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GP > ILA 1 - Hypertension & Heart failure > Flashcards

ILA 1 - Hypertension & Heart failure Flashcards

1
Q

Marker of heart failure

A

BNP (B-type natriuretic peptide)

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2
Q

Chest x-ray in LV failure signs

A 
ABCDE
Alveolar oedema 
Kerley B lines 
Cardiomegaly 
Dilated prominent upper lobe vessels 
Pleural Effusion
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3
Q

Nonpharmacological management of heart failure

A

Stop smoking, less salt, optimise weight and nutrition

prevent exacerbating factors (anaemia, thyroid, infection BP)

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4
Q

Drugs to avoid in heart failure and why?

A

NSAIDS - fluid retention and renal impairment

Verapamil - negatively ionotropic

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5
Q

Drug pathway for heart failure

A

ACEi
Add b-blocker
Spironolactone / diuretic
Digoxin + refer and seek advice

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6
Q

Things to remember when adding b-blockers in heart failure

A

CI in asthma / pregnant

start low, go slow

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7
Q

Investigations in heart failure

A

Bloods - Anaemia, TSH, HBA1C
ECG - ischemia
BP

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8
Q

Eg of diuretic in heart failure? What to do if it reduces k<3.2mmol?

A

furosemide

use k sparing eg spironolactone

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9
Q

what to do if cough is a problem with ACEi?

A

use ARB eg candesartan

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10
Q

What can be used if intolerant to ACEi and ARB?

A

Vasodilators (hydralazine & isorbide dinitrate )

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11
Q

Target bp in hypertension? Diabetes? >80yr?

A

140/90
130/80
15/90

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12
Q

Why higher target bp in >80

A

vessels lose elasticity

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13
Q

When taking bp how should it be done?

A

Rest for 15 mins with arms at heart level

both arms, sitting and standing

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14
Q

What is white coat hypertension

A

peoples BP rises when a doctor takes it

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15
Q

Hypertension drug pathway?

A

<55 - ACEi
>55 / black - CCB
A+Diuretic / C +D
A+C+D

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16
Q

What to do If hypertensive on A+C+D

A

Resistant HTN and refer

17
Q

eg of ACEi

A

Ramipril

18
Q

eg of CCB

A

Amlodipine

19
Q

What monitoring with Ramipril

A

Check renal function - U&E after each dose change

20
Q

Side effects of amlodipine?

A

ankle swelling

21
Q

Side effect of diuetics ?

A

Wee alot

22
Q

Eg of thiazide like diuetic?

A

indapamide

23
Q

Things to remember in polypharmacy

A

increase falls, deaths,
physcological impact
need good vision and dexterity

GP (6 decks)

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