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37 Cards in this Set

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In children, HTN is based on what percentile or greater? How many readings must be taken?
1. 95th percentile
2. 3
What are some causes of essential HTN?
1. sleep apnea
2. drug-induced
3. chronic kidney disease
4. primary aldosteronism
5. renovascular disease
6. chronic steroid use or cushing's disease
7. pheochromocytoma
8. coarctation of the aorta
9. thyroid or parathyroid disease
Normotensive 55 y/o people have what risk of developing HTN?
90%
When taking BP, cuff bladder should encircle how much of the arm? Cuff width should be how wide?
1. 80% of arm
2. 2/3 of arm width
What are the BP readings in normotension, pre-HTN, stage 1 HTN, and stage 2 HTN?
1. <120/80
2. 120/80-140/90
3. 140/90-160/100
4. >160/100
What are the recommendations for normal, prehypertension, stage 1 HTN and stage 2 HTN?
1. encourage lifestyle modification
2. lifestyle modification
3. lifestyle modification and thiazide diuretic
4. lifestyle modification and thiazide diuretic + another drug
GFR that is considered a risk for HTN?
<60 ml/min
What are some hints to secondary HTN?
1. CVD
2. cerebrovascular disease
3. renovascular disease
4. pheochromocytoma
5. hyperparathyroidism
What are the 5 grades of retinopathy?
Grade 1: arteriole narrowing (silver wiring)
Grade 2: AV nicking
Grade 3: hemorrhage of blood vessels (flame hemorrhages)
Grade 4: soft exudates from microinfacts
Grade 5: papiledema from HTN
What sx will cushing's disease present with?
1. moon facies
2. hypertrichosis
3. obesity
Neurofibromas or cafe-au-lait spots may indicate what?
1. pheochromocytoma
2. renal dysplasia
3. renal stenosis
ECG may show what in HTN?
1. LVH
2. primary AV block
3. inverted p wave in V1
UA results may show what in HTN?
1. SG elevation may indicate chronic renal failure
2. glucose-DM
3. proteinuria-renal disease
4. casts-glomerular disease
Hypokalemia in electrolyte panel may indicate what?
1. primary aldosteronism
2. laxative abuse
3. vomiting
What is the goal of antihypertensive therapy?
1. BP<140/90
2. BP<130/80 in DM or renal disease
Diuretics are the first line of treatment for HTN with the following exceptions:
1. ischemic heart disease
2. heart failure
3. DM
4. chronic kidney disease
5. cerebrovascular disease
What should be given to treat HTN in patients with stable angina?
1. beta blocker
2. Ca++ channel blocker
What should be given to treat HTN in patients with acute coronary syndrome or post-MI?
1. ACE inhibitors
2. beta blockers
3. aldosterone antagonists (in post-MI only)
What should be given in asymptomatic heart failure?
1. ACE inhibitors
2. beta blockers
What should be given in symptomatic heart failure?
1. ACE inhibitors
2. beta blockers
3. ARB's
4. aldosterone antagonists
5. loop diuretics (in combo w/antihypertensives)
In diabetics, which drugs are the first line? What are problems with the other antihypertensives?
1. ACE inhibitors and ARB's
2a. thiazides raise blood sugar
2b. beta blockers blunt hypoglycemic response
2c. Ca++ channel blockers should not be given without ACE inhibitors
What drugs can be given to treat HTN in chronic kidney disease? What should you be careful of?
1. ACE inhibitors and ARB's
2. GFR<60 or increase in creatinine or K+
If GFR <30 ml/min, what drug should be given in combination with antihypertensives?
loop diuretics
How should HTN be treated following an acute stroke? What drugs are used?
1. lower to 160/100 first until this level stabilizes, then lower more
2. ACE inhibitors and thiazide diuretics
What are causes of resistant HTN?
1. improper BP measurement
2. volume overload
3. drug induced
4. HTN associated conditions
What are the guidelines for f/u visits for HTN?
1. monthly visits (more frequent if stage 2) until goal is reached
2. 3-6 month visits after goal is reached
3. serum creatinine and K+ once/twice per year
4. low dose ASA after goal is reached
Which antihypertensives work well with blacks?
diuretics or Ca++ channel blockers
What antihypertensives can be given to pregnant women?
1. methyldopa
2. beta blockers
3. direct acting vasodilators
LVH will regress with all but which antihypertensives?
hydralazine and minoxidil
What are some favorable actions of antihypertensives?
1. thiazides reduce demineralization in osteoporosis
2. beta blockers also treat atrial tachyarrhythmias, migraines, and thyrotoxicosis
3. Ca++ channel blockers also work in raynaud's syndrome and certain arrhythmias
4. alpha blockers help with BPH
What are some unfavorable actions of antihypertensives?
1. thiazides may cause gout or hyponatremia
2. beta blockers will make asthma worse or cause 2nd or 3rd degree heart block
Which spinal segments are connected to the adrenal glands?
T10 and T11
What OMT can be used to decrease SNS tone at T10 and T11?
1. treat thoracolumbar junction
2. chapman's reflexes
What OMT can be used to help with retained fluids and electrolytes?
fascial techniques
What OMT can reduce the hypothalamic activation of the SNS?
1. CV IV
2. correct SBS
3. OA
4. parietal lift
What OMT can be used to treat baroreceptor activation of PVR?
1. OA
2. cervical tissues
What OMT can be used to treat ANS activation of PVR?
1. rib raising
2. chain ganglion