L3: cardiovascular disease/ HTN

Question 1

BLOOD PRESSURE CATEGORIES :

Answer 1

normal : less than 120/80

elevated:
120-129/less than 80

stage 1 hypertension:
130-139/80-89

stage 2 hypertension :
>140/>90

hypertensive crisis:
>180/>120

Question 2

systolic BP is more important cardiovascular risk factor when ?

Answer 2

after age of 50 . before then it is the diastolic which is more important

Question 3

what’s the difference between a hypertensive urgency and a hypertensive emergency ?

Answer 3

hypertensive urgency : severely elevated BP no progressive organ dysfunction , usually due to uncontrolled HTN

Hypertensive emergency :
severely elevated BP with end organ dysfunction

Question 4

examples of hypertensive emergencies :

Answer 4

Hypertensive encephalopathy

Acute left ventricular failure with pulmonary edema

Acute MI or unstable angina pectoris

Dissecting aortic aneurysm

Question 5

essential hypertension means _____

Answer 5

HTN with no known etiology , 95% of cases

Question 6

causes of secondary HTN :

Answer 6

intrinsic renal disease

renovascular disease

mineralocorticoid excess

sleep breathing
disorders

chronic steroid therapy

uncommon (just read):
Pheochromocytoma
Glucocorticoid excess
Coarctation of Aorta
Hyper/hypothyroidism

Question 7

increased creatine and abnormal urinalysis (renovascular and renal parenchymal disease is a clue to

Answer 7

secondary HTN

SO IS episodic headache , chest pain , palpitations , morbid obesity ,unexplained hypokalemia (hyperaldersteronisim)
impaired blood glucose (hypercortisolism)
impaired TFT (hypo/hyper thyroidism)

Question 8

complications of prolonged uncontrolled HTN :

Answer 8

change in vessel wall leading to injury and arteriosclerosis throughout vasculature

target organ dysfunction

Question 9

target organs of HTN ;

Answer 9

CVS ( heart and vessels):
-left ventricular hypertrophy
-angina or prior myocardial infarction
-prior coronary revascularization
-heart failure
-peripheral arterial disease

kidneys:
-chronic kidney disease

nervous system:
-stroke or transient ischemic attack

eyes:
-retinopathy

Question 10

cardiovascular risk factors of HTN( not obvious ):

Answer 10

microalbuminuria

Question 11

routine lab tests:

Answer 11

-EKG
-CXR
-urinalysis
-blood glucose and hemocrit

-serum potassium , -creatine(GFR) and calcium
-lipid profile

-Urinary albumin excretion

Question 12

treatment goal of HTN in otherwise healthy patient :

Answer 12

<140/90

primary goal is attaining the systolic blood pressure

Question 13

treatment goal of HTN in patient suffering from diabetes:

Answer 13

<130/80
\
primary goal is attaining the systolic blood pressure