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Cardio Module > Hypertension- Felner > Flashcards

Hypertension- Felner Flashcards

1
Q

4 phases of diastole

A
  1. isovolumic relaxation
  2. rapid filling
  3. diastasis
  4. atrial contraction
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2
Q

________% lifetime risk of HTN

A

90%

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3
Q

which number is higher, controlled or uncontrolled HTN?

wwho would be the most likely to have TN?

A
  • uncontrolled-

- a non-hispanic black woman who’s above 60 years old

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4
Q

how does CVD mortality relate to BP?

A
  • doubles with each 20 mmHg increase in systolic BP over 115/75
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5
Q

Define BP

A

The force exerted by blood on the arterial walls and the force of the arterioles as they resist blood flow

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6
Q

T/F: diastolic BP is a stronger predictor of CV mortality than Systolic

A

F… systolic

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7
Q

what’s the one thing to avoid while taking BP

A
  • avoid auscultatory gap

- avoid taking BP after recent alcohol, caffeine, tobacco, or exercise

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8
Q

what local forces affet TPR

A
  1. autoregulation

2. pH/hypoxia

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9
Q

Give some determinants of BP

A
  1. heredity defects
  2. genetic makeup
  3. environment
  4. age
  5. obesity
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10
Q

What is the role of kidneys in controlling BP

A
  • regulating vascular volume via RAAS/ANF
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11
Q

Where are the two baroreceptors located? what CN’s are at each location and where do they transmit signals to?

A
  1. aortic arch; transmits via vagus to medulla

2. carotid sinus: transmits via IX

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12
Q

what happens after barorecceptors are signaled?

A
  • increase adrenergic tone to increase sympathetics to decrease parasympathetics
  • leads to vasoconstriction; incrased HR and increased LV contractility to increase BP
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13
Q

What is considered too wide ofa pulse pressure and what are some causes?

A

greater than 55-60

  • increase stroke volume (AR
  • decreased compliance (elderly)
  • Decrased diastolic blood pressure (Fever- dilates distal vessels)
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14
Q

What is considered too narrow of pulse pressure?

A

less than 20-25 mmHG

  • LVOT obstruction (As)
  • Decreased stroke volume (heart failure)
  • Decreased LV volume (mitral stenosis, diuretics)
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15
Q

what’s another name for primary HTN

A

essential/idiopathic (95%!)

  • includes isolation hypertension (either systolic or diastolic), potentially sodium/renin-mediated
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16
Q

Give causes of Secondary hypertension

A

ABCDEs

A- aldosteronism, OSA
B- Bruits (renal artery stenosis)
C- CKD, Coarcation, Catecholamines, Cocaine
D- Drugs (NSAIDs/OCP’s, decongestants)
E- endocrine (thyroid, adrenal, Cushing’s, parathyroid)

17
Q

What population has higher BP

A
  • PREGNANT WOMEN

- those with lifestyle perturbation (obesity, alcohol, salt)

18
Q

How do you define hypertension

A
  • an increased blood pressure that leads to increased risk of CV events and TARGET ORGAN DAMAGE
19
Q

give formula for MAP

A

2/3 DBP + 1/3 SBP

20
Q

what is the main pathophys of HTN

A
  • imbalance of CO and PVR

- initally, SNS gives increased CO, but eventually we get compensatory PVR

21
Q

What is masked HTN

A
  • normal in clinic, hypertensive outside.. mainly in AA with CD, or young children with hypertension
22
Q

What are the two acute forms of BP

A
  1. accelerated (BP> 240/120); rapidly progressive with TOD

2. Malignant: BP> 170/110; rapid with TOD, but no LVH ( too acute)… activates coag cascade

23
Q

What is the main concern in the plan/work up/ assessment of HTN?

What is the goal of work-up/assessment/plan

A
  • detect if there’s any TOD!!

- ACHIEVE IDEAL, not NORMAL, BP (less than or equal to 120/80)

24
Q

why with a hypertensive patient would you test BP standing?

A
  • because you’re planning on treating them…… treatment is decreasing blood pressure, so you don’t want to do it too strongly so they become hypotensive
25
Q

Name some simple labs for CV

A
  1. urinalysis/FBS/Hgb
  2. Na/K/Ca
  3. BUN/creatinine
  4. Lipid
  5. ECG
26
Q

contrast dipper v non dipper

A
  • dipper: BP decreases 10-20% at night, in both normal and HTN patients
  • non dippers: doesn’t dip… increased CVD risk
27
Q

Name some organs involved in TOD

A
  1. heart
  2. aorta (dissection)
  3. Brain (stroke)
  4. kidney
  5. peripheral arteries
  6. retina
28
Q

LVH is an adaptation to _______

A

pressure overload

29
Q

Pathologic hypertrophy is iniitally ________, but eventually ______

A
  • beneficial; deleterious
30
Q

LVH heart sound

A
  • sustained systolic with an S4 heart sound (stiff, hypertrophic ventricle)
31
Q

Name 3 sequale of LVH

A
  1. Diastolic dysfunciton FIRST (cavity is smaller… decreased compliance and need more atrial contraction)
  2. myocardial ischemia (decreased coronary blood flow, in relation to ventricle’s need for blood since it’s hypertrophied)
  3. Late—> Systolic dysfunction
32
Q

trio of symptoms for aortic stenosis

A

SAD

syncope
angina
dyspnea upon exertion

33
Q

upper limits of BP for:

age < 60

age greater than 60

DM

CKD

A

<140/90

<150/90

<140/90

<140/90

34
Q

Describe method, result, and complication of Sprint study

A

Sprint medicine: getting 1 group to SBP < 120 with 3 meds (intensive), and another decrease to <140 with 2 meds (standard)

Result: decrease death and CVD, but incrase risk of syncope and Acute Kidney Disease

35
Q

What 3 patient groups would you want to treat HTN immediately for?

A
  1. BP > 180/110 mm Hg
  2. Evidence of end-organ damage
  3. secondary hypertension

Cardio Module (25 decks)

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