abnormal UA
41
rare catecholamine-secreting tumor on the adrenal medulla that presents with triad of headache, palpitations, and sweating
pheochromocytoma
42
what should we check for in a 24hr urine sample to screen for pheochromocytoma? (2)
1. metanephrines 2. catecholamines
43
what should I check for in a 24hr urine sample to screen for hyperaldosteronism? (2)
1. unexplained hypokalemia 2. serum aldosterone : renin ratio
44
what test should I do to screen for cushing's syndrome to see an increase of cortisol?
dexamethasone suppression test
45
what test confirms coarctation of the aorta?
CT angiography
46
hypertension in the upper extremities, hypotension in the lower extremities, and differing BP between the arms indicates ...
coarctation of aorta
47
what would I check to screen for hypothyroidism?
TSH
48
what would I check to screen for hyperparathyroidism? (2)
1. serum PTH 2. calcium
49
what is the most common form of secondary hypertension?
renal parenchymal disease
50
renal artery stenosis that is usually due to atherosclerosis or fibromuscular dysplasia
renovascular disease
51
rare congenital narrowing of the proximal aorta near the origin of the left subclavian artery which may lead to hypertension
coarctation of aorta
52
what is commonly seen on a CXR in a patient with coarctation of the aorta?
rib notching
53
rare, excessive mineralocorticoid secretion of aldosterone from adrenal adenoma or bilateral hyperplasia
primary hyperaldosteronism
54
rare, renin-secreting tumors that causes hypertension, that is mediated by increased Na+ retention due to excess aldosterone
secondary hyperaldosteronism
55
rare cause of hypertension mediated by excess glucocorticoids (cortisol) that leads to increased B.V and renin production
cushing's syndrome
56
thyroid problem that is associated with systolic hypertension
hyperthyroidism
57
thyroid problem that is associated with diastolic hypertension
hypothyroidism
58
the number of calories you burn as your body performs basic life-sustaining functions
basal metabolic rate
59
what increases HR, which in turn affects cardiac output?
increased basalmetabolic rate
60
how does hypothyroidism increase BP?
fluid retention
61
at what age should I start screening patients for hypertension?
18 years
62
what 4 things should I test to screen a patient for secondary hypertension?
1. potassium 2. calcium 3. creatinine 4. UA
63
what 2 causes of secondary hypertension can cause hypertension to persist even after treatment?
1. coarctation of aorta 2. hyperparathyroidism
64
what are the 2 main causes of hypertensive crisis?
1. uncontrolled primary hypertension 2. secondary hypertension
65
severely elevated BP without acute symptoms (often asymptomatic) or clinically-evident end-organ damage
hypertensive urgency
66
severely elevated BP with evidence of impending or progressive targe organ damage
hypertensive emergency
67
what are 5 evidence of impending or progressive target organ damage in a hypertensive crisis?
1. headache/vision changes 2. n/v 3. chest pain 4. cerebral infarction 5. acute pulmonary edema
68
what 4 tests NEED to be ordered in a hypertensive crisis?
1. electrolytes 2. renal function 3. UA 4. ECG
69
what radiology should be ordered in a hypertensive crisis with suspected pulmonary edema or aortic aneurysm?
CXR
70
what radiology should be ordered in a hypertensive crisis with headache, AMS, or other neurological symptoms?
CT scan
71
therapeutic goals in a hypertensive crisis is prompt reduction of MAP by _____% and DBP below _____
20-25; 100
72
what is something that patients with true hypertensive emergency require?
invasive BP monitoring (radial arterial line)

Cardiology (19 decks)

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