hypertension

Question 1

what is white coat hypertension

Answer 1

spike in BP when it is measured at the doctors

Question 2

what is masked hypertension

Answer 2

normal BP in the clinic but elevated BP out of clinic

Question 3

does BP have diurinal variation

Answer 3

yes

Question 4

when would you prescribe a Ca channel blocker first

Answer 4

> 55

black african or caribbean

Question 5

effect of high BP on the brain

Answer 5

stroke - causes cerebral haemorrhage

Question 6

effect of high BP on eyes

Answer 6

impaired vision - hypertensive retinopathy

retinal arterioles may become occluded or leak - oedema, haemorrhages, infarcts, microaneurysms

Question 7

what is optic neuropathy

Answer 7

oedema of the optic disc - papilloedema
associated with flame haemorrhages
grade IV retinopathy

Question 8

what is retinal vein thrombosis often followed by

Answer 8

glaucoma - inc intraocular pressure

Question 9

effect of high BP on kidneys

Answer 9

narrowing and thickening of renal arteries

filter less fluid - nitrogenous waste builds up in the body

Question 10

effect of inc BP on the atrial tree

Answer 10

internal elastic lamina thickening and SM hypertrophy and fibrosis
smaller arteries show hyaline sclerosis which narrows the lumen

Question 11

when to suspect 2y hypertension

Answer 11

young patients with acute onset

Question 12

what is 2y hypertension often due to

Answer 12

history of renal or endocrine cause

Question 13

what is conn’s syndrome

Answer 13

excess aldosterone

Question 14

what is cushing’s syndrome

Answer 14

excess corticosteroid

Question 15

what is phaecromocytoma

Answer 15

excess noradrenaline

Question 16

what do berry aneurysms cause

Answer 16

subarachnoid haemorrhages

Question 17

how many measurements per hour must ABPM give

Answer 17

at least 2

Question 18

how must measurements be taken for HBPM

Answer 18

two consecutive seated measurements, 1 minute apart

BP is recorded twice a day for at least 4 days and preferably for 7 days

Question 19

what is the target BP for people under 80

Answer 19

140/90

ABPM - 135/85

Question 20

what is the target BP for people over 80

Answer 20

150/90

ABPM - 145/85

Question 21

what is the pathological hallmark of accelerated hypertension

Answer 21

accelerated microvascular damage

Question 22

how does cushing syndrome present

Answer 22

moon face, buffalo hump and proximal weakness

Question 23

investigation - urine dipstick

Answer 23

haematuria and proteinuria

Question 24

what would be the most useful investigation in assessing CV risk

Answer 24

fasting lipids

Question 25

what is seen on ECG

Answer 25

LV hypertrophy