Hypertension CIS Flashcards

1
Q

to diagnose hypertension

A

need TWO readings

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2
Q

essential HTN

A

no known cause - idiopathic

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3
Q

most likely cause of HTN

A

essential - no known cause

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4
Q

risk factors for essential HTN

A
obesity
high salt diet
hereditary
alcohol
age
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5
Q

headaches and HTN

A

don’t treat to solve headache

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6
Q

HTN risk of what conditions

A
stroke
MI
heart failure
ESRD
aortic dissection
PVD
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7
Q

HTN in young**

A

increased peripheral vascular disease (vasospasm)

  • level of small arterioles
  • both systolic and diastolic elevated
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8
Q

HTN in old**

A

aorta stiff - collagen replaces elastin

-isolated systolic HTN**

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9
Q

recommended life-style modifications for patient

A

minimum 30 minutes most days of week
-HR elevation 70% (220-age)

DASH diet - fruit, veggies, low fat

moderation of alcohol - less than 2/day or 10/week

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10
Q

treat with drugs or wait for lifestyle mods?

A

drug.

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11
Q

intitial HTN med for non-black

A

ACE (-)
ARB
CCB
thiazide diuretics

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12
Q

initial HTN med for black

A

CCB

thiazide diuretics

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13
Q

cushings

A
  • adrenal overactivity
  • striae - fast weight gain
  • cause of HTN
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14
Q

dexamethasone suppression test

A

cushing test

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15
Q

secondary HTN

A
  • hard to control HTN
  • compelling ginding
  • atypical age
  • absence of predisposing factors
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16
Q

renal artery stenosis

A

cause of secondary HTN

17
Q

Dx for renovascular HTN

A
captopril
DSA
MRI - angiography
arteriography
renal vein renin ration
18
Q

captopril

A

rise in renin and large fall in BP after administration

captopril - ACE (-)

  • abnormal test - renovascular disease
  • diagnosis - renal artery stenosis
19
Q

two main causes of renal artery stenosis

A
  • atherosclerosis

- fibromuscular dysplasia

20
Q

careful with these meds with renal a. stenosis

A

ACE (-)

unilateral - BP falls
bilateral - unpredictable, may worsen HTN
one kidney - unpredicatble, may worsen HTN

21
Q

fibromuscular dysplasia

A

young females
bilateral renal a stenosis
responds to angioplasty

22
Q

atherosclerosis

A

older males

unilateral renal a stenosis

23
Q

test for hyperthyroid

24
Q

black with hyperthyroid meds for HTN

A

beta-blocker

  • non-selective
  • propanolol
25
HTN with low K
hyperaldosteronism hypokalemia is the clue**
26
hypertensive urgency
systolic > 180 diastolic > 130 NO evidence of organ damage
27
hypertensive emergency
any BP - includes end organ damage
28
secondary hyperaldosteronism
``` diuretics CHF cirrhosis ascites nephrosis etc ```
29
weak with hyperaldosteronism?
hypokalemia - muscle weakness
30
Tx for hyperaldosterone HTN
spironolactone | -aldosterone blocker**
31
adrenal conditions with 2nd HTN
cushings hyperaldosteronism pheochromocytoma
32
test for pheochromocytoma
VMA levels
33
coarctation of aorta
difference in BP arms to legs -20mmHg also - systolic ejection murmur can cause secondary HTN narrowing medial layer of aorta - commonly at ligamentum arteriosum - interrupted, preductal, postductal