HYPERTENSION, COAGULATION, HEMOSTASIS, AND DISORDERS

Question 1

average diastolic BP ____mmHg or

average systolic BP ___mmHg

Answer 1

> 90

> 140

Question 2

LIFESTYLE MODIFICATIONS

→ advised at least 2 or more of the ff.:

Answer 2

weight loss

limit alcohol intake

reduce sodium intake

dietary potassium

calcium and magnesium

o stop smoking
o dietary saturated fat & cholesterol
o exercise

Question 3

weight loss
- for every 10 kilos that a patient loses, there is an
automatic reduction in the systolic BP reading by
____ mmHg

Answer 3

5-20

Question 4

limit alcohol intake

• for ____, should not be more than 1 oz (30 ml) of
  alcohol per day
• for ___, not more than .5 oz (15 ml) of alcohol
  per day

Answer 4

males

females

Question 5

reduce sodium intake
- ____ of sodium chloride

Answer 5

6 g

Question 6

dietary potassium
-___ mmol per day

Answer 6

90

Question 7

exercise
- aerobic exercise for at least 30 minutes daily or
most of the days → systolic BP reduction of about ____ mmhg

Answer 7

4-9

Question 8

recommended diet is:

Answer 8

o low sodium
o high potassium
o high vegetables and fruits
o low fat and dairy

Question 9

Basal index is advised to be ___ kg/m2

Answer 9

20-25

Question 10

waist circumference for men should be <____ cm and in women,
less than <___cm

Answer 10

94

80

Question 11

CLASS OF DRUGS FOR INDICATIONS

Answer 11

Heart Failure

Patients Following MI

Diabetes

Chronic Kidney Disease

Question 12

→ diuretic (given first)
→ beta blocker
→ ACE inhibitor/ARB
→ aldosterone antagonist

Heart Failure

Patients Following MI

Diabetes

Chronic Kidney Disease

Answer 12

Heart Failure

Question 13

→ beta blocker
→ ACE inhibitor

Heart Failure

Patients Following MI

Diabetes

Chronic Kidney Disease

Answer 13

Patients Following MI

Question 14

ACE inhibitor/ARB

Heart Failure

Patients Following MI

Diabetes

Chronic Kidney Disease

Answer 14

Diabetes

Chronic Kidney Disease

Question 15

endocrine causes

Answer 15

accounts for larger proportion of secondary hypertension
(10-20%)

Question 16

females lower prevalence until ____ decade (51% in males
and 39.7% in females)

Answer 16

5th

Question 17

ACQUIRED HEMOPHILIA

DIAGNOSIS

Answer 17

→ activated partial thromboplastin time (aPTT) –prolonged

→bleeding time, prothrombin time (PT) and platelet count –normal

→reduced factor VIII levels with factor VIII inhibitor –markedly
reduced; critical in diagnosis

Question 18

intraarticular (in the joints) bleeding is ___ common in this
type of hemophilia

Answer 18

not

Question 19

ACQUIRED HEMOPHILIA

ETIOLOGY

Answer 19

development of autoantibodies (IgG) subclass 1 and 4 directed
against clotting factors

Question 20

conditions associated with acquired hemophilia:

Answer 20

pregnancy

Diabetes

malignancies

Question 21

Factor VIII deficiency

Answer 21

HEMOPHILIA-A

Question 22

→ “Christmas Disease”

Answer 22

HEMOPHILIA-B

Question 23

→ factor IX deficiency in plasma

Answer 23

HEMOPHILIA-B

Question 24

hemorrhage into joints (painful)

Answer 24

HEMOPHILIA-B

Question 25

permanent deformities, misalignment, loss of mobility, extremities unequal lengths

Answer 25

hemorrhage into joints (painful)

Question 26

- in ____, prolonged bleeding or severe hematoma following procedures such as circumcision, immunization or IV procedures - in toddlers, trauma related soft tissue hemorrhages or oral bleeding during teething - in children, hemarthrosis and hematomas with increasing physical activity or traumatic intracranial hemorrhage

Answer 26

neonates

Question 27

HEMOPHILIA-B LABORATORY TESTS ____normal or low Hgb/Hct; normal platelet count ____ normal BT & PT or prolonged aPTT, vWF, FVIII levels

Answer 27

CBC Coagulation Studies

Question 28

deficiency of Factor XI →

Answer 28

HEMOPHILIA C

Question 29

sometimes called Rosenthal syndrome

Answer 29

HEMOPHILIA C

Question 30

PLATELET DISORDERS → hemostatic system:

Answer 30

o platelets o coagulation factors - endothelial cells (blood vessels)

Question 31

hemostatic proteins:

Answer 31

o fibrinogen o vWF o growth factors (platelet-derived growth factor) ALL OF THE ABOVE

Question 32

dense granules of platelets contain

Answer 32

pro-aggregatory products such as adenosine diphosphate, calcium, and serotonin

Question 33

when these platelets are activated, a negatively charged phospholipids from the inner to the outer leaflet of the membrane layer produce binding sites for enzymes and cofactors of coagulation system resulting in formation of a clot o this clot is now the start of ___ hemostasis

Answer 33

secondary

Question 34

Elavated systolic and diastolic

Answer 34

Systolic: 120-129 Diastolic 80

Question 35

PATIENT EDUCATION for hypertension

Answer 35

strategies: o prevention if patient has tendency to be obese o quantity of aerobic physical activity o intake of other micronutrients o alcohol consumption o cigarette smoking o use of illicit drugs

Question 36

benefits of hypertensive therapy:

Answer 36

o average of 35-40% reduction in stroke incidence o 20-25% reduction in myocardial infarction o average greater than 50% reduction in heart failure if particular patient will receive medication