Hypertension Flashcards

Question 1

Q

Symptoms

Answer

A

End organ damage

Headaches and nose bleeds not really caused by it but common

Question 2

Q

Stage 1 definition

Answer

A

140/90
AND
ABPM 135/85

Question 3

Q

Stage 2 definition

Answer

A

160/100
AND
ABPM 150/95

Question 4

Q

Stage 3 definition

Answer

A

Systolic >180

Diastolic >110

Question 5

Q

Malignant hypertension

Answer

A

BP>180/110

Papilloedema or retinal haemorrhages

Question 6

Q

Postural hypotension

Answer

A

measure BP seated or supine
stand patient for 1 minute
systolic drops by more than 20mm

Question 7

Q

ABPM

Answer

A

24 hour
take BP 3 times an hour during day
hourly at night
night should dip, if not = worse prognosis
home monitoring acceptable alternative

Question 8

Q

Who should be offered ABPM

Answer

A

All patients

Question 9

Q

What to ask about in HPC?

Answer

A

pregnancy
the pill
BP check for work -e.g. HGV

Question 10

Q

What to ask about in PMH?

Answer

A

diabetes
CVA
MI
renal disease

Question 11

Q

What to ask about in FH?

Answer

A

cause and age of death
MI and CVA specifically
parents and siblings

Question 12

Q

What to ask about in SH?

Answer

A

smoking
alcohol
salt
dairy
5 a day
exercise
caffeine
snoring

Question 13

Q

What to ask about in CV systems review?

Answer

A

angina
claudication
exercise tolerance
erectile function

Question 14

Q

What to ask about in systems review for women?

Answer

A

pregnancy plans

- contraception

Question 15

Q

What to do on examination/

Answer

A

both arms
APBM before starting treatment
end organ damage signs = eyes, proteinuria
secondary causes = cushings, coarctaton, RAS

Question 16

Q

What investigations

Answer

A

ABPM
Urinalysis
U&amp;E
Lipids
FUndi
ECG
Weight
Secondary care = ECHO, urinary cats, renin/aldo, renal/liver US

Question 17

Q

Artifact causes

Answer

A

White coat

wrong cuff size

Question 18

Q

Diagnosis of exclusion

Answer

A

genetic
city living
alcohol
obesity
salt
lack of exercise
OSA

Question 19

Q

2ry causes

Answer

A

phaeo
cushings
OSA
obesity
conns
renal disease
RAS
drugs = OC, steroids, recreational

Question 20

Q

Heart end organ damage

Question 21

Q

Brain end organ damage

Question 22

Q

Kidney end organ damage

Answer

A

Nephrosclerosis

Accelerates other forms of kidney disease

Question 23

Q

End organ damage e.g.

Answer

A

Brain
Heart
Kidney
Legs
ED
(depends on ethnicity)

Question 24

Q

Stage 1 management

Answer

A

asses CV risk
if target organ damage or 20% risk = drugs
lifestyle

Question 25

Q

Stage 2 management

Answer

A

APBM check

- drugs and lifetsyle

Question 26

Q

Stage 3 management

Answer

A

treat now

Question 27

Q

DRUGS

Answer

A

ACEi/ARB
CCB
diuretics

Question 28

Q

CI for ACEi/ARB

Answer

A

check pregnancy plans
under 55
not as monotherapy in africans or caribbean

Question 29

Q

CI for CCB

Answer

A

over 55
African or caribbeans
caution if worried about HF or oedema

Question 30

Q

Targets

Answer

A

under 80 = 140/90
over 80 = 150/90
end organ damage, diabetic, renal disease = 130/80

Question 31

Q

Other drugs

Answer

A

spironolactone
beta blockers
alpha blockers
moxonidine (centrally acts)
renin inhibitors

Question 32

Q

Which drugs to use in pregnancy

Answer

A

labetolol
methyldopa
nifedipine

Question 33

Q

Surgical treatments

Answer

A

renal denervation

- AV fistula