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20 Cards in this Set
- Front
- Back
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1. Essential HTN?
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a. No identifiable cause
b. Applied to >95% of cases of HTN. |
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2. Causes of Secondary HTN?
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a. Renal/renovascular disease
b. Endocrine causes c. Medications d. Coarctation of the Aorta e. Cocaine, other stimulants f. Sleep apnea. |
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3. Renal/Renovascular causes of secondary HTN?
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1. Renal Artery Stenosis (most common cause of secondary HTN)
2. Chronic renal failure 3. Polycystic kidneys. |
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4. Endocrine causes of secondary HTN?
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a. Hyperaldosteronism
b. Thyroid or parathyroid disease c. Cushing’s syndrome d. Pheo e. Hyperthyroid f. Acromegaly |
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5. Medication causes of secondary HTN?
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a. Oral contraceptives
b. Decongestants c. Oestrogen d. Appetite suppressants e. Chronic steroids f. TCAs g. NSAIDs |
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6. Risk factors for HTN?
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a. Age-Both systolic and diastolic BP increase w/age.
b. Gender- more common in men (gap narrows over 60). c. Race- 2x as common in African American pts as caucasion. i. Blacks have higher complication rates (stroke, renal failure, heart disease) d. Obesity, sedentary life style e. Family hx f. Increased sodium intake g. Alcohol. |
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7. Correlation of increased sodium intake and HTN?
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a. This correlates w/increased prevalence in large populations, although not in individuals.
b. Individual susceptibility to the effects of high salt intake varies. |
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8. How is alcohol associated w/HTN?
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a. Intake of >2 oz (8 oz of wine or 24 oz of beer) per day is associated w/HTN.
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9. Major Complications of HTN?
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a. Cardiac (CAD, CHF w/LVH). HTN is a major risk factor for CAD!!!! w/resulting angina and MI.
b. Stroke c. Renal failure. |
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10. What organs are primarily affected by HTN?
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1. CV system (effects on heart are most imp)
2. Eyes 3. CNS 4. Kidney |
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11. How does HTN affect the cardiovascular system?
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HTN is a major risk factor for CAD.
b. CHF is a common end-result of untreated HTN as LVH occurs. c. Most deaths due to HNT are ultimately due to MI or CHF. d. HTN predisposes the pt to Peripheral Vascular Disease (PVD). e. HTN is associated w/increased incidence of aortic dissection. |
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12. How does HTN affect the eyes?
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a. Retinal changes:
i. Early changes: AV nicking and cotton wool spots)- Can cause visual disturbances and scotoma. ii. More serious disease: Haemorrhage and exudates. iii. Papilledema: An ominous finding w/severely elevated BP. |
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13. AV nicking pathophys?
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a. Discontinuity in the retinal vein secondary to thickened arterial walls.
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14. Pathophys of Cotton wool spots?
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a. Infarction of the nerve fibre layer in the retina.
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15. How is the CNS affected by HTN?
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a. Increased incidence of intracerebral haemorrhage
b. Increased incidence of other stroke subtypes as well (TIA, ischaemic stroke, and lacunar stroke). c. Hypertensive encephalopathy when BP is severely elevated (uncommon) |
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16. HTN affect on Kidney?
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a. Arteriosclerosis of afferent and efferent arterioles and glomerulus- called nephrosclerosis.
b. Decreased GFR and dysfunction of tubules- w/eventual renal failure. |
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17. Most common cause of secondary HTN in young women?
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a. Birth Control pills.
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18. BP measurement?
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a. Unless the pt has severe HTN or evidence of end-organ damage, never diagnose HTN on the basis of one BP reading.
b. Establish the dx on the basis of at least 2 readings over a span of 4 or more weeks. |
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19. Effect of a cuff that is too small on BP?
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a. Can falsely elevate BP reading.
b. The bladder w/in the cuff should encircle at least 80% of the arm. |
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20. What tests should be ordered to evaluate target organ damage and assess overall CV risk?
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a. UA
b. Chem panel: serum K+, BUN, Cr c. Fasting glucose (if pt is diabetic, check for microalbuminuria) d. Lipid panel e. ECG. |
