ILAs Flashcards
over what values is hypertension ?
> 140/90
confirmed with ambulatory/home: >135/85
most common cause of hypertension
primary (90%) high BP has developed on ownc
causes of secondary hypertension ? 2 most common ?
ROPED
- renal disease (common)
- cons disease/primary hyperaldosteronism (common)
- obesity
- pregnancy induced/pre eclampsia
- endocrine
- drugs (alcohol, steroids, NSAIDs, oestrogen)
If high BP is not responded to treatment, what should you consider ?
consider renal artery stenosis
(duplex US)
what ranges for stage 1/2/3 hypertension ?
- stage 1: >140/90 (>135/85)
- stage 2: >160/100 (>155/95)
- stage 3: > 180/120
what lifestyle advice for hypertension ?
- healthy diet
- smoking cessation
- reduce alcohol
- reduce caffeine
- reduce salt
- regular exercise
50 year old white man hypertension. what first line drug ? who else in the category ?
ACEI
(<55 or T2DM (any age))
50 year old black man with hypertension. what first line drug? who else in this category ?
CCB
(>55 or black African)
first line hypertension managment not enough, then add what ?
- consider ACEI or CCB (whichever they’re not already on)
OR - Thiazide-like diuretic
third line hypertension Mx ?
ACEI + CCB + thiazide like dietetic
what tests would you do in a newly diagnosed patient with hypertension to ensure they do not the any end-organ damage ? (3)
- fundoscopy (check for hypertensive retinopathy)
- urine dipstick (check for renal disease, either as a cause of consequence of hypertension)
- ECG (to check for LV hypertrophy of IHD)
ACEI SE ? (2)
- cough
- hyperkalaemia
CCB SE ? (3)
- headache
- flushing
- ankle oedema
BB SE ? (3)
- bronchospasm (especially in asthmatics)
- fatigue
- cold peripheries
bendoflumethiazide SE (4)
- gout
- hyppokalaemia
- hyponatraemia
- impaired glucose tolerance
what antihypertensive is first line in diabetic patients ?
ACEI/ARBS regardless of age
What drugs can contribute to idiopathic intracranial hypertension ? (5)
- COCP
- steroids
- tetracyclines
- retinoids
- lithium
what are the BP target ranges over a patient over 80 years ?
<150/90 (<145/85)
describe the antibodies associated with RA ? and what their sensitivity is ?
- RF (IgM): autoantibody that attacks IgG => inflam (70% of RA patients have it)
- Anti-CCP (more specific -80-90%)
what indicates a worse prognosis in RA ? (3)
- disease activity
- positive Ab (RF or anti-CCP)
- erosions on xray
- extra-acrituclar features (nodules)
RA RF ?
F:M (3:1)
middle age
smoking
obesity
FHx
RA presentation ? which joints affected ?
rapid of gradual: (triad) joint pain, stiffness swelling (worse with rest, improve with activity)
- MCP, PIP, wrist, MTP
RA hand OE ?
- synovial thickening => boggy feeling
- positive squeeze test
- z shaped deformity
- swan neck deformity
- boutineirs deformity
- ulnar deviation
name some extra articular manifestations of RA ?
- sjorgrens
- eye manifestations (keratoconjunctivitis sick - dry eyes)
- nodules
