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37 Cards in this Set
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- Back
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In children, HTN is based on what percentile or greater? How many readings must be taken?
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1. 95th percentile
2. 3 |
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What are some causes of essential HTN?
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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 |
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Normotensive 55 y/o people have what risk of developing HTN?
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90%
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When taking BP, cuff bladder should encircle how much of the arm? Cuff width should be how wide?
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1. 80% of arm
2. 2/3 of arm width |
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What are the BP readings in normotension, pre-HTN, stage 1 HTN, and stage 2 HTN?
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1. <120/80
2. 120/80-140/90 3. 140/90-160/100 4. >160/100 |
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What are the recommendations for normal, prehypertension, stage 1 HTN and stage 2 HTN?
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1. encourage lifestyle modification
2. lifestyle modification 3. lifestyle modification and thiazide diuretic 4. lifestyle modification and thiazide diuretic + another drug |
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GFR that is considered a risk for HTN?
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<60 ml/min
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What are some hints to secondary HTN?
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1. CVD
2. cerebrovascular disease 3. renovascular disease 4. pheochromocytoma 5. hyperparathyroidism |
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What are the 5 grades of retinopathy?
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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 |
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What sx will cushing's disease present with?
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1. moon facies
2. hypertrichosis 3. obesity |
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Neurofibromas or cafe-au-lait spots may indicate what?
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1. pheochromocytoma
2. renal dysplasia 3. renal stenosis |
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ECG may show what in HTN?
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1. LVH
2. primary AV block 3. inverted p wave in V1 |
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UA results may show what in HTN?
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1. SG elevation may indicate chronic renal failure
2. glucose-DM 3. proteinuria-renal disease 4. casts-glomerular disease |
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Hypokalemia in electrolyte panel may indicate what?
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1. primary aldosteronism
2. laxative abuse 3. vomiting |
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What is the goal of antihypertensive therapy?
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1. BP<140/90
2. BP<130/80 in DM or renal disease |
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Diuretics are the first line of treatment for HTN with the following exceptions:
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1. ischemic heart disease
2. heart failure 3. DM 4. chronic kidney disease 5. cerebrovascular disease |
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What should be given to treat HTN in patients with stable angina?
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1. beta blocker
2. Ca++ channel blocker |
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What should be given to treat HTN in patients with acute coronary syndrome or post-MI?
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1. ACE inhibitors
2. beta blockers 3. aldosterone antagonists (in post-MI only) |
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What should be given in asymptomatic heart failure?
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1. ACE inhibitors
2. beta blockers |
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What should be given in symptomatic heart failure?
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1. ACE inhibitors
2. beta blockers 3. ARB's 4. aldosterone antagonists 5. loop diuretics (in combo w/antihypertensives) |
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In diabetics, which drugs are the first line? What are problems with the other antihypertensives?
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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 |
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What drugs can be given to treat HTN in chronic kidney disease? What should you be careful of?
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1. ACE inhibitors and ARB's
2. GFR<60 or increase in creatinine or K+ |
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If GFR <30 ml/min, what drug should be given in combination with antihypertensives?
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loop diuretics
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How should HTN be treated following an acute stroke? What drugs are used?
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1. lower to 160/100 first until this level stabilizes, then lower more
2. ACE inhibitors and thiazide diuretics |
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What are causes of resistant HTN?
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1. improper BP measurement
2. volume overload 3. drug induced 4. HTN associated conditions |
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What are the guidelines for f/u visits for HTN?
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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 |
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Which antihypertensives work well with blacks?
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diuretics or Ca++ channel blockers
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What antihypertensives can be given to pregnant women?
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1. methyldopa
2. beta blockers 3. direct acting vasodilators |
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LVH will regress with all but which antihypertensives?
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hydralazine and minoxidil
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What are some favorable actions of antihypertensives?
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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 |
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What are some unfavorable actions of antihypertensives?
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1. thiazides may cause gout or hyponatremia
2. beta blockers will make asthma worse or cause 2nd or 3rd degree heart block |
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Which spinal segments are connected to the adrenal glands?
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T10 and T11
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What OMT can be used to decrease SNS tone at T10 and T11?
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1. treat thoracolumbar junction
2. chapman's reflexes |
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What OMT can be used to help with retained fluids and electrolytes?
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fascial techniques
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What OMT can reduce the hypothalamic activation of the SNS?
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1. CV IV
2. correct SBS 3. OA 4. parietal lift |
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What OMT can be used to treat baroreceptor activation of PVR?
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1. OA
2. cervical tissues |
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What OMT can be used to treat ANS activation of PVR?
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1. rib raising
2. chain ganglion |
