hypertension and shock

Question 1

what is the diagnostic criteria for hypertension

Answer 1

look for modifiable and non-modifiable risk factor, history of endocrine disorders, sleep apnea, drug use and medications

Question 2

Stage 1 hypertension

Answer 2

SBP 130-139 DBP 80-89

Question 3

Stage 2 hypertension

Answer 3

SBP above 140 DBP above 90

Question 4

hypertension and hypertensive urgency will not ___________

Answer 4

demonstrate acute targeted-end organ damage

Question 5

pharmacologic management is indicated for____________

Answer 5

stage 1 HTN with CV disease or
stage 2 HTN with no history of CV disease

Question 6

first line oral anti hypertensive

Answer 6

thiazide diuretics, ACE, ARB’s, CCB

Question 7

second line oral anti hypertensive

Answer 7

loop diuretic, aldosterone antagonist, alpha 1 blockers, beta blocker, central alpha agonist, direct vasodilators

Question 8

Rapid acting anti hypertensive medications

Answer 8

clonidine and captopril

Question 9

hypertensive emergency needs

Answer 9

ICU admission

Question 10

Hypertensive emergency situation
blood pressure should reduced no more than

Answer 10

25% in the 1st hour
160/100 in the next 2-6 hours
normal in the next 24-48 hours

Question 11

drug of choice for aOrtic DisectiOn

Answer 11

esmOlOl, labetOlOl (two O)

Question 12

drug of choice for Acute pulmonary edema

Answer 12

Clevedipine, NTG, Nitroprusside (CNN)

Question 13

drug of choice for Acute coronary syndrome

Answer 13

esmolol, labetalol, nicardipine, nitroglycerine

Question 14

drug of choice for acute renal failure

Answer 14

clevidipine, fenoldopam, Nicadipine,

Question 15

drug of choice for Catecholamine excess states

Answer 15

Clevidipine, nicardipine, phentolamine

Question 16

drug of choice for acute ischemic stroke

Answer 16

labetalol, clevedipine, nicardipine

Question 17

drug of choice for Acute ICH

Answer 17

labetalol, clevedipine, nicardipine,

Question 18

Dihydropyridine CCB examples

Answer 18

cardene 5-15mg/hr ; clevedipine 2-32 mg/hr max dose

Question 19

vasodilators examples

Answer 19

Na Nitroprusside 0.3-0.5 max 10 mg/kg/min
NTG 0.5-20 mcg/min
hydralazine 10 mg (max 20) q4-6 hours

Question 20

Adrenergic Blocker example

Answer 20

Esmolol 500-1000 mcg/min load then 50-200 mcg/kg/min

labetalol 0.3-1 mg/kg max max 300 mg

phentolamine 5 mg q10 min

Question 21

dopamine receptor selective antagonist example

Answer 21

Fenoldopam 0.1-1.6 mcg

Question 22

Ace inhibitor example

Answer 22

enalapril 1.25 mg max 5 mg q6

Question 23

african american anti-hypertensive meds include

Answer 23

thiazide diuretics and CCB

Question 24

non modifiable risk

Answer 24

age - below 45:male
45to 64: equal
65 above: female

sex

race and ethnicity : African American

hereditary

Question 25

Modifiable risk

Answer 25

sedentary lifestyle, obesity BMI > 30 Increase sodium intake increase alcohol consumption tobacco use HLD, high LDL,TC >240, low HDL DM

Question 26

Anti-HTN medication Preferred in patients with DM

Answer 26

ACE inhibitor because of renal protective properties/ may use arbs

Question 27

Decrease heart rate, cardiac output and renin release

Answer 27

beta blockers

Question 28

indication for use of ACE/ARBs side effect of ACE/ARBS ends in -PRIL

Answer 28

DM, CHF, POST MI, schleroderma, white people angioedema, cough, hyperkalemia, hyponatremia, increase crea

Question 29

indication for use of beta blockers side effect of betablockers

Answer 29

POST MI, CHF, white people bradycardia, hypotension, increase lipid level, increased depression, increased asthma, copd with bronchospasm, increased potassium

Question 30

indication for use of CCB and diuretics side effect of calcium channel blockers

Answer 30

AA, ELDERLY DIHYDROPYRIDINE ( ends in -pine) cause peripheral vasodilation Non- DIHYDROPYRIDINE ( dilt, verapamil) - decrease inotrope -edema in Lower extremities -constipation -heart failure

Question 31

HCTZ WILL INCREASE

Answer 31

calcium, uric acid, lipids, Glucose, decrease potassium, increase creatinine,

Question 32

lasix will decrease

Answer 32

calcium and potassium.

Question 33

alpha 1 blockers -ends in osin

Answer 33

-reduce blood pressure -can be use in PTSD -side effect is first dose hypotension -BPH

Question 34

ALPHA 2 AGONIST example

Answer 34

clonidine- inhibits norepinephrine release -help opiod withrawal -

Question 35

nitrates can cause

Answer 35

venodilation and vasodilation -choice for myocardial ischemia