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Lottie's DPD 2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is S3?

A

Rapid ventricular filling due to ventricular dilatation

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2
Q

What is S4?

A

Sound of atrial contraction in ventricular hypertrophy

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3
Q

Who can have S3 physiologically?

A

Really fit athletes

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4
Q

Contrast ventricular hypertrophy and ventricular dilatation

A 
VH = HTN causes muscle to push really hard and become thicker inwards 
VD = failing heart becomes baggy outwards
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5
Q

Ventricular hypertrophy on ECG?

A

Tall R waves

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6
Q

Ventricular dilatation on CXR?

A

Cardiomegaly

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7
Q

Which state is S3?

A

Kentucky

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8
Q

Which state is S4?

A

Tenesse

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9
Q

What is gallop rhytm?

A

FOUR heart sounds

Have HTN & heart failure so have 4 1 2 3

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10
Q

BMI <18. Dx?

A

Underweight

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11
Q

What is healthy BMI?

A

18.5 - 24.9

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12
Q

Overweight BMI?

A

25-29.9

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13
Q

Obese BMI?

A

30-34.9

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14
Q

Morbid obese BMI?

A

40-50

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15
Q

Why is a BMI of 24 not necessarily healthy?

A

If Asian, >23 is a huge risk factor

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16
Q

Unfit man with BP 200/120. He wants to go the gym. What should you say to him?

A

Low salt diet

BP treatment if persistently high

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17
Q

List signs of chronic HTN

A

S4
Flame haemorrhages / AV nipping on fundoscopy
Heave
Bruits

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18
Q

What BP reading would you be worried about enough to send to A&E?

A

If diastolic >140

19
Q

List the grades of HTN retinopathy

A 
SAFE 
1= Silver wiring 
2= AV nipping 
3= Flame haemorrhages 
4= papilloEdema
20
Q

What is silver wiring?

A

Silver line in middle of arteries coming off blind spot

21
Q

What is AV nipping?

A

Artery crosses vein and causes vein to squish due to really high pressure in artery

22
Q

What can also be present with flame haemorrhages?

A

Cotton wool spot

23
Q

What does cotton wool spot mean?

A

Ischaemia in the retina

24
Q

What does papilloedema look like?

A

Edge of disc isn’t visible

25
Q

What does papilloedema mean?

A

Pressure in CSF is high - can be due to really high HTN or space occupying lesion causing raised ICP

26
Q

Are hard exudates part of HTN retinopathy?

A

NO - they are diabetic features

27
Q

What are the Sx of retinopathy?

A

NONE - patients will just suddenly go blind

28
Q

What are signs of LV hypertrophy on examination?

A

NONE - only detected on ECG

29
Q

What does HTN retinopathy show?

A

Pt has had HTN for a long time

30
Q

List secondary causes of HTN

A 
Phaeochromocytoma  
Acromegaly 
Renal artery stenosis 
Cushings 
Drugs - eg cocaine 
Conns 
Coarctation of aorta
31
Q

What is essential HTN?

A

Ppl that just have HTN due to poor diet / randomly - they just need normal HTN medication

32
Q

What basic Ix need to be done after HTN found?

A 
FBC 
U&E 
ECG
Urinalysis
Fasting glucose 
Lipid profile
33
Q

Why would you do a FBC?

A

Look for polycythaemia

34
Q

Why would you do U&Es?

A

K might be low in Conns etc

Renal function might be affected

35
Q

Why would you do an ECG?

A

LV hypertrophy

36
Q

Why would you do urinalysis?

A

Nephritis or renal disease

37
Q

HTN with high aldosterone but low renin. Dx?

A

Conn’s

38
Q

HTN with high aldosterone and high renin. Dx?

A

Renal artery stenosis

39
Q

What causes renin secretion?

A

Pressure on juxtaglomerular artery

40
Q

Which drug should be used in patients with DM who have microalbuminaemia ?

A

ACE i

41
Q

What drug is available to statin intolerance?

A

Ezetemibe

Evolocumab

42
Q

Side effects of statins?

A

Muscle aches - but might be psychological

43
Q

What drugs are -mab ?

A

Monoclonal antibodies

44
Q

Which group of patients will benefit from evolocumab?

A

Familial hypercholesteralaemia

Lottie's DPD 2 (10 decks)

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