Systemic Hypertension Flashcards
What are the procedures for using the Korotkoff(indirect) method?
Inflate 20mmHg above sBP
Deflate slower than 3mmHg/sec
Record 1st and 5th sounds
What is considered the Direct method of Syst. HTN measurement?
Intra-Arterial Catheter
What are the 5 Korotkoff sounds?
Tapping Soft Murmur Louder Murmur Muffling of sound Disappearance
What is the definition of Borderline HTN?
BP occasionally exceeds normal
What is the definition of Primary HTN?
Elevated Systemic BP without know cause
What is the definition of Secondary HTN?
Elevated Systemic BP for which a caue CAN be identified (renal failure)
What constitutes a Hypertensive Emergency?
Life Threatening
Focal or General Symptoms of ongoing organ damage
Requires a rapid Reduction of BP
How will a loose BP cuff affect your BP Readings?
It will give you an artificially high BP
What constitutes a Malignant Hypertension?
Hypertensive Retinopaty grages 3-4 and severe BP Elevation
What constitutes a Hypertensive Encephalopaty?
S and S of cerebral Edemacaused by severe and/or sudden rises in BP
Why is it necessary to take multiple BP readings?
Resting vs agitated
Coarctation of aorta
Which Korotkoff sounds should you record in Kids? Adults?
1, 4-5
1, 5
What are the Grading Parameters for Hypertensive Retiopathy?
Gr1- Arteriolar Narrowing Gr2- AV nicking Gr3- Hemhorrages and exudates Gr4- papilledema Gr 3-4 are indicative of Target organ damage
What is AV Nicking?
Arteriole is pushing the Venuole down out of the field of view
What are the possible CNS consequences of Systemic HTN?
Decreasing Cognitive Function with age
Transient Ischemic Attack
Stroke- Thromboembolic(more common) or hemorrhagic
What is the impact of HTN on Renal Function?
Reanl Dys may cause Primary systemic arterial HTN
Intraglomerular HTN ==> Albuminurea
Nephrosclerosis -> Loss of renal Concentrating ability ->Renal failure -> Uremia
What are the Cardio effects of HTN?
Early
Late
Early: Increasing LV Mass with loss of LV function (poor filling)
Chronic: LVH with LV dilation and Failure => Death
What are the Vascular effects of HTN?
SAH is a risk factor for ASCVD, MI, Heart Failure, Sudden Cardiac Death
What is the Kidney’s response to underperfusion?
Renin is released
What is Pheochromocytoma?
A tumor that secretes BP raising Hormones
What are the ID-able causes of HTN?
Renal Parenchymal disease 1* Aldosteroneism Renovascular disease Chronic Steroid Therapy Pheochromocytoma Coarctation of the Aorta Thyroid or parathyroid disease Sleep Apnea Drug Induced or related causes
What Does SAH stand for?
Systemic Arterial Hypertension?
What are other diseases to pay attention to in the History?
Ischemic Heart Disease
Heart Failure
Diabetes Mellitus
Chronic Kidney Disease (GFR
What should ALWAYS be included in your cardiac exam?
Serial Bilateral BP Measurements HEENT(ALWAYS FUNDUSCOPIC EXAM) Pulm Cardiovacular Abdomen(Aortic, Renal Bruits) Neurologic
How do you select the Correct BP cuff?
2/3 Length of Upper arm
Bladder should encircle arm 80%
Mercury Manometer Best
What are causes of Unprovoked hyperkalemia?
Hyperaldosteronisma and ANY other Secondary HTN
What is the JNC 8 Reccommendations for sBP?
What is the DASH Diet?
Dietary Approach to Stop Hypertension
What is the realtionship between Alcohol and Tobacco and HTN?
Alcohol: J shaped Curve
Tobacco: Vasopressors
What are the drug classes used to Treat HTN?
Diuretics (THIAZIDES ARE BEST) Ca Channel Blockers ACE Inhibitors Angiotensin Receptor Blockers Anti-adrenergics Vasodilators
What are the drug therapy Reccomendations for HTN in the General Pop?
Start Drug at >150 or dBP >90
