management of hypertension Flashcards

1
Q

which 4 points should be asked about on history

A

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

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2
Q

describe the examination of a patient when formulating a diagnosis

A
BP
search for identifiable causes
optic fundi
edema
tendon reflexes
liver tenderness
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3
Q

which investigations should be done

A
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
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4
Q

which special investigations can be done

A
screen for antiphospholipid antibodies
screen for congenital thrombophilia
collagen screen
urinary catecholamines and normetadrenaline levels
chest x ray and ecg
uterine artery doppler
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5
Q

List 6 circumstances that put the mother at risk

A
  1. uncontrolled Hypertension (DBP over 120 associated with fibrinoid changes and necrosis in the walls of small arterioles)
  2. eclampsia
  3. impending eclampsia
  4. HELLP syndrome
  5. Pulmonary edema
  6. renal failure
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6
Q

List 6 complications of eclampsia

A
cerebrovascular haemorrhage
cerebral edema
aspiration pneumonia
multi organ disease 
renal failure
HELLP
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7
Q

How is imminent eclampsia diagnosed

A

symptoms: headache, visual disturbance
signs: hyperreflexic, edematous

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8
Q

what is HELLP syndrome

A

Haemolysis
elevated liver enzymes
low platelets

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9
Q

pathogenesis of pulmonary edema

A

Lowered plasma oncotic pressure and increased capillary permeability

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10
Q

which lesion is histologically characteristic of GPH

A

glomerular capillary endotheliosis

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