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Clin Med 2 > hypertension > Flashcards

hypertension Flashcards

0
Q

HTN findings on physical exam?

A

fundoscopy: hemorrhage, papilledema, cotton wool spots
rhonchi, rales
renal masses, bruits

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1
Q

clinical presentation of secondary hypertension (symptoms)

A

muscle weakness, tachycardia, sweating, tremor, thinning of the skin, flank pain, confusion

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2
Q

rx management of HTN? (8)

A

diuretics, Ca2+ channel blockers, ACE inhibitors/ARB, B-blockers, direct renin inhibitor, central a-agonists, a-blockers

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3
Q

thiazide diuretic electrolyte effects

A

decrease K+, Mg2+, Na+

increase Ca2+

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4
Q

thiazide diuretic contraindication

A

sensitivity to sulfonamide-derived drugs

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5
Q

loop diuretic?

and the risk?

A

furosemide

hypokalemia- supplement K+

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6
Q

K+ sparing diuretic?
tx guidelines?
contraindications?

A

Triamterene
Weak anti-HTN, used w/ thiazide
Contraindicated in hepatic disease, renal failure, hyperkalemia

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7
Q

aldosterone antagonist?

side effects?

A

spironolactone

gynecomastia & hyperkalemia

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8
Q

aldosterone antagonist contraindications? (3)

A

renal impairment
DM w/ proteinuria
hyperkalemia

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9
Q

Ca2+ channel blocker? MOA?

A

-dipine

inhibition of Ca2+ influx into myocardial & vascular smooth muscle cells, decreasing resistance, causing vasodilation

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10
Q

Ca2+ channel blocker contraindication?

A

acute MI
acute HTN- nifedipine
heart conditions: AV block, cardiogenic shock, heart failure, ventricular tachycardia, etc

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11
Q

ACE inhibitors? MOA?

A

-pril

inhibit the RAAS & stimulate bradykinin –> vasodilator effect

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12
Q

ACE inhibitor indication? (4)

A

chronic kidney disease
DM
heart failure
post-MI

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13
Q

ACE inhibitor side effects? (4)

A

cough
hyperkalemia
angioedema
acute renal failure

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14
Q

ACE inhibitor contraindications? (3)

A

pregnancy
angioedema
renal a. stenosis

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15
Q

ARBs? MOA?

A

-sartan

inhibit the RAAS system

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16
Q

ARB side effects? (3)

A

hyperkalemia
angioedema
acute renal failure

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17
Q

ARB contraindications? (2)

A

pregnancy

renal aa. stenosis

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18
Q

direct renin inhibitor?

A

Aliskiren (Tekturna)

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19
Q

direct renin inhibitor side effects? (3)

A

hyperkalemia
renal impairment
hypersensitivity reactions

20
Q

direct renin inhibitor contraindications (2)

A

use w/ ACE-I or ARB in diabetics

pregnancy

21
Q

central alpha agonists (2)

A

clonidine

methyldopa

22
Q

central alpha agonist side effects? (3)

A

anticholinergic side effects: dry mouth, hot red skin, urinary retention
bradycardia
orthostatic hypotension

23
Q

methyldopa contraindication & ok?

A

ok for pregnancy

not for liver disease

24
Q

alpha blockers? and usage guidelines?

A

-zosin

use in mild to moderate HTN & not for monotherapy

25
Q

B-blockers?

effects?

A

-lol

decreased CO, PVR, renin activity

26
Q

B-blockers cautions (3) & contraindications (4)?

A

caution: asthma/COPD, DM, depression
contraindications: AV block, cardiogenic shock, CHF, hypotension

27
Q

hypertensive urgency?

A

180/120

asymptomatic- usually due to treatment non-adherence

28
Q

hypertensive emergency?

A

180/120

associated w/ acute end-organ damage

29
Q

ocular damage, encephalopathy, brain infarct, hemorrhage, aortic dissection, LV failure, MI, acute glomerulonephritis
are signs of?

A

end-stage organ damage secondary to HTN

30
Q

failure to achieve a BP goal in a patient adhering to a full dose tx of a 3 drug regimen, incl HCTZ?

A

resistant HTN

31
Q

resistant HTN causes? (5)

A 
improper BP measurement
volume overload/retention
medication/drug induced
obesity
excess EtOH
32
Q

requirements for resistant HTN? (3)

A

3 dose regimen
full doses
including HCTZ

33
Q

hypertensive urgency tx (3)

A

gradual reduction to < 160/100
Rest, increase doses of meds, Sodium reduction
SL nifedipine is contraindicated

34
Q

HTN emergency tx? (3)

A

hospitalized in ICU
BP goal of 160/100 over 2-6h.
IV Nitro

35
Q

when end organ damage hits the eye

A

malignant HTN

36
Q

marked HTN w/ retinal hemorrhages, exudates, or papilledema

A

malignant HTN

37
Q

HCTZ is a?

A

thiazide diuretic

38
Q

furosemide is a?

A

loop diuretic

39
Q

Triamterene is?

A

K+ sparing diuretic

40
Q

Spironolactone?

A

aldosterone antagonist

41
Q

-dipine

A

Ca2+ channel blockers

42
Q

-pril

A

ACE inhibitor

43
Q

-sartan

A

ARBs

44
Q

Aliskiren (Tekturna)

A

direct renin inhibitor

45
Q

clonidine, methyldopa

A

Central Alpha Agonists

46
Q

-zosin

A

Alpha blockers

47
Q

-lol

A

B-blockers

Clin Med 2 (8 decks)

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