Hypertension

Question 1

What is stage 1 hypertension

Answer 1

140/90 - 160/100

Question 2

What is stage 2 hypertension

Answer 2

160/100-180/120

Question 3

What is stage 3 hypertension

Answer 3

More than 180

More than 120

Question 4

Hypertension diagnosis

Answer 4

Question 5

Hypertension NICE guidelines

Answer 5

Question 6

Overview

Answer 6

Question 7

Hypertension in pregnancy

Answer 7

1st line - labetolol
(100mg BD) - usual dose is 200mg daily in 2 divided doses. Take with food

2nd line - nifedipine

3rd line - methyldopa

Question 8

What is used for hypertension when breastfeeding |

Answer 8

Enalapril maleate

(monitor renal function and potassium)

Question 9

What is the target in pregnancy

Answer 9

140/90

Question 10

What is the target in renal disease (CKD)

Answer 10

140/90

Question 11

What is the target in Renal disease and diabetes together

Answer 11

130/80

Question 12

Type 1 diabetes target

Answer 12

135/85

Question 13

Same day specialist referral

Answer 13

180/120

Question 14

Age less than 80

Answer 14

140/90

Question 15

Age 80 or more

Answer 15

150/90

Question 16

What betareceptors are found in the heart

Answer 16

B1

Question 17

What Beta receptors are found in the lungs

Answer 17

B2

Question 18

Which ones have less coldness and less bradycardia

Answer 18

ICE PACO

Pindolol
Acebutalol
Celiprolol
Oxprenolol

Question 19

Water soluble beta blockers

Answer 19

CANS

Celiprolol
Atenolol
Nadolol
Sotalol

Question 20

Cardioselectove beta blockers (less effect on B2, less respiratory problems

Answer 20

B A MAN

Bisoprolol
Atenolol
Metropolol
Nebivolol

Question 21

Long duration of action

Answer 21

BACN

Bisoprolol
Atenolol
Celiprolol
Nadolol

Give ONCE daily
Rest are short duration of action

Question 22

Name some SE of betablockers

Answer 22

Fatigue
Coldness
Sleep disturbances
Bradycardia
Hypo/hyperkalaemia
Masks symptoms of hypo
Look out for asthmatic patients

Question 23

What respiratory issue do beta blockers cause

Answer 23

Bronchospasm - keep an eye out for asthmatic patients, those with COPD etc

Question 24

What can beta blockers do to heart rate

Answer 24

Bradycardia - my be countered with atropine sulphate

Question 25

What do beta blockers interact with that increases risk of hypotension

Answer 25

Verapamil

Question 26

What can labetalol cause

Answer 26

Liver damage

Question 27

What BB is used in migraines and anxiety

Answer 27

Propranolol

Question 28

What BB is used in glaucoma

Answer 28

Timolol

Question 29

What BB is used in thyrotoxicosis

Answer 29

Propranolol

Question 30

What are some contraindications with BB

Answer 30

Asthma, COPD and bronchospasm (if no alternative then cardioselective) Marked bradycardia 2nd and 3rd degree AV block Uncontrolled HF

Question 31

What 2 CCBs should not be given in HF

Answer 31

Verapamil and Diltiazem

Question 32

What are some examples of CCBs

Answer 32

Amlodipine Felodipine Lacidipine Lercanidipine

Question 33

Common SE of verapamil

Answer 33

Constipation

Question 34

Should diltiazem be prescribed by same brand

Answer 34

yes

Question 35

What can sudden withdrawal of CCBs cause

Answer 35

Angina

Question 36

Side effects of CCBs

Answer 36

Ankle swelling, dizziness, flushing, headaches, postural hypotension

Question 37

Name 2 thiazide diuretics

Answer 37

Bendroflumethiazide, indapamide

Question 38

What is mechanism of thiazide d

Answer 38

Inhibit sodium reabsorption

Question 39

When should thiazide d be given

Answer 39

In the morning to avoid getting up during the night

Question 40

What side effects can thiazide d cause

Answer 40

exacerbate diabetes, gout, constipation, postural hypotension

Question 41

When should thiazide d be avoided

Answer 41

Severe liver disease

Question 42

What are 2 examples of loop diuretics

Answer 42

Furosemide, bumetanide

Question 43

Where are loop diuretics used

Answer 43

Pulmonary oedema

Question 44

How quickly do loops act

Answer 44

within the hour

Question 45

Can they interfere with sleep

Answer 45

no

Question 46

Where are loop contraindicated

Answer 46

hyponatremia, hypokalameia and liver chirrosis

Question 47

What can loops cause

Answer 47

tinnitus or deafness

Question 48

What 2 can turn urine blue

Answer 48

Furosemide Triamterene

Question 49

Give an example of potassium sparing diuretics

Answer 49

Spironolactone

Question 50

What should you not give with spironolactone

Answer 50

Potassium - severe hyperkalaemia

Question 51

What can cause gynaecomastia

Answer 51

Spironolactone

Question 52

How does ACE work

Answer 52

Inhibits conversion of angiotensin 1 to 2

Question 53

What are ACEs and Aliskiren contraindicated

Answer 53

Diabetes and egfr less than 60

Question 54

Is first dose hypotension possible with ACE

Answer 54

Yes

Question 55

What are the common side effects ACE

Answer 55

Dry cough (due to bradykinin), GI reactions, alopecia, angiodema

Question 56

Should you use NSAIDs with ACE

Answer 56

No

Question 57

What can ACE and potassium sparing diuretics cause

Answer 57

Hyperkalaemia

Question 58

When should you stop use of ACEs

Answer 58

Signs of liver damage

Question 59

Are ARBs less likely to cause dry cough

Answer 59

Yes

Question 60

Should ARBs and ACEs be avoided in pregnancy

Answer 60

Yes

Question 61

Can ARBs cause hyperkalaemia

Answer 61

Yes