Hypertension (no meds)

Question 1

Who gets hypertension more, men or women?

Answer 1

about equal!

Question 2

At what age does the risk for hypertension increase greatly

Answer 2

55

Question 3

What % of americans have hypertension? Pre-HTN?

Answer 3

33%, another 30% pre HTN

Question 4

Which race has the greatest incidence of HTN

Answer 4

blacks

Question 5

What is the value for “normal” BP?

Answer 5

119/79

Question 6

What is the value for “pre-hypertensive”

Answer 6

120-139 / 80-89

Question 7

What is the value for “stage 1 hypertension”

Answer 7

140-159/ 90-99

Question 8

What is the value for “stage 2 hypertension”

Answer 8

160+ / 100+

Question 9

What are the 7 modifiable risk factors that Mr. B said we needed to know for HTN

Answer 9

1. smoking
2. high sodium diet
3. excess alcohol
4. obesity
5. physical inactivity
6. dislipidemia
7. vitamin D deficiency

Question 10

What are the 4 NON-modifiable risk factors that Mr. B said we needed to know for HTN

Answer 10

1. Age 55+
2. race (African American)
3. Family history
4. personality (impatience, depression)

Question 11

What are the classic symptoms of Pheochromocytoma

Answer 11

headache
sweating (flush)
tachycardia
hypertension

Question 12

What are the classic symptoms of Cushing’s Syndrome

Answer 12

skin atrophy
striae
proximal muscle weakness
buffalo hump
hypertension

Question 13

What are the classic symptoms of Hyperaldosteronism

Answer 13

hypokalemia
metabolic alkalosis
hypertension

Question 14

When you are checking BP in both arms in children, what are you looking for?

Answer 14

coarctation of aorta

Question 15

What is the gold standard for diagnosing HTN

Answer 15

ambulatory blood pressure monitoring

serial measurements!

Question 16

If ambulatory blood pressure monitoring is not available, what is an alternative?

Answer 16

home BP monitoring

automated office BP

Question 17

Erroneously high BP is called:

Answer 17

white coat BP

Question 18

Erroneously low BP is called:

Answer 18

masked BP

Question 19

At what time of day is BP most accurate?

Answer 19

nocturnal BP readings

Question 20

What four things should the patient avoid doing before taking their BP

Answer 20

1. caffeine consumption
2. smoke
3. eat
4. exercise

Question 21

Can you diagnose HTN with one BP reading

Answer 21

don’t be a dumbass of course not!

SERIAL READINGS

Question 22

What agents can cause HTN

Answer 22

estrogen
sympathomimetics
adrenal steroids

Question 23

What signs and symptoms during a patient history would be indicative of target organ damage

Answer 23

headache
transient weakness
transient blindness
loss of visual acuity
chest pain
dyspnea
claudication

Question 24

What signs and symptoms during a patient history would lead you to believe the hypertension is secondary (versus primary)

Answer 24

muscle weakness
tachycardia
sweats
tremors
skin thinning
flank pain
sleep apnea

Question 25

What tests should be ordered for patients with HTN

Answer 25

Lipid Panel
Urinalysis
Basic Metabolic Panel (glucose, creatinine, electrolytes)
EKG

Question 26

What is the FIRST LINE treatment for HTN

Answer 26

lifestyle modifications

Question 27

What are the lifestyle modifications a patient should do if they have HTN

Answer 27

DASH diet
decrease sodium intake
decrease alcohol intake
exercise 3-4 x week for 40 min
healthy weight
smoking cessation

Question 28

Treatment threshold is ____/____, unless you are over 60 (and otherwise healthy), then it is ____/_____

Answer 28

140/90

150/90

Question 29

What is the threshold for treatment in a patient who is 65 years old and has diabetes

Answer 29

140/90

because of the diabetes

Question 30

What is it called when a patient is on three different HTN medications and still has high BP readings

Answer 30

resistant hypertension