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Cardio All > Hypertension > Flashcards

Hypertension Flashcards

1
Q

How is Cushing’s Syndrome related to secondary HTN?

A
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2
Q

What drugs are used for Migraine prevention, even if a PT does not have HTN?

A

BB and CCB are first line therapy for migraine prevention (with/without HTN)

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3
Q

Describe the Efficacy and ADRs for [Verapamil + diltiazem]

A
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4
Q

What is phentolamine used to treat?

A

Sympathetic Overdrive but has rebound tachycardia

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5
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
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6
Q

What is MOA for all drugs that end with -sartan?

A
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7
Q

Describe the MOA and efficacy for [Prazosin, terazosin, doxazosin]

A
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8
Q

What does Chronic hypertension do to the baroreceptor reflex?

A
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9
Q

What does this image of an arteriolar wall show?

A
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10
Q

Describe the directed PE for HTN crisis

  • BP measurements?
  • Pulses
  • Eye Exam?
  • Other Exams
A
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11
Q

What is the nocturnal dip?

What groups of people show a decreased nocturnal dip

A
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12
Q

What is malignant hypertension and what is it associated with?

A
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13
Q

Describe how α-Methyldopa works and its ADRs

A
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14
Q

What is the amount of salt req. every day?

A

1500 mg but people on average have 3400 mg

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15
Q

What kind of drug is Hydrochlorothiazide?

A

diuretic

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16
Q

Describe the MOA and PK s for [Verapamil + diltiazem]

A
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17
Q

If has a history of Gout and has HTN, what drugs do you not give them?

A

Diuretics

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18
Q

Describe the MOA, Efficacy, and ADRs for Nifedipine

A
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19
Q

If has a history of chronic kidney disease and has HTN, what drugs can you start them with?

A

ACE, ARB are 1st line therapy

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20
Q

Describe how “Blood Cells” are related to secondary HTN

A
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21
Q

Describe the MOA for Reserpine

A
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22
Q

What is Sodium nitroprusside used for?

What does it do to afterload and preload?

A
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23
Q

Describe how Angiotensin works

A
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24
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
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25
Q

Concerning reasons for secondary HTN and the memory device “ABCD”, what does D stand for?

A
  • D
    • Drugs
    • Diet
    • Dysfunctional Endocrine System
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26
Q

What are the ADRs/contraindications for Diuretics?

A
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27
Q

What group of drugs does the following describe?

A
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28
Q

What are the common reasons for HTN for the following age group?

Anyone over the age of 65

A
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29
Q

How do you confirm HTN?

A
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30
Q

Describe how α-Methyldopa works and its ADRs

A
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31
Q

What are the three main classes of Diuretics?

A
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32
Q

What are the pearls of HNT crisis Tx and what are the exceptions?

A
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33
Q

What percentage of HTN emergency is cardiac related and what percentage is cerebral related?

A
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34
Q

Describe the PKs and ADRs for propranolol

A
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35
Q

What is the major form of Peripheral resistance control?

A
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36
Q

What are the two types of HTN? Which is more common, what are the main causes of the more uncommon one?

A
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37
Q

Concerning reasons for secondary HTN and the memory device “ABCD”, what does A stand for?

A
  • A
    • Accuracy of measurement
    • Aldosteronism
    • Apnea
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38
Q

What are the common reasons for HTN for the following age group?

0-18 year olds

A
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39
Q

Describe how “Bad Kidneys” are related to secondary HTN

A
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40
Q

Describe the MOA and for Efficacy propranolol

A
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41
Q

Describe the MOA and Efficacy for Clonidine

A
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42
Q

How do Natriuretic peptides work?

A
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43
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
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44
Q

Why were the classes of HTN changed in 2017?

A
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45
Q

List and describe the two major types of Hypertension

A
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46
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
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47
Q

What are the common reasons for HTN for the following age group?

40-64 year olds

A
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48
Q

How does Chronic HTN relate to pregnancy?

A
  • tldr
    • HTN Dx in 1st 20 weeks
    • 5% of pregnancies
    • Increased with older women
    • Mild/Moderate: Do Not Treat
    • Severe: Treat
      • Over 160 SBP or 110 DBP
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49
Q

What are the Single-gene disorders associated with HTN?

A
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50
Q

How do Kidneys influence peripheral resistance and sodium
excretion/retention?

A
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51
Q

What are the Lifestyle (Non-Pharmacological) Modifications for Hypertension?

A
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52
Q

At what age do you treat pediatric HTN the same as adult HTN?

A

13

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53
Q

If you suspect an underlying cause of secondary HTN, what specific evaluations or labs do you want to find/conduct?

A
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54
Q

What are the benefits and ADRs for [Prazosin, terazosin, doxazosin]?

A
55
Q

Describe the Tx plan for a Hemorrhagic stroke

A
56
Q
  • Which of the following is the best predictor of stress on arterial walls?
    • Systolic BP
    • Diastolic BpP
    • Mean Arterial Pressure
A

MAP

57
Q

If a PT has diabetes with no nephron disease, what drugs can you start them with?

A
  • ACE, ARBs or CCBs
    • AVOID Diuretics
      • Diabties =/= Diuretics
58
Q

Describe the efficacy and PKs for Reserpine

A
59
Q

Describe what EDRF is and how it works

A
60
Q

What are the hallmarks of Cushing’s Syndrome?

A
61
Q

What areas of America have the highest prevalence of HTN? What about the world?

A

Southeast USA

Russia + Africa

62
Q

Describe how Aldosteronism can cause secondary HTN

A
  • Excessive secretion of aldosterone.
    • This disturbs the balance of sodium, potassium, and water in the blood and so leads to high blood pressure.
  • Primary Hyperaldosteronism aka (Conn’s Syndrome)
    • low K+
    • Resistant HTN on 3 meds
    • Due to
      • solitary adrenal tumor
      • bilateral adrenal hyperplasia
63
Q

What are the ADRs of Hydralazine?

A
64
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
65
Q

What type of HTN is necrotizing arteriolitis associated with?

Where does it occur?

A
66
Q

What does this slide of a renal artery show?

A
67
Q

What are the characters of Hyaline arteriolosclerosis

A
68
Q

What are the general outcomes of hypertension?

A
69
Q

Describe the leakage of plasma components in Hyaline arteriolosclerosis?

What occurs in the kidneys in this disease?

A
70
Q

Give the Tx and BP Goals for this Pregnancy-related-HTN

A
71
Q

Describe the PKs for ACE INHIBITORS

A
72
Q

Explain the process of a Directed Physical Exam for HTN patients

A
73
Q

Why has primary HTN increased in pediatric PTs and what would make you suspect secondary HTN in a pediatric PT?

A
74
Q

Describe how Bruits is related to secondary HTN

A
  • Bruit
    • turbulent flow in peripheral vessels
    • Suggested of Renal Artery Sclerosis
      • Difficult to control HTN with 3 meds
      • Older age with multiple risk factors for CAD
      • DO NOT GIVE PTs with Renal Artery Sclerosis an ACE inhibitor
        • This will lead to kidney failure and will be seen as a 20% drop in eGFR or 30% rise in serum Cr
    • Also suggestive of Fibromuscular dysplasia
      • Seen in young, healthy women.
      • Fibrous changes in lumen, narrowing of renal arteries
      • 2/3 of PTs have multiple arteries involved causing arterial aneurysms/narrowing/ tortuosity
      • “string of pearls” appearance angiographically
      • Fenetics (PHACTR1 gene/rs9349379 variant)
75
Q

If has a history of coronary artery disease or an MI and has HTN, what drugs can you start them with?

A
  • BBs are 1st line after MI
    • Metoprolol, nadolol, bisoprolol, propanol or timolol ONLY
  • ACE/ ARB
    • Use for stable CAD or Left ventricular heart failure
    • Can add thiazide diuretic or CCB (dihydropyridine only) if BP goal is not reached
76
Q

What are the uses of Minoxidil?

A
77
Q

Besides Rx, what other things do you recommend a PT who has HTN do?

A

DASH-1 decreases Bp by 11, DASH-2 by 16

78
Q

How does Diet cause secondary HTN?

A
79
Q

What determines stroke volume and what determines Heart rate and myocardial contractility?

A
80
Q

How do you treat HTN without Rx in pregnant women?

A
81
Q

What are the 4 types of HTN that are related to pregnancy?

A
  1. Chronic HTN
  2. Pre-Eclampsia or Eclampsia
  3. Pre-Eclampsia or Eclampsia + Chronic HTN
  4. Gestational HTN
82
Q

What are the common reasons for HTN for the following age group?

19-35 year olds

A
83
Q

How does each of the following conditions relate to secondary HTN?

  • End-stage renal disease (ESRD)
  • Renal Artery Stenosis
  • Pheochromocytoma (a rare tumor that usually starts in the cells of one of your adrenal glands)
A
84
Q

Describe the Tolerance development seen in Hydralazine use?

A
85
Q

Describe the general PKs of Diuretics

A
86
Q

If a PT has diabetes with nephron disease, what drugs can you start them with?

A

ARBS, or ACEI

87
Q

How does Pre-Eclampsia or Eclampsia relate to HTN during pregnancy?

A
  • Multi-organ disease that may be related to the placenta and autoimmunity
  • Need BP to be over 140/90 AND one of:
    • Proteinuria
    • Liver enzyme elevations
    • Renal insufficiency
    • Visual/Cerebral changes
    • Pulmonary edema
88
Q

What are the three forms of HTN?

A
89
Q

What are the benefits and ADRs for [Prazosin, terazosin, doxazosin]?

A
90
Q

What are the ADRs for Angiotensin receptor blockers?

A
91
Q

What is the MOA for Minoxidil?

A
92
Q

What glaring statistic shows that age greatly influences HTN?

A

A healthy 65-year-old who has no sign of HTN has a 95% chance of developing HTN in 20 years.

93
Q
  • When do BPs in pregnant women drop and when do they return to normal?
  • How is the prevalence of HTN-related pregnancy problems?
  • When do you treat chronic HTN in pregnant women?
A
94
Q

What are the safe options for Rx in pregnant women with HTN?

(Give the name of the drug as well as the class)

A

Nice Meth Labs

  • Labetalol
    • First Choice
    • NS Beta blocker with alpha 1 activity
  • Methyldopa
    • Alpha 2 agonist
  • Nifedipine
    • CCB
95
Q

Describe how the “Coarctation of the aorta” is related to secondary HTN

A
96
Q

What kind of drug is Chlorthalidone?

A

Diuretic

97
Q

What are the most common drugs that cause secondary HTN?

A

Tobacco, alcohol, anti-inflammatories

98
Q

Concerning reasons for secondary HTN and the memory device “ABCD”, what does B stand for?

A
  • B
    • Bruits (suggests RAS)
    • Bad kidneys
    • Blood Cells (Erythropoietin)
99
Q

Describe how Apnea can cause secondary HTN

A
  • Sleep apnea is the most COMMON cause of resistant hypertension (64%).
  • Until addressed, BP’s will not reach ideal BPs
  • See nocturnal dip
100
Q

How do ACEI/ARB’s cause renal function to decline in RAS?

A
101
Q

What are the current measurements for HTN stage 2?

What percentage of adults in America has HTN stage 2?

A
102
Q

Describe the MOA, Efficacy, and ADRs for Nifedipine

A
103
Q
  • What is HELLP syndrome?
    • How does it relate to HTN?
    • How many PTs with HELLP die?
A
104
Q
  • What is hypertension defined as?
A
105
Q

What is the first choice of drugs for HTN when a patient doesn’t have any medical contraindications?

Which drug is usually started first and what other drug is commonly taken with it?

What is important to keep in mind when prescribing these drugs?

A
106
Q
A
107
Q

If a PT is African America, what is drugs do you avoid when starting Tx for HTN? What drugs do you start them with?

A
  • African Americans
    • less responsive to ACEI & ARB’s
      • African American =/= ACEI or ARB
    • Start with diuretics and CCB
108
Q

What does this slide show?

A
109
Q

When would you use Diuretics?

  • Who do they work best on?
A
110
Q

What are Eclampsia and Pre-Eclampsia?

A
  • Eclampsia
    • the onset of seizures/convulsions in a woman with pre-eclampsia.
  • Pre-eclampsia
    • a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction. Onset may be before, during, or after delivery.
111
Q

What particular group of people has the worst control of HTN? What group has the best control of HTN?

A

Worst: Asian men

Best: White women

112
Q
  • What are the diastolic pressures that indicate hypertension?
  • What race has a high risk for hypertension?
  • What occurs in untreated hypertension in about half of patients?
A
113
Q

What happens to the vessels in Hyperplastic arteriolosclerosis?

A
114
Q

What is Endothelin and how does it work?

A
115
Q

Describe the Tx plan for an aortic dissection

A
116
Q

Describe the Tx plan for an ischemic stroke

A
117
Q

What are the ADR for Reserpine?

A
118
Q

Describe the ADRs for ACE INHIBITORS

A
119
Q

Describe how autoregulation and pH determine resistance in vessels?

A
120
Q

When do you treat pre-eclampsia?

A
  • Can use baby aspirin too
121
Q

Describe how angiotensinogen eventually affects blood vessel size and aldosterone

A
122
Q

What group of drugs does the following describe?

A
123
Q

What drugs do you avoid when prescribing Rx for pregnant women with HTN?

A

Played on my Nintendo-DS while waiting for AAA

  1. ACEI
  2. ARBS
  3. Atenolol
    • Beta Blocker
  4. Nitroprusside
    • Cyanide
  5. Spironolactone
    • Anti-androgenic
  6. Dieretics
    • Lowers placental perfussion
124
Q

How does a Dysfunctional Endocrine cause secondary HTN?

A
125
Q
  • In HTN crisis, what is considered HTN Emergency?
    • What symptoms are associated with it?
    • What subset of HTN Emergency is associated with death if undiagnosed if not treated correctly/right away?
A
126
Q

Describe the general mechanisms of Diuretics

A
127
Q

Describe how “Catecholamines” are related to secondary HTN

A
128
Q

What is the MOA and ADRs for Sodium nitroprusside?

A
129
Q

What is Gestational HTN?

A
  • HTN after 20 weeks
  • 1/2 of women get it
  • Usually resolves 6 weeks after birth
130
Q

What labs do you consider when you find that a PT has HTN?

A
131
Q

Describe how Aldosterone works

A
132
Q
  • In HTN crisis, what is considered HTN Urgency?
    • Who does it affect most?
A
133
Q

Concerning reasons for secondary HTN and the memory device “ABCD”, what does C stand for?

A
  • C
    • Catecholamines
    • Coarctation of aorta
    • Cushing’s Syndrome
134
Q

How do genetics play a part in HTN?

A
  • Parental HTN increases the chance of HTN in children
    • Chance increase more with age compared to others
    • Anywhere between 65% to 27% of essential HTN due to genetics.

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