Top 50 Diagnoses Physical Signs

Question 1

Retinopathy, S4, absent/diminished peripheral pulses

Other?

Answer 1

HTN

- also bruits

Question 2

What order if suspect HTN?

Answer 2

HCT, glucose, creatinine
Electrolytes, urinalysis, fasting lipid panel
EKG

Question 3

Papilledema

Retinal hemorrhages

Answer 3

Think HTN emergency (evidence of end organ damage)

or HTN urgency (severe HTN >180/120) with no evidence end organ damage

Question 4

Initial treatment of HTN in non AA population

Answer 4

Thiazide diuretic
ACEi / ARB
CCB

Question 5

Initial treatment of HTN in AA population

Answer 5

Thiazide diuretic
CCB

(why not ACEi = higher incidence stroke)

Question 6

Initial treatment of all patients with HTN and CKD?

Answer 6

ACEi or ARB

Question 7

Do NOT treat HTN with?

Answer 7

ACEi + ARB

Beta blocker

Question 8

How treat HTN + CAD?

Answer 8

Beta-blocker

Question 9

Treat HTN emergencies with?

Answer 9

Nitroprusside

• but only up to 24 hours
• can cause cyanide toxicity at
  
  • high doses
  • with prolonged use

Question 10

How should you not treat gestational HTN?

Answer 10

ACEi / ARB / DRI