MJ- Foundations 2 Exam 2 > HTN 1 > Flashcards

HTN 1 Flashcards

(52 cards)

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1
Q
  • Elevated Systolic BP
  • Elevated Diastolic BP
  • Both systolic & diastolic BP elevated
  • Often asymptomatic
A

HTN

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2
Q

Contraction

A

Systolic

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3
Q

Relaxation

A

Diastolic

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4
Q
  • HTN is a precursor to which 4 main systemic diseases?
  • What is the physiology?
A
  • Cardiovascular disease***
  • Renal failure
  • Cerebrovascular disease
  • Hypertensive retinopathy

Physiology: The perfusion to these organs are affected, leading to damage.

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5
Q

Why do women have higher rates of HTN when they turn 55 compared to when they were 45-54 y/o?

A

Menopause

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6
Q

Which race has higher incidence of HTN?

A

African Americans

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7
Q

Beginning at a BP of 115/75 mmHg, the risk for CVD doubles for each increment of what?

A

20/10

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8
Q

Which type of HTN accounts for 90-95% of all cases?

A

Primary (essential) HTN

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9
Q

Which 3 things control BP?

A
  • Sympathetic Nervous System
  • RAAS
  • Plasma volume (mediated by kidneys)
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10
Q

What are the 5 modifiable risk factors of HTN?

A
  • Smoking
  • Diet (sodium)
  • Excess ETOH
  • Obesity/weight gain
  • Physical inactivity
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11
Q
  • Renal disease
  • Medication induced
  • Thyroid/Parathyroid disease
  • Obstructive sleep apnea (obese patients)
  • Pheochromocytoma
A

Causes of Secondary HTN

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12
Q
  • Coarctation of the Aorta
  • Primary Aldosteronism
  • Renovascular Disease
  • Cushing’s Syndrome
A

Causes of Secondary HTN

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13
Q
  • HTN onset at young age
  • onset of Diastolic HTN at age over 50 yrs
  • Target organ damage (end organ damage)
  • Poor response to generally effective therapy
A

You should suspect Secondary HTN

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14
Q
  • Hypokalemia
  • Abdominal bruit
  • Labile pressures w/ tachycardia, sweating, and tremor
  • Family hx of kidney disease
A

Signs of secondary HTN

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15
Q
  • Myocardial infarction
  • Angina
  • Coronary revascularization
  • Heart failure
A

Heart disease

(Target Organ Damage / End Organ Damage)

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16
Q
  • Ischemic stroke
  • Cerebral hemorrhage
  • TIA
A

Cerebrovascular Disease

(Target Organ Damage / End Organ Damage)

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17
Q
  • Retinopathy
  • Renal Disease
  • Peripheral arterial disease
A

Target Organ Damage / End Organ Damage

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18
Q
  • Medications
  • Illicit drug use
  • Muscle weakness
  • Tachycardia
  • Sweating
  • Tremor
  • Thinning skin
  • Flank pain
A

Secondary HTN

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19
Q
  • Early morning headaches
  • Daytime somnolence
  • Loud snoring
  • Erratic sleep
A

Signs of sleep apnea

(Secondary HTN)

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20
Q
  • Smoking
  • Diabetes
  • Dyslipidemia
  • Physical inactivity

(risk factors for what?)

A

Cardiovascular risk factors

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21
Q
  • HA
  • Transient weakness/blindness
  • Loss of visual acuity
  • CP
  • Dyspnea
  • Claudication
  • Sexual dysfunction
Study These Flashcards
A

Signs of Target Organ Damage

22
Q

What are 2 additional “vital signs” of a HTN evaluation?

Study These Flashcards
A
  • BMI
  • Waist circumference
23
Q

What are 4 general PE findings you should assess for when evaluating HTN?

Study These Flashcards
A
  • Body fat distribution
  • Skin lesions
  • Muscle strength
  • Alertness
24
Q
  • Narrowing of the arterial diameter to less than 50% of venous diameter
Study These Flashcards
A

Grades 1 - 2 Hypertensive Retinopathy

25
* Copper or silver wire appearance * Exudates 3+ * Cotton wool spots * Hemorrhages
Grade 3 Hypertensive Retinopathy
26
* Flame hemorrhage * Hard exudate * Cotton wool spot * Papilledema \*\*
Grade 4 Hypertensive Retinopathy
27
What are 2 components of a neck exam needed to evaluate for HTN?
* Thyroid (secondary HTN) * Carotids
28
2 concerning respiratory PE findings for HTN
* Rhonchi * Rales
29
3 concerning abdominal PE findings for HTN
* Renal masses * Renal bruits * Femoral pulses
30
3 concerning Neuro PE findings for HTN
* Visual disturbance * Focal weakness * Confusion
31
Which 2 pulses should you palpate simultaneously when evaluating a patient who may have HTN?
* Brachial * Femoral
32
* Displaced PMI * ECG evidence FIndings for what?
Left Ventricular Hypertrophy (HTN)
33
What murmur will you hear in patient w/ HTN?
S4 (presystolic gallop) due to decreased compliance of left ventricle
34
What 3 arteries do you need to auscultate for bruits when evaluating pt w/ HTN?
* Carotid * Abdominal (aorta) * Femoral
35
What are the screening recommendations for HTN by the USPSTF?
**All adults 18+** * 18 - 39 y/o _(every 3 - 5 years)_, w/ normal BP and no risk factors * 40+ y/o _(annually)_ * At increased risk for HTN _(annually)_
36
**What is required for diagnosis of HTN?** * How many readings? * How many office visits?
Based on the average of: * 2 (or more) properly measured, seated, BP readings * on each of 2 (or more) office visits
37
**SBP:** \<120 and **DBP:** \<80
**Normal BP** | (2017 ACC/AHA guidelines)
38
**SBP:** 120 - 129 and **DBP:** \<80
**Elevated BP** | (2017 ACC/AHA guidelines)
39
**SBP:** 130 - 139 or **DBP:** 80 - 89
**Stage 1 HTN** | (2017 ACC/AHA guidelines)
40
**SBP:** \>140 (140 or higher) or **DBP:** \>90 (90 or higher)
**Stage 2 HTN** | (2017 ACC / AHA guidelines)
41
* If a patient has BPs within more than 1 category, do we diagnose the higher or lower category? * *Ex: **SBP:** 130 **DBP:** 92*
* Higher (always round up) * Stage 2 HTN
42
Ex: **SBP:** 125 **DBP:** 83
Stage 1 HTN
43
Ex: **SBP:** 122 **DBP:** 78
Elevated BP
44
* 20 - 25% of Stage 1 HTN * Pt is hypertensive only in the office
White coat HTN
45
* 10% of patients * Increased cardiovascular risk * In office, pt w/ normal BP, but most of the time has high BP at home
Masked HTN
46
What 6 tests should you order to evaluate for HTN?
* CBC * TSH * EKG * UA * Blood chemistries (glucose, Ca, creatnine, electrolytes, GFR) * Lipid profile
47
What are 3 tests you might consider ordering to evaluate for HTN?
* Urine albumin excretion * Echocardiogram * Sleep study
48
Treatment for pt w/ **normal BP** **less than 120/80** (according to ACC/AHA 2017)
* Promote healthy lifestyle habits * Reassess in 1 year
49
Tx for pt w/ **elevated BP** **120-129 / less than 80** (according to ACC / AHA 2017)
* Nonpharm therapy (lifestyle changes) * Reasses in 3 - 6 months
50
Tx for Pt w/ **Stage 1 HTN** w/ risk under 10% **130 - 139 / 80 - 90** (according to ACC / AHA 2017)
* Nonpharm therapy (lifestyle changes)
51
Tx for Pt w/ **Stage 1 HTN** w/ risk 10% or higher **130-139 / 80-90** (according to ACC / AHA 2017)
* Nonpharm therapy (lifestyle changes) * BP lowering medication
52
Tx for Pt w/ **Stage 2 HTN** **Over 140/90** (according to ACC / AHA 2017)
* Nonpharm therapy (lifestyle changes) * BP lowering medication
MJ- Foundations 2 Exam 2
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