Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

clinical cond 2 hypertension > hypertension & CAD > Flashcards

hypertension & CAD Flashcards

1
Q

modifiable risk factors for CAD

A
  • dislipidemia
  • smoking
  • hypertension
  • diabetes
  • obesity
  • thrombogenic factors
  • sedentary lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

non-modifiable risk factors for CAD

A
  • family history of CAD
  • age
  • sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

levels of risk associated with CAD

A
  • smoking
  • hypertension (DBP >90 mmHg)
  • serum total cholesterol level (>240 mg/dL)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

high blood pressure puts you at risk for what?

A

heart disease and stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hypertension increases RR by 2-4 fold for what

A
  • CAD, stroke, HF, PAD, AF, CKD
  • dementia: vascular, Alzheimer’s
  • mild cognitive deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

attributable risk for HTN

A
  • stroke (62%)
  • CKD (56%)
  • HF (49%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

who gets hypertension?

A
  • males > females up to age 64

- females > males after age 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HTN is more common and severe in what race?

A

African Americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

other risk factors for HTN?

A
  • positive family history
  • obesity
  • diabetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SBP or DBP more important as a CAD risk factor for persons over 50?

A

SBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hypertension fact/statistic

A

persons who are normotensive at age 55 have a 90% lifetime risk of developing HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cerebral perfusion autoregulation

A

persons with chronic hypertension have a higher MAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CNS damage conditions

A
  • hypertensive encephalopathy
  • hemorrhagic stroke
  • ischemic stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

renal system damage conditions

A

acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cardiopulmonary system damage conditions

A
  • acute decompensated HF
  • acute coronary syndrome (including MI)
  • acute pulmonary edema
  • dissecting aortic aneurysm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ophthalmologic damage conditions

A
  • exudates
  • papilledema
  • retinal hemorrhages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is blood pressure?

A
  • pressure exerted by circulating blood upon the walls of blood vessels
  • refers to the pressure in the systemic circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

blood pressure varies with what?

A
  • strength of heartbeat
  • elasticity of arterial walls
  • volume and viscosity of blood
  • health, age, and physical condition of person
  • location of measurement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is hypertension?

A
  • systemic arterial blood pressure is elevated

- based on the average of 2 or more readings taken at 2 or more visits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

primary hypertension

A
  • aka essential HTN
  • accounts for 95% cases of HTN
  • no established cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

secondary hypertension

A
  • 5% of HTN cases

- secondary to other potentially rectifiable causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

identifiable causes of secondary HTN

A
  • sleep apnea
  • drug induced or related causes
  • CKD
  • primary aldosteronism
  • renovascular disease
  • chronic steroid therapy or Cushings syndrome
  • pheochromocytoma
  • coarctation of the aorta
  • thyroid or parathyroid disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HTN pathophysiology

A
  • ANS
  • intravascular fluid volume = aldosterone stimulation
  • vascular autoregulation
  • renin-angiotensin aldosterone system (RAAS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

RAAS picture

A

look at notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

HTN symptoms

A
  • headache
  • dizziness
  • blurred vision
  • shortness of breath (especially with exertion)
  • chest pain
  • rapid pulse, palpitations
  • malaise and fatigue
  • OFTEN NO SYMPTOMS AT ALL
26
Q

normal BP numbers

A

SBP = <120/<80 mmHg

27
Q

elevated BP numbers

A

SBP= 120-129 mmHg
DBP= <80 mmHg
treatment: life style modifications

28
Q

stage 1 HTN BP numbers

A

SBP= 130-139 mmHg
DBP= 80-89 mmHg
treatment: life style modifications (+ meds for those with CVD)

29
Q

stage 2 HTN BP numbers

A

SBP= >140 mmHg
DBP= >90 mmHg
treatment: life style modifications and meds

30
Q

BP goals for general >60 years

A

< 150/90 mmHg

31
Q

BP goals for <60 years

A

< 140/90 mmHg

32
Q

BP goals for black americans (any age; with or without DM)

A

< 140/90 mmHg

33
Q

BP goals for adults with DM who are not black

A

< 140/90 mmHg

34
Q

BP goals for adults with CKD

A

< 140/90 mmHg

35
Q

weight reduction leads to reduction in SBP….

A

5-20 mmHg/10kg weight loss

36
Q

adopting DASh eating plan leads to reduction in SBP of

A

8-14 mmHg

37
Q

reducing dietary sodium leads to reduction of SBP of

A

2-8 mmHg

38
Q

physical activity leads to reduction in SBP of

A

4-9 mmHg

39
Q

moderation of alcohol reduction leads to reduction of SBP of

A

2-4 mmHg

40
Q

thiazide type diuretics

A
  • Hydrochlorothiazide
  • Chlorthalidone (acts on distal convoluted tubule and inhibits Na and Cl transport) (also has longer mechanism of action and more potent
41
Q

how do ACE inhibitors work?

A

block Angiotensin I from converting into Angiotensin II

42
Q

how do Angiotensin Receptor Blockers (ARB) work?

A

block the effects of Angiotensin II receptors

43
Q

what do calcium channel blockers do?

A

slow HR and lower BP

44
Q

acute coronary syndromes (ACS)?

A
  • unstable angina
  • MI
  • non ST elevation MI (NSTEMI)
  • ST elevation MI (STEMI)
45
Q

pathogenesis of acute coronary syndromes

A

plaque rupture > platelet adhesion > platelet activation > partially occlusive arterial thrombosis & unstable angina > microembolization & NSTEMI > totally occlusive arterial thrombosis & STEMI

46
Q

spectrum of acute coronary syndromes

A

look at notes

47
Q

what is angina?

A
  • occurs with activity and stress
  • pain is described as pressure, squeezing, heaviness and may be associated with diaphoresis, nausea or vomiting and/or shortness of breath
  • relieved with rest or nitroglycerin
48
Q

cardiac markers

A

picture in notes

49
Q

anti-ischemic treatment for NSTEMI

A
  • bed rest
  • nitroglycerin
  • oxygen
  • morphine
  • beta blocker (metoprolol)
  • possibly calcium channel blocker (verapamil)
  • ACE inhibitor for decrease LV function
50
Q

anti-platelet/anti-thrombotic treatment

A
  • aspirin
  • heparin
  • add platelet GP IIb/IIIa receptor antagonist
51
Q

early invasive strategy (aggressive?)

A

cath lab

52
Q

early conservative medical management

A

look at notes

53
Q

STEMI criteria

A
  • elevated serial enzymes

- ST elevation in 2 or more leads

54
Q

hospital discharge care

A 
A: aspirin & anticoagulants
B: beta blockers & BP
C : cholesterol & cigs
D: diet & diabetes
E: education & exercise
55
Q

candidates for cardiac cath

A
  • MI
  • known CAD
  • positive stress test
  • not reach target HR on stress test
  • possible HF
  • structural deformities
  • identify bacterial infection
56
Q

goal of cardiac cath (left system)

A
  • identify location of CAD for PCA or CABG
  • measure LV ejection fraction
  • if needed, measure aortic valve
57
Q

risks of cardiac cath procedure

A
  • very rare, death, MI, stroke, renal failure
  • bleeding 2-5% (biggest risk)
  • allergic reaction to dye
58
Q

patient population for percutaneous transluminal coronary artery (PTCA/stent)

A
  • blockage greater than 70%

- Patient is a candidate for CABG (left main disease, proximal LAD, triple vessel disease)

59
Q

intra-procedure

A
  • receives heparin
  • GP IIb/IIIa inhibitor
  • nitroglycerin
60
Q

PTCA/stent patient directions

A
  • stay in bed for 4-6 hrs after procedure
  • may resume regular activities in 4-5 days
  • discharged from hospital in 1 day
  • if received stent, discharged on anticoagulant

clinical cond 2 hypertension (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions