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23 Cards in this Set
- Front
- Back
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In a woman of 35 apart from essential hypertension what could cause hypertension? |
Renal Disease Renal Artery stenosis Hyperthroidism Conns syndrome Cushings syndrome pheochromocytoma (adrenalin secreting tumour) Drugs Hormonal contraceptive |
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What do NICE guidelines recommend is the first step in someone with clinc BP >140/90? |
Offer ambulatory BP monitoring |
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What are the complications associated with hypertension? |
MI Stoke Heart failure Hypertensive nephrosclerosis dissecting aortic aneurysm PVD Accelerated (malignant) hypertension |
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What is the NICE guileline for target BP? |
>80 150/90 <80 140/90 |
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What are the NICE guidelines for defining hypertension? |
Stage 1: clinic BP >140140/90 + ABPM/HBPM average >135/85 Stage 2: Clinic BP >160/100 + ABPM/HBPM >150/95 Stage 3: Clinic systolic BP >180 or diastolic >110 |
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What are some examples of hypertensive treatments? |
Diuretics B-blockers CCBs ACE inhibitors |
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What are some contraindications of durietics? |
Gout Renal Failure |
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What are some contraindications of b-blockers? |
Asthma COPD Heart block
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Who are b-blockers most suitable for? |
Angina, post MI, tachycardias |
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Who are ACE inhibitors particularly useful for? |
HF, younger patients, nephropathy |
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What is step 1 of the BHS guide for treating hypertension? |
Aged under 55: ACE inhibitor/ ARB Aged over 55 or African/caribbean orgin: CCB |
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Why should ACE inhibits been avoided in pregnacy? |
50% risk of congenital malformation, still birth and neonatal deaths (not if stopped within 7-8weeks) |
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What drug can be used in pregnancy to treat hypertension (existing and gestational)? |
Methyldopa |
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Why is methyldopa not given to all hypertensive women of child baring age? |
Adverse effect of drowsiness and depression |
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Which hypertensive drugs should be avoided in pregnancy? |
B-blocker (growth retardation) Thiazides (oligohydramnios) Ace inhibitors |
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According to the NICE guidelines what is the first line treatment in acute HF? |
Sit patient up, give high flow oxygen, IV access Furosemide 40-120mg IV |
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If the LVEF <40% which drugs should all patients be on unless contraindicated? |
ACE inhibitor |
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What are the contraindications of ACE inhibitors? |
Angio-oedema Renal artery stenosis Hyperkalaemia Severe renal impairment |
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When should the U+Es be checked of someone starting an ACE inhibitor? |
Prior to starting treatment then 1-2 weeks after treatment (also after dose adjustment) |
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What is benefit of diuretic treatment in heart failure? |
Symptomatic- does not halt disease progression |
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What should be monitored regularly on treatment with diuretics? |
Electrolytes- looking for hypokalaemia and hypovolemia Weight to assess degree of fluid retention |
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When should patients with HF be treated with B-blockers? |
All patients with symptomatic HF and an LVEF <40% where not contraindicated. They should initiated in stabilised patients already on diuretics and ACE inhibitors regardless of whether or not symptoms persist |
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When should Angiotensin-II receptor antagonist be used in the treatment of HF? |
Patients intolerant of standard ACE inhibitors and must only be used in patients with adequate renal function and a normal serum potassium |
