Pales Hypertension CIS

Question 1

What are the contributing (risk) factors for developing essential HTN? 5

Answer 1

• Genetic predisposition
• Abdominal Obesity
• Salt intake
• Alcohol intake
• Age

Question 2

Pts with HTN have increased risk of which conditions? 7

Answer 2

• stroke
• MI
• HF
• ESRD
• atrial fibrillation
• Aortic Dissection
• PVD

Question 3

Likely mechanism of HTN in younger patients?

Answer 3

Arterial Vasoconstriction (RAAS)

Question 4

Likely mechanism of HTN in older pts?

Answer 4

atherosclerosis in aorta

Question 5

Initial recommended HTN treatment for non-black population? 4

Answer 5

• ACEI
• ARB
• CCB
• Thiazide diuretics

Question 6

Initial recommended HTN treatment for Black Population?

Answer 6

• CCB

- Thaizide

Question 7

Dx test for Cushing’s Disease?

Answer 7

dexamethasone suppression test or 24 hour cortisol levels

Question 8

When do you suspect secondary HTN?

Answer 8

• compelling finding on exam
• HTN difficult to control
• young age of diagnosis (

Question 9

5 tests for renovascular HTN:

Answer 9

1. captopril test (rise in renin and large fall in BP after administration
2. DSA
3. MRI angiography
4. arteriography
5. renal vein: renin ratio (>1.5)

Question 10

Two main causes of renovascular HTN?

Answer 10

1. Atherosclerosis

2. Fibromuscular Dysplasia

Question 11

Common age and sex for atherosclerosis?

Answer 11

> 50 , Male

Question 12

Common age and sex for Fibromuscular Dysplasia

Question 13

Which is more likely to be bilateral? Atherosclerosis or Fibromuscular Dysplasia

Answer 13

Fibromuscular Dysplasia

Question 14

Which responds better to angioplasty? Atherosclerosis or Fibromuscular Dysplasia

Answer 14

Fibromuscular Dysplasia

Question 15

Which is rapidly progressing? Atherosclerosis or Fibromuscular Dysplasia

Answer 15

Atherosclerosis

Question 16

What medications should you be careful to prescribe a pt with renalvascular HTN?

Answer 16

Ace inhibitors

Question 17

renalvascular HTN unilateral vs bilateral:

intravascular volume?

Answer 17

unilateral - decreased intravascular volume

Bilateral - increased intravascular volume

Question 18

renalvascular HTN unilateral vs bilateral:

Renin mediation

Answer 18

unilateral - increased renin mediation

Bilateral - varied

Question 19

Ace inhibitors my worsen HTN in pts with _____.

Answer 19

renovascular HTN

Question 20

Tests to order for graves disease?

Answer 20

T3/T4 levels

Question 21

Define Hypertensive urgency?

Answer 21

A systolic BP >180 or a diastolic BP >130 and NO evidence of end organ damage

Question 22

Define Hypertensive Emergency

Answer 22

Any BP and involves acute damage to at least one organ system

Question 23

Lab findings in Primary hyperaldosteronism

Answer 23

• high aldosterone
• low renin
• low K

Question 24

Lab findings in secondary hyperaldosteronism

Answer 24

high aldosterone and renin

Question 25

Causes of secondary hyperaldosteronism 5

Answer 25

1. diuretics
2. CHF
3. Cirrhosis
4. ascites
5. nephrosis

Question 26

Generalized mm weakness is caused by ____

Answer 26

Hypokalemia

Question 27

Medication for pt with primary hyperaldosteronism?

Answer 27

K sparing - spironolactone