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Renal II Final DF > Hypertension CIS > Flashcards

Hypertension CIS Flashcards

1
Q

urgency vs emergency

A

urgency occurs at systolic BP over 180 or diastolic BP over 130 with no evidence of end organ damage

emergency may occur at any BP but involves DAMAGE to at least 1 organ system

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2
Q

signs of target organ involvment

CV
CNS
Renal
Ophthalmologic

A

CV: MI, angina, aortic dissection, aneurysmal dilation of large vessels, LVH, CHF

Renal: hematuria, proteinuria, AKI

CNS: cerebral edema, altered mental status, bleed, stroke

Ophthalmologic: retinal hemorrhages or exudates, papilledema, A-V nicking

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3
Q

what type of drug is methyldopa

A

alpha agonist

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4
Q

reponse to angioplasty when you have renal artery stenosis from atherosclerosis

A

not very responsive because of a progressive disease

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5
Q

2 causes of renal artery stenosis

A

fibromuscular dysplasia and atheroscleoris

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6
Q

medial fibromuscular dysplasia uni or bilateral

A

70% are bilateral,

and this type of dysplasia is the most common (85%) of the fibromuscular dysplasias

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7
Q

unilateral, bilateral, one kidney RAS and intravascular volume

A

unilateral - decreased intravas volume

bilateral and one kidney - increased intravascular volume

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8
Q

which of the RAS are unpredictable and may worsen hypertension

A

bilateral and one kidney

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9
Q

diagnosis of renovascular hypertension

A

renal ultrasound with arterial dopplers

captopril test (reactive rise in renin and large fall in BP after admin)

DSA - digital subtraction angiography

MRI - angiography

arteriography

renal vein renin ratio (ratio of 1.5 or greater)

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10
Q

contraindications of ACE inhibitors

A

bilateral renal artery stenosis

unilateral RAS with solitary kidney

pregnancy

known angioneurotic edema with prior ACE admin

ACE induced cough

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11
Q

secondary hypertension causes

A 
sleep apnea
drug induced causes 
CKD
primary aldosteronism
renovascular disease
steroid therapy or cushing's syndrome
pheochromocytoma
coarctation of aorta
thyroid disesae 
parathyroid disease
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12
Q

AV nicking found in

A

long standing HTN

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13
Q

papilledema found in

A

hypertensive emergency

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14
Q

cardiovascular causes of hypertension

A 
MI
acute LV failure
vasculitis
coarctation of aorta
aortic dissection 
volume overload (including pulm edema)
essential hypertension
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15
Q

coarctation of aorta

A 
narrowing of medial layer of aorta
commonly at ligamentum arteriosum
3 types
 -interrupted 
 -preductal
 -postductal
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16
Q

diagnosis of coarctation

A

differences in UE and LE
systolic hypertension in infant
20 mmhg btwn arms difference

systolic ejection murmur in aortic outlet

cardiomegaly
rib nothcin on PA chest
3-sign on lateral chest

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17
Q

primary hyperaldosteronism cause

A

aldosterone producing adenoma

bilateral adrenal hyperplasia

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18
Q

secondary hyperaldosteronism causes

A

elevated aldosterone and renin levels
from:
diuretics, CHF, cirrhosis, ascites, nephrosis

19
Q

after MI give

caution with

A

beta blocker, ACEI

caution: direct vasodilater

20
Q

with CHF give

caution with

A

diuretic, ACEI, beta blocker

caution: beta blocker, and CCB

21
Q

with hypertrophic cardiomyopathy give

caution with:

A

bb, ccb

caution: diuretic, ACEI, vasodilator

22
Q

with tachyarrhythmias give

A

BB, verapamil

23
Q

with angina give

caution with

A

beta blocker, ccb, nitroglycerine

caution: direct vasodilators

24
Q

with copd/road give

caution with

A

ccb, arb, thiazide diuretic

caution: beta blockers

25
Q

with aortic dissection give

caution with

A

nitroprusside and beta blocker

caution: drugs that increase cardiac output

26
Q

with bilateral RAS be cautious with

A

ACEI, angiotensin blockers

27
Q

with chronic renal insufficiency agent of choice

caution with:

A

ACEI with serum creatinine below 2.5

loop diuretics, CCB

caution: ACEI, angiotensin blockers

28
Q

renal transplants be careful with

A

ACEI

29
Q

migraine headacehes give

A

beta blockers, CCB

30
Q

stroke or TIA give

caution with

A

ACEI

caution: vasodilators (may increase intracranial pressure)

31
Q

diabetes give

A

ACEI

32
Q

prenancy (preeclampsia, eclampsia)

A

methyldopa, hydralazine

caution: ACEI, angiotensin blockers, diuretics

33
Q

gout be cautious with

A

diuretics

34
Q

cocaine use, use __

caution with

A

labetalol, clonidine

caution: selective b-blockers

35
Q

GI bleed use

caution

A

non selective beta blocker

caution beta blockers

36
Q

pheochromocytoma use

caution

A

alpha blocker then beta blockade

caution with selective beta blocker

37
Q

BPH use and caution with

A

alpha 1 antag (terazocin)

caution selective beta blocker

38
Q

weight reduction and BP

A

maintain normal body weight (BMI 18.5-24.9) reduce 5-20 mm hg/10 kg weight loss

39
Q

DASH eating plan and BP

A

diet rich in fruits, veggies, low fat dairy products with reduced saturated and total fat

-8-14 mmhg bp reduction

40
Q

dietary sodium reduction and BP

A

reduce intake to no more than 100 mEq/day

decrease bp by 2-8 mmhg

41
Q

physical activity and bp

A

aerobic activity for at least 30 mintues per day most days of week

-drop bp 4-9 mmhg

42
Q

moderation of alcohol consumption and bp

A

no more than 2 drinks per day in men
no more than 1 drink per day in women

-drop bp by 2-4 mmhg

43
Q

in coronary ischemia what is the preferred drug treatment

A

nitroglycerin

Renal II Final DF (5 decks)

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