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Small Animal Medicine > Systemic Hypertension > Flashcards

Systemic Hypertension Flashcards

1
Q

Formula for BP

A

CO X PVR

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2
Q

Formular for CO

A

HR X SV

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3
Q

What are the three types of systemic hypertension?

A

White coat

Primary

Secondary

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4
Q

What are the differentials for Secondary hypertension?

A

Renal Disease

Adrenocortical disease

Diabetes mellitus

Hyperthyroidism

Pheochromocytoma

Polycythemia

Acromegaly

Iatrogenic

Diet & Breed (sigh hounds)?

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5
Q

What drugs are associated with secondary systemic hypertension?

A

corticosteroids

phenylpropranolamine

cyclosporin A

Erythropoietin

NSAIDS

Electrolyte solutions

Adrenergic agonists

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6
Q

What three elements can be changed to result in systemic hypertension?

A

PVR, HR, SV

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7
Q

What is the most common cause of systemic hypertension?

A

renal disease

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8
Q

A dog presents with systemic hypertension and a left-sided murmur. Explain the pathophysiology of the murmur?

A

concentric hypertrophy of the left ventricle d/t pressure overload which leads to increase wall stiffness & reduced diastolic filling

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9
Q

What organs are most commonly affected by systemic hypertension?

A

CV

Renal

Ocular

CNS

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10
Q

When using a doppler to read BP, what is being measured?

A

systolic pressure

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11
Q

If you want to perform an indirect BP reading in a cat, which method is most accurate?

A

Doppler

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12
Q

A BP > than ____ would warrant further dx & tx.

A

160/100 mmHg

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13
Q

Which breed of dog typically has BP measures 10-20 mmHg higher than other breeds?

A

sighthounds

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14
Q

List the BP values for the different severities of systemic hypertension.

A

Minimal risk BP<150/95

Mild risk BP= 150-159/95-99

Moderate risk BP= 160-179/100-119

Severe risk BP>180/120

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15
Q

At which risk level are anti-hypertensive medications recommended?

A

Moderate risk BP= 160-179/100-119

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16
Q

An owner asks you about using salt restriction for BP control in her cat. What are your recommendations?

A

Salt restriction is not recommended as it can activate the RAAS to increase peripheral vascular resistance which will worsen the CV & renal consequences

17
Q

What are the adverse effects of using ACEi?

A

Decreased GFR & azotemia

Hyperkalemia

18
Q

You place a cat with renal insufficiency and proteinuria on an ACEi. How soon after should the renal values be checked?

A

5-7 days

19
Q

Why are ACEi typically combined with Ca channel blockers?

A

the vasodilation caused by the decreased Ca influx into the vascular smooth muscle may activate the RAAS.

20
Q

Which antihypertensive is the first line drug used in cats?

A

amlodipine

21
Q

In addition to serving as an anti-hypertensive, what other effects does Diltiazem have on the CV system?

A

decreased HR & contractility (decr. CO)

22
Q

Why is amlodipine often combined with Acei?

A

Amlodipine causes preferential vasodilation of afferent renal arterioles & increased intraglomerular pressure –> promotes glomerular damage

ACEi are renoprotective (reduce glomerular pressure and proteinuria)

23
Q

What is the treatment of choice for hypertension d/t hyperthyroidism?

A

B-blocker

24
Q

Which B-blockers (esmolol, atenolol, propranolol) are nonspecific vs. cardioselective?

A

Propranolol- nonspecific

esmolol (short acting), atenolol- cardioselective

25
Q

What is the treatment of choice for pheochromocytomas?

A

a1 blockers- peripheral vasoddilation

(phenoxybenzamine & prazosin)

26
Q

Which drug causes direct vasodilation by an unknown mechanism with a rapid onset of action?

A

Hydralazine

27
Q

What is the adverse effect of nitroprusside that may occur with high doses or prolonged treatment?

A

cyanide toxicity

28
Q

What diuretic may be indicated in cases of hyperaldosteronism?

A

Spironolactone

29
Q

When would administration of diuretics (furosemide & hydrochlorothiazide) be contraindicated?

A

chronic renal disease & dehydration

30
Q

How closely should you monitor BP after a dose adjustment? Once BP is controlled?

A

7-10 days

q1-4 months (start w/ shorter interval & increase)

31
Q
A

Small Animal Medicine (7 decks)

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