Week 1 - A 35 year old woman with hypertension Flashcards
What condition(s) may be responsible for this patient’s presentation? What further history is required from her?
Which drugs could be the cause of this patient’s hypertension?
What is the definition of hypertension?
- In adults?
- In children?
- Primary?
- Secondary?
- Resistant?
Classification of Hypertension?
Epidemiology of HTN:
- Prevalence?
- Sex?
Aetiology of Primary Hypertension?
- 3 Non-modificable Risk factors for primary HTN?
- 7 modificable Risk factors for primary HTN?
Which clinical signs are suggestive of secondary HTN vs. Primary/Essential HTN?
What is the RECENT acronym for remembering the causes of secondary hypertension?
- What are the most common causes of secondary HTN in adults?
- What are the most common causes of secondary HTN in children?
3 causes of renal hypertension?
What are 7 common causes of endocrine hypertension, their potential indications for further workup and their typical findings?
Other than renal and endocrine causes of secondary HTN, what are 3 other causes?
What would you look for on examination?
What are the clinical features of HTN?
What are the cardiovascular complications of HTN?
What are the Brain complications of HTN?
What are the renal complications of HTN?
What are the opthalmic complications of HTN? Hypertensive retinopathy?
- 4 Grades?
What does her retinal image show?
- Hard exudates
- Cotton wool spots
- Flame haemorrhages
- This is grade 3 hypertensive retinopathy. There are considerable hard exudate in the posterior pole with formation of a partial macular star.
- In grade 4 retinopathy optic disc swelling would also be present, but there is no evidence that clinical outcomes differ on the basis of the fundoscopic findings and both grade 3+4 should be regarded as indicators of hypertensive emergency.
What treatment should be immediately instituted?
Once BP has been initially lowered in a hypertensive crisis what should your management involve next?
Discuss screening for hypertension:
- Indications?
- Method?
How should hypertension be diagnostically confirmed?
Which tests should be included in the Evaluation of patients with newly diagnosed hypertension?
What is this investigation and what does it show?
What are the First-line antihypertensive medications?
What are the second line antihypertensive medications and their indications?
Which Antihypertensive treatments should be used in patients with:
- CKD?
- Diabetes?
- CHF?
- Asthma?
Discuss the Incidence, Risk Factors and Presentation of Hypertensive crises?
List 6 causes of hypertensive crisis?
- Which drugs?
Hypertensive crisis management algorithm?
Which drugs are most commonly used? (3)
The drugs most commonly used to treat hypertensive emergencies are nitroprusside, labetalol, and nicardipine.
Nitroprusside = An intravenously administered, short-acting nitrate used to treat hypertensive crisis. Releases nitric oxide, which causes arterial and venous dilation.
Labetalol = An adrenergic blocker with nonselective β antagonism (both β1 and β2 receptors) and some α1 antagonism.
Narcidipine = A medium-acting dihydropyridine calcium channel blocker with a half-life of 8-12 hours commonly used in the management of hypertension, angina and supraventricular arrhythmias.
Renal Artery Stenosis:
- Epidemiology?
- Aetiology?
What is the pathophysiology of renal artery stenosis?
Renal artery stenosis:
- 6 Clinical features?
- 8 Indications for imaging?
Renal artery stenosis:
- Imaging modalities?
- 8 Indications for imaging?
- Imaging findings?
- 2 Lab ixs?
Ixs - Lab
1. Basic Metabolic Panel - Evidence of renal insufficiency (↑ serum creatinine, ↑ BUN, hyperkalemia) & Hypokalaemia (uncommon)
2. Urinalysis: Proteinuria may be present.
Renal Artery Stenosis Treatment
- Tx of associated hypertension?
- Tx of atherosclerosis?
- Surgical? Indications? 2 Options?
