management of hypertension Flashcards
which 4 points should be asked about on history
symptoms of severe disease or impending eclampsia
previous obs or medical history including renal disease/endocrine cause of hypertension
family history of hypertesnion
fetal movements
describe the examination of a patient when formulating a diagnosis
BP search for identifiable causes optic fundi edema tendon reflexes liver tenderness
which investigations should be done
proteinuria over 24 hours spun deposit of urine = granula casts platelet count urea, creatinine, creatinine clearance serum urate HELLP liver enzymes ultrasound CTG if after 28 weeks
which special investigations can be done
screen for antiphospholipid antibodies screen for congenital thrombophilia collagen screen urinary catecholamines and normetadrenaline levels chest x ray and ecg uterine artery doppler
List 6 circumstances that put the mother at risk
- uncontrolled Hypertension (DBP over 120 associated with fibrinoid changes and necrosis in the walls of small arterioles)
- eclampsia
- impending eclampsia
- HELLP syndrome
- Pulmonary edema
- renal failure
List 6 complications of eclampsia
cerebrovascular haemorrhage cerebral edema aspiration pneumonia multi organ disease renal failure HELLP
How is imminent eclampsia diagnosed
symptoms: headache, visual disturbance
signs: hyperreflexic, edematous
what is HELLP syndrome
Haemolysis
elevated liver enzymes
low platelets
pathogenesis of pulmonary edema
Lowered plasma oncotic pressure and increased capillary permeability
which lesion is histologically characteristic of GPH
glomerular capillary endotheliosis
