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MB1: Cardio > Hypertension > Flashcards

Hypertension Flashcards

1
Q

true/false - automatic BP machines still work if pulse is irregular

A

false - do a manual pressure

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2
Q

in what environment would you ideally do a BP reading?

A

quiet, relaxed environment with patient seated

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3
Q

Is a clinic BP good enough to diagnose hypertension?

A

no, you have to take a ABPM or HBPM

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4
Q

what is ABPM

A

Ambulatory blood pressure measuring

2 readings per hour for a patients waking day

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5
Q

what is HBPM

A

Home blood pressure measuring
3 readings twice a day for 7 days
Lowest value taken

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6
Q

what is white coat hypertension

A

high blood pressure in clinic that is not normally high

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7
Q

what is masked hypertension

A

low blood pressure in clinic that is normally high

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8
Q

What is stage I hypertension

A

clinic BP - 140/90 mmHg

ABPM/HBPM - 135/85 mmHg

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9
Q

what is stage II hypertension

A

clinic BP - 160/100 mmHg

ABPM/HBPM - 150/95 mmHg

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10
Q

what is severe high blood pressure

A

clinic BP - 180/110 mmHg

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11
Q

Does everyone with hypertension get treatment?

A

no, only those with stage II or stage I with suspected organ failure or CVD risk factor >20%

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12
Q

in addition to testing for CVD risk, what other tests would you do?

A 
Fundoscopy 
12-lead ECG
urinalysis for protein 
glucose fasting 
creatinine/albumin
U+E
cholesterol and TAG
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13
Q

end organ damage signs and types

A

LVH - ST depression and raised QRS
Albuminuria - renal failure
hypertensive retinopathy
raised creatinine

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14
Q

what causes hypertension

A

secondary causes
genes
environment

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15
Q

a -5 mmHg diastolic pressure causes…

A

decrease in stroke by 40% and CHD risk by 25%

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16
Q

Causes of secondary hypertension

A 
OSA
renal disease
renovascular disease
fibromuscular dysplasia 
cushing's 
phenochromocytoma 
hyperparathyroidism 
aortic coarctation
intracranial tumour 
Conn's syndrome
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17
Q

ways to non-pharmacologically reduce CV risk

A 
Reduce alcohol consumption
smoking cessation
lose weight if obese
reduce salt intake 
DASH diet
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18
Q

how many people have a salt sensitivity relating to BP?

A

25%

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19
Q

If a high risk normotensive with normal cholesterol was in your practice, would you prescribe a statin to lower both?

A

yes!

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20
Q

first line antihypertensive for under 55

A

ACEI or ARB or BB for pregnant/fertile women

21
Q

first line antihypertensive for over 55/black patient any age

A

CCB or diuretic

22
Q

second line antihypertensives if response nil

A

ACEI/ARB and CCB OR ACEI/ARB and diuretic

23
Q

third line antihypertensives if response nil

A

ACEI/ARB, CCB and diuretic

24
Q

antihypertensives if all other lines fails

A

alpha/beta blocker

Spironolactone if resistant - low slow dose

25
Q

what are the drug treatment targets for hypertension

A

<65 - 140/90, 130/80 if tolerated
>65/diabetic - 130-140/90 but not under 120 mmHg
very old - 130-140 but not under 130 mmHg

26
Q

is upping a dose or adding a drug better?

A

adding a drug

27
Q

how do NSAIDS cause increase in BP

A

salt retention

28
Q

true/false - systolic BP increases with age

A

true

29
Q

true/false - diastolic BP increases with age

A

false - it increases with age and then decreases

30
Q

what happens if HTN is untreated?

A

it becomes resistant due to vascular and renal damage

31
Q

hypothyroidism is directly linked to high BP

A

not really, it causes dyslipidaemia due to high triglycerides so increases CV risk

32
Q

what would a renal ultrasound/MRA/TTE reveal and who would it be done in?

A

fibromuscular dysplasia

9 times more common in women

33
Q

why do older people have a higher therapeutic target for BP

A

pulse pressure widens with age as diastolic pressure drops

if BP lowered too much coronary arteries will not be effectively perfused

34
Q

if an expecting mother has a high BP would you aggressively lower it?

A

no, it can be adverse on foetus

35
Q

can you give ARB/ACEI in breastfeeding

A

no, its not been tested to be safe yet

36
Q

where is pre-eclampsia most common following a mother with a previous Hx pre-eclampsia

A

HELLP

37
Q

why do you treat high hypertriglyceridaemia

A

to prevent acute pancreatitis

38
Q

if you put a patient on an ACEI, ARB or spironolactone what MUST you tell them

A

not to take it if you have had diarrhoea, vomiting or dehydration
Renal function must be annually monitored
Watch out for dry cough

39
Q

conns syndrome causes excess ____

A

aldosterone

40
Q

cushings syndrome causes excess ___

A

corticosteroid

41
Q

phaeochromocytoma causes excess ___

A

noradrenaline

42
Q

how does renal failure or stenosis cause hypertension

A

less blood flow to kidneys so increased renin release to increase fluid retention

43
Q

effect of hypertension on eyes

A

can cause hypertensive retinopathy

may lead to papillary oedema

44
Q

effect of hypertension on brain

A

can cause stroke or TIA
headache due to raised ICP
subarachnoid harmorrhage due to ruptured berry aneurism

45
Q

effect of hypertension on heart

A

causes LVH leading to ischaemia due to muslce hypertrophy with no increased blood flow
causes left heart failure sometimes causing right heart and overall congestive heart failure

46
Q

effect of hypertension on kidneys

A

high pressure may cause kidney failure/disease

47
Q

malignant hypertension has diastolic pressure >…

A

130-140 mmHg

48
Q

malignant hypertension may cause

A

cerebral haemorrhage
fibrinoid necrosis in blood vessels
acute renal and heart failure
papillary oedema in retina

49
Q

effect of hypertension on blood vessel

A

plasma proteins forced into vessel wall to cause hyaline atherosclerosis
hypertrophy T media

MB1: Cardio (17 decks)

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