HTN DA5

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Author:
HUSOP2014
ID:
170511
Filename:
HTN DA5
Updated:
2012-09-12 23:12:21
Tags:
DA5 HTN HUSOP
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Description:
DA 5 HTN
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  1. Name the major risk factors for developing cardiovascular disease
    • HTN
    • age
    • low HDL
    • smoking
    • high LDL
  2. Identify the complications of hypertension
    Target organ damage

    • · Stroke
    • · Myocardial infarction
    • · Angina
    • · Heart failure
    • ·  Kidney failure (end-stage kidney disease)
    • ·  Early death
  3. Primary HTN is caused by __________.
    unknown causes
  4. Is primary HTN curable or controlable?
    controlable
  5. Secondary HTN is caused by _______.
    morbid diseases or  medications
  6. Is secondary HTN curable or controlable?
    Curable by treating underlying cause
  7. Prehypertension blood pressure goal  ___________
    Return to normal BP with lifestyle modifications
  8. Hypertension blood pressure goal  ______
    <140/90 mmHg
  9. Hypertension  with Diabetes or renal diease  blood pressure goal  ______
    <130/80 mmHg
  10. Blood Pressure =
    Cardiac Output (CO) x Total Peripheral Resistance (TPR)
  11. Activation of α1 receptors causes ________ which _______ BP
    • vasoconstriction
    • increases
  12. Activation of α2 receptors causes _______ BP
    decreased
  13. Activation of β1 receptors causes ________ which _______ BP
    • increased heart rate & contractility 
    • increases
  14. Angiotensin II cause _______ sympathetic outflow
    increased
  15. __________ are pressure sensing nodes in the _________ and ________
    • baroreceptors
    • carotid
    • aorta
  16. When the baroreceptor sense a drop in BP the cause ______, _______, and ______________
    • vasoconstriction
    • ↑ HR
    • forced cardiac constriction
  17. The žNatriuretic Hormone has what effect on the Na/K ATPase?
    inhibition
  18. When the Na/K ATPase is blocked, does this prevent Na excretion or reuptake?
    What effect does this have on blood volume & BP?
    • excretion
    • Na retention will --> ↑blood volume --> ↑BP
  19. —Prostacyclin, —Bradykinin, —& Nitric Oxide are what kind of substances?
    žVasodilating Substances
  20. —Angiotensin II & —Endothelin I are what kind of substances?
    žVasoconstricting Substances
  21. HTN is defined as a Systolic blood pressure (SBP) _____ OR
    Diastolic blood pressure (DBP) _______  with _____ different readings on ____ different days.
    •  ≥140mmHg
    • ≥90mmHg
    • 2
    • 2
  22. Normal BP is
    <120 AND <80
  23. Prehypertension is
    120-139 OR 80-89
  24. Stage 1 HTN is
    140-159 OR 90-99
  25. Stage 2 HTN is
    ≥160 OR ≥100
  26. Hypertensive Crisis is
    ≥180 OR ≥120
  27. A Hypertensive Crisis that has no target organ (non-symptomatic) is a _______________
    hypertensive urgency
  28. A Hypertensive Crisis that involves a target organ is a _________.
    hypertensive emergency
  29. What are the 3 main ways to lower BP?
    • Reduce HR
    • Reduce volume
    • Vasodilation
  30. What drugs reduce HR?
    Beta Blockers 
  31. What drugs reduce volume?
    diuretics
  32. What drugs cause vasodilation?
    • ACE-Is
    • ARBs
    • α1 agonists
    • α2 blockers
    • CCBs
    • direct vasodilators
  33. AHA recommends a BP of _____________ for left
    ventricular dysfunction.
    120/80 mm Hg
  34. What compelling indications are required for a JNC7 BP recommendation of 130/80mmHg?
    • Diabetes
    • CKD
  35. What class of antihypertensives is contraindicated in heart failure?
    CCBs
  36. What 2 classes of drugs are recommended in heart failure?
    • ACE-Is
    • ARBs
  37. What 2 classes of drugs are the standard of care post-MI?
    • Beta Blockers
    • ACE-Is
  38. What classes of antihypertensives are the standard of care for HTN with diabetes and why?
    • ACE-Is
    • ARBs
    • They are renal protective
  39. What classes of antihypertensives are the standard of care for HTN with CKD and why?
    • ACE-Is
    • ARBs
    • They are renal protective
  40. What classes of drugs are recommended for recurrent stroke prevention?
    • diuretics
    • ACE-Is
  41. What antihypertensives should be avoided in asthma and why?
    • beta blockers
    • beta 2 receptors in lungs
  42. What antihypertensives should be avoided in AV heart block?
    • beta blockers
    • CCBs
  43. What antihypertensives should be avoided in hyponatremia?
    diuretics
  44. What antihypertensives should be avoided in K > 5 & SCr >2.5?
    • diuretics
    • ACE-Is
    • ARBs
    • Aldosterone antagonists
  45. What antihypertensives should be avoided in pregnancy?
    • ACE-Is
    • ARBs
  46. What antihypertensives should be avoided in angioedema?
    • ACE-Is
    • ARBs
  47. Stage 1 HTN without compelling indications is usually treated with a _______________.  _________, _________, __________, ____________, or a combination may be considered.
    • thiazide diuretic
    • ACE-Is
    • ARBs
    • BBs
    • CCBs
  48. Stage 2 HTN is usually treated with a ____________ of a _________ and an _________, _________, ________, or ________
    • 2 drug comb
    • thiazide diuretic
    • ACE-I
    • ARB
    • BB
    • CCB
  49. What antihypertensives are going to be the first line agent for most patients without a compelling indication
    thiazide diuretics
  50. JNC-7 suggests starting patients with Stage 2 Hypertension on one antihypertensive agent
    True or False
    • False
    • 2 agents
  51. Which diuretic is a more effective antihypertensive thiazide or loop
    thiazide
  52. Which is a more potent diuretic thiazide or loop?
    loop
  53. What benefit do thiazide diuretics have in osteoporosis?
    ↑Ca2+
  54. Chlorthalidone is ________ more potent than hydrochlorothiazide
    1.5x
  55. What diuretic should be used when CrCl < 30ml/min
    loop
  56. What class of drugs does bumetanide belong to?
    loop diuretics
  57. Triamterene & Aldosterone antagonists are both
    K+ sparing diuretics
  58. K+ levels should be monitored within  ____ days of starting a K+ sparing diuretic
    7
  59. SCr & electrolytes should be monitored within ___ weeks of starting a diuretic
    4
  60. ________ is the only loop diuretic that does not contain a sulfonamide group
    –Ethacrynic acid
  61. Spironolactone and Eplerenone belong to what class of drugs?
    Aldosterone Antagonists
  62. Contraindications of Aldosterone Antagonists include
    • Severe renal impairment
    • Hyperkalemia
  63. Lisinopril & Enalapril belong to what class?
    ACE-Is
  64. For what compelling indications should ACE-Is be used?
    • DM
    • proteinuria
    • post MI
    • CHF
  65. SCr & electrolytes should be monitored ________ after starting an ACE-I
    2-3 weeks
  66. ACE-Is are allowed to cause an increase in –SCr of no more than a ____  from baseline
    30%
  67. ACE-Is may ___–K+ and ____Na+
    • increase
    • decrease
  68. Contraindications of ACE-Is are
    • Pregnancy
    • Bilateral Renal Artery Stenosis
    • Hyperkalemia (relative) 

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