Hypertension

Question 1

Examples of ACE inhibitor

Answer 1

Ends in pril
Captopril
Prindopril

Question 2

Examples of ARB

Answer 2

Sartan
Olmesartan
Valsartan

Question 3

Example of Ca channel blocker

Answer 3

Ends in pine
Amlodipine
Felodipine
Or
Verepamil

Question 4

Example of thiazides

Answer 4

Chlorathiildone
Hydrochlorothiazide
Indapimide

Question 5

Examples of Beta blocker

Answer 5

End in lol
Propranolol
Metoprolol

Question 6

Side effects of ACE inhibitor

Answer 6

Cough
Hyperkalemia
Renal Impairment
Angiodema

Question 7

Side effects of ARB

Answer 7

Hyperkalemia
Renal impairment
Rare- cough and angiodema

Question 8

Side effect of Ca channel blocker (dihydropiradine)

Answer 8

Peripheral vasodilation —> odema (don’t treat with diuretic)
Postural hypertension 
Tachycardia
Chest pain 
Palpitation 
Gingival hyperplasia

Question 9

Side effects of Ca channel blocker (non-dihydropyradine)

Answer 9

Bradycardia - because reduces HR and cardiac contractility
Constipation (severe with verapamil)
AV block
Heart fail

Question 10

Side effects of Thiazides

Answer 10

Hypokalemia
Hyponatremia
Postural hypertension
Dizziness
Hyperuricalcemia 
Hyperglycemia

Question 11

Side effects of Beta blocker

Answer 11

Bradycardia
Postural hypertension 
Worsening HF
Bronchospasm
Cold extremities

Question 12

Contraindications of ACE/ARB

Answer 12

Pregnancy
Hyperkalemia
Bilateral renal artery stenosis

Question 13

Contraindication for thiazides

Answer 13

Gout

Age

Question 14

Contraindication for Beta blocker

Answer 14

Asthma
Bradycardia
AV block

Question 15

Combination for hypertension and diabetes

Answer 15

ACE/ARB and Ca channel blocker

Question 16

Combination for hypertension post stroke or HF

Answer 16

ACE/ARB + diuretic

Question 17

Combination post MI or HF

Answer 17

ACE/ARB + Beta blocker

Question 18

Combinations to avoid

Answer 18

ACE + ARB —> renal impairment

Verapamil + beta blocker —> risk of heart block

Question 19

What is more dangerous, high systolic or high diastolic

Answer 19

High systolic - indicates left ventricular hypertrophy esp if patient >50 years old

Question 20

End organ damage in HT

Answer 20

Heart - ischemic heart disease, congestive heart failure
CNS - TIA, stroke
Kidney- hypertensive nephropathy
Eyes - hypertensive retinopathy
Vessels - athrosclorosis

Question 21

Prehypertensive range

Answer 21

120-139/80-89

Question 22

Risk management in prehypertensive range

Answer 22

Change in lifestyle
Physical activity increase
smoking avoidance
hyperlipidemia mangement
stress mangement
weight mangement
salt reduction 
more fruits and veggies
relax

Question 23

Types of HT

Answer 23

1. Essential/Idiopathic HT (Primary)

2. Secondary HT

Question 24

What determines the systolic BP (CO or TRP)

Answer 24

cardiac output

Question 25

BP=

Answer 25

CO x TRP

Question 26

Systolic BP relation to heart

Answer 26

ventricular squeeze in presence of open valves = systolic BP, because no resistance, the BP can be read in arteries

Question 27

Diastolic BP relation to the heart

Answer 27

no relationship, because valve closed. related to TRP and the amount of blood left

Question 28

Changes in systolic indicate

Answer 28

changes in CO

Question 29

Changes in diastolic indicate

Answer 29

changes in TRP or vessel dilation/contriction

Question 30

What influences CO

Answer 30

1. Blood volume | 2. Cardiac factors

Question 31

What influences BV

Answer 31

Na intake mineralocorticoid like aldosterone atriopeptides ANP = vasodilation

Question 32

What cardiac factors influence CO

Answer 32

Heart rate contractility anxiety (increases symp = increase HR and contractility)

Question 33

What influences TRP

Answer 33

Humoral factors - dilators | Neural factors

Question 34

What causes the release of Renin

Answer 34

Reduced renal perfusion can be due to reduced BP or due to stenosis Overall - reduced Na in macular densa in DCT (because slowly flowing waste = increases Na retention)

Question 35

Where is Renin released from

Answer 35

Juxtaglomerulo apparatus, which is modified afferent from arterioles and macular densa from DCT

Question 36

What happens to Renin

Answer 36

converted to angiotensin 1 by angiotensinogen (from the liver)

Question 37

What happens to Angiotensin I

Answer 37

converted to angiotensin 2 by ACE (angiotensin converting enzyme) from the lungs

Question 38

What are the effects of Angiotensin II

Answer 38

Thirst - hypothalamus Vasoconstrictor - Arterial = increase TRP, venous increases CO Aldosterone release - from zonaglomulosa --> acts on principle cell to increase H2O and Na rentention thus increasing CO