Hypertension

Question 1

Treatment choices

Answer 1

Acei - ramiPRIL
ARB - Lorsartan
Loop diuretic - hydrochlorothiazide - systolic BP
Beta-blockers - metoprolol
Ca channel blockers - Amlodipine

Question 2

Diabetic BP goals

Answer 2

<130/80

Question 3

Causes of Htn

Answer 3

Diabetes
Coarctation of the aorta - bicuspid aortic valve, early systolic click and murmur over the aortic area
- discrepancy btw upper and lower limb BP
Cushings - centripetal obesity, abdominal striae, hyperglycemia
Primary hyperaldosteronism - unexplained low K, elevated serum bicarb level (that does not improve with hydration
Pheochromocytoma - episodic HA, sweating, tachycardia, anxiety, tremor, paroxysmal htn
OSA - snoring, sleepiness, neck circumference
Pre-eclempsia

Question 4

Treatment for pre-eclempsia

Answer 4

Methyldopa

Question 5

Elevation of serum creatinine after Ace-i

Answer 5

• increase in serum creatinine concentration > 20% after ACE inhibitor therapy is highly suggestive of renal artery stenosis

Question 6

Primary hyperaldosteronism

Answer 6

Excess serum aldosterone:

• sodium sensitive hypertension
• concomitant hypokalemia due to renal potassium wasting

Question 7

Hypertensive emergency treatment - end organ damage

Answer 7

IV nitroprusside (vasodilator)