Cv: 4. Boisvert/maloney : Essential Hypertension

Front 1

what is hypertension for a pt greater than 18

*** (give both diastolic and systolic)

Back 1

The average of two or more diastolic measurements on each of two or more visits being 90 mmHg or higher

The average of two or more systolic measurements on each of two or more visits being 140 mmHg or above.

Front 2

What is Essential Hypertension?

Back 2

Hypertension with no identifiable cause

90% of all cases of hypertension are essential

Front 3

is essential hypertension prevalent?

Back 3

shit ya! tons of fatties

Front 4

what is the relationship between BP and CVD?

Back 4

continuous

For those 40-70 each 20/10 mmHg increase from 115/75-185/115 mmHg doubles the risk

Front 5

how long should the patient be seated before taking a BP?

Back 5

5 minutes

Front 6

how much of the cuff bladder should encircle the arm?

Back 6

80%

Front 7

A patient walks in and just put their cigarette out, should you take their BP?

Back 7

no wait 30 mins

Front 8

if you have a normal BP classification, what range are your systolic and diastolic BP

Back 8

SBP <120
DBP <80

Front 9

if you have a prehypertension BP classification, what range are your systolic and diastolic BP

Back 9

SBP 120-139
DBP 80-89

Front 10

if you have a stage 1 hypertension BP classification, what range are your systolic and diastolic BP

Back 10

SBP 140-159
DBP 90-99

Front 11

if you have a stage 2 hypertension BP classification, what range are your systolic and diastolic BP

Back 11

SBP >160
DBP >100

Front 12

if you have a patient with dyspnea orthopnea, edema

what should you be thinking?

Back 12

Secondary Hypertension

Front 13

Narrowing of Arterioles are indicative of what grade retinopathy?

Back 13

grade 1

Front 14

AV nicking is indicative of what grade retinopathy?

Back 14

grade 2

Front 15

flame hemorrhage is indicative of what grade retinopathy?

Back 15

grade 3

Front 16

Soft exudates are indicative of what grade retinopathy?

Back 16

grade 4

Front 17

Papillemedema is indicative of what grade retinopathy?

Back 17

grade 5

Front 18

What is goal of therapy for hypertension with respect to BP? what if you have renal disease or are diabetic?

Back 18

<140/90

130/80 if you have diabetic or renal disease

Front 19

what is DASH with respect to hypertension?

Back 19

Dietary Approach to Stop Hypertension

goal of therapy

Front 20

if someone had diabetic or renal disease what is the goal to lower their BP to?

Back 20

130/80 if you have diabetic or renal disease

Front 21

Discuss the use of ambulatory blood pressure monitoring and
home monitoring in the diagnosis and treatment of hypertension.

Back 21

basically you can compare their home readings to your office reading and look for changes

Front 22

what type of pharmacologic treatment is unsurpassed in preventing CV complications of hypertension?

Back 22

diuretics

Front 23

what are 2 drug types you can use for stable angina

Back 23

B-blocker

Calcium channel Blocker

Front 24

what are 2 drug types you can use for acute coronary syndrome

Back 24

B blocker
ACE I

Front 25

what are 2 choices for first line treatment of HT in a pt with Diabetes?

Back 25

ACE and ARB

Front 26

when is a pt. said to have chronic kidney disease? if you are treating this pt what would you use for their HT?

Back 26

GFR<60

use ACEI or ARB

Front 27

Recurrent stroke rates lowered with a combination of?

Back 27

ACEI and Thiazide diuretic

Front 28

what is the best drug choice to treat HT in blacks? (2)

Back 28

Diuretics or CCBs

Front 29

what drug option should you use for children with HT?

Back 29

YOU SHOULDN'T. make lifestyle changes (aka make them get their fat asses off the couch, put down the McDonalds, and run)

only if in 95th percentile

Front 30

what drug would you NOT want to use in someone with gout?

Back 30

Thiazide because it increases uric acid

Front 31

What drugs would absolutely not want to give to a preggo woman who was HT?

Back 31

ACEI or ARB

Front 32

If a pt has Diabetes, what do you want to use to treat HT? ***

Back 32

ACE inhibitor (ARB would be second choice)

Front 33

Know this

Back 33

write it out

Front 34

When do you use Methyldopa?

Back 34

preggo with HT

Front 35

Outline follow-up visits for the treatment of hypertension.

objective

Back 35

Monthly until BP goal reached

More frequent visits if Stage 2 or complicating conditions

3-6 month visits after goal is reached

Serum creatinine and potassium 1-2 times/year

Low dose aspirin only after goal is reached

Front 36

discuss patient compliance.

objective

Back 36

Must agree upon goal
Must understand the condition and treatment
Overcome denial of illness
Cost of medication and medical care

Front 37

what is resistant hypertension?

Back 37

Failure to reach goal on full dose of appropriate three drug regimen that includes a diuretic

Front 38

what are some of the possible causes of resistant hypertension?

Back 38

Improper blood pressure measurement

Volume Overload (ie. excess Na+ intake, volume retention from kidney disease, inadequate diuretic therapy)

Drug induced (ie. NSAID, illicit drugs, BCP, steroids, decongestants, licorice, ephedra)

Associated Conditions (ie. obesity, excess alcohol intake)

Identifiable Causes of Hypertension

Front 39

please list where the 3 different diuretics act and their names

Back 39

Loop Diuretics: Loop of Henley
Thiazides: Distal Convoluted Tubule
K-Sparing: Collecting ducts