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26 Cards in this Set
- Front
- Back
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what are the A's of secondary hypertension?
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- apnea
- aldosteronism |
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what are the B's of secondary hypertension?
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- bruits (renal artery stenosis)
- bad kidneys (renal parenchymal disease) |
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T or F: kids as young as 8 have been diagnosed with sleep apnea.
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true
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what are the Cs of secondary hypertension?
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-catecholamines (pheochromocytoma)
- coarctication of the aorta |
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what are the D's of secondary hypertension?
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- drugs (oral contraceptives, cyclosporins)
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what are the E's of secondary hypertension?
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endocrine
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is secondary hypertension common? why do we treat it?
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- no
- we treat it because it is curable and tends to be much worse than primary hypertension |
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what 2 things can cause flash pulmonary edema?
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- diastolic dysfunction of the heart
- renal artery stenosis |
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what accounts for about 50% of secondary hypertension?
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renal and renovascular diseases
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why do we do 4 extremity blood pressures?
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to pick up coarctication of the aorta
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a person has hypertension, hypokalemia, and metabolic acidosis. what is the most likely diagnosis?
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hyperaldosteronism; this is the classic triad. usually caused by an Aldosterone Producing Ademoa
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you suspect a person is inappropriately secreting aldosterone. what is you next step?
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check the aldosterone/renin ration. if it is < 30 it is a safe bet that you do not have an Aldosterone Producing Adenoma.
if it is > 100 it is a safe bet that you do have an Aldosterone Producing Adenoma |
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what is the major side effect of spironolactone?
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gynecomastia
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what effect does aldosterone have on renin?
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aldosterone suppresses renin
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what are the major symptoms in pheochromocytoma?
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- headache
- tachycardia - anxiety - visual disturbances |
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how can you tell if catecholamines are coming from the nerve cells or adrenal cells?
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by how they are metabolized.
Adrenal catecholamines are broken down into metanephrine and normetanephrine while nerve cell catecholamines are not |
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do nerve cells cause pheochromocytoma?
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no
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what 2 things can give a person a false positive test for elevated levels of MN and NMN?
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- tylenol
- coffee |
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what are the rules of 10 for isolated pheochromocytoma?
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- 10% malignant
- 10% bilateral - 10% extra-adrenal - 10% genetic |
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what are the common genetic causes of pheochromocytoma?
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-MEN 1
- MEN 2 - MEN 3 - VHL - von Recklinghausen disease |
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what chromosome is MEN 2 on?
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- chromosome 10
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why should we never use a beta blocker alone when treating pheochromocytoma?
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the unopposed alpha receptors can cause rapid spikes in blood pressure that can be deadly
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a patient with renal artery stenosis has a resistive index of < 0.8. is it safe to open the stenosis?
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yes
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a patient has a renal artery stenosis of > 0.8. is it safe to open the stenosis?
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no
< 0.8 safe to open the artery > 0.8 do not open the artery |
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what is the most common cause of secondary hypertension?
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renal artery stenosis
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how do we treat hyperaldosteronism?
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- surgery
- aldosterone inhibiting drugs |
