• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

image

PLAY BUTTON

image

PLAY BUTTON

image

Progress

1/20

Click to flip

Card Range To Study

through

20 Cards in this Set

  • Front
  • Back
What is the definition of a hypertensive urgency?
Systolic BP >180 mmHg
and/or Diastolic BP >120 with NO EVIDENCE of end-organ damage
What is the definition of a hypertensive emergency?
Systolic BP >180 mmHg
and/or Diastolic BP >120 with EVIDENCE of end-organ damage
What are examples of CV system end-organ damage? Renal? Neuro? Heme?
CV – MI, unstable angina, acute CHF, Aortic dissection

Renal – Acute renal failure

Neuro – Stroke, Aneurysms, brain hemorrhage

Heme – Microangiopathic hemolytic anemia
What clinical questions are you going to ask to assess for possible cardiac end-organ damage?
Chest pain, cough, vomiting, leg swelling, back pain, jaw pain, arm pain, orthopnea
What maneuvers will you perform in your exam to assess for possible cardiac end-organ damage?
Auscultate heart and lungs, percuss lungs (edema?), check pulses (equal?), inspect neck (JVD?), inspect legs (swollen?)
What labs would you order if you suspect cardiac end-organ damage?
EKG, BNP, CK-MB or Troponin, CXR
Why is it important to treat hypertensive emergency?
One-year mortality following untreated hypertensive emergency is 70% to 90%; with treatment, this decreases to 10%
What are some cardiovascular morbidities that are the result of untreated hypertensive emergency?
Acute and Chronic CHF

MI or unstable angina

LVH and Diastolic Dysfunction

Aortic Dissection
What are some neurolgic morbidities that are the result of untreated hypertensive emergency?
Subarachnoid hemorrhage

Intracranial hemorrhage

Ischemic Stroke
What are some renal morbidities that are the result of untreated hypertensive emergency?
Acute Renal Failure

Chronic Kidney Disease

Need for dialysis
What are some causes of hypertensive urgency/emergency?
Untreated/undertreated hypertension

Med noncompliance

Rebound hypertension

Illicit drug use (ie nose candy)

Hormones
Acute MI is a compelling indication for the use of what drugs?
Beta Blockers

ACEIs/ARBs

Nitrates
What drugs are contraindicated in Acute Renal Failure?
No ACEIs/ARBs
What drugs are contraindicated in acute CHF?
No Beta Blockers or Calcium Channel Blockers
Aortic dissection is a compelling indication for what drug?
Beta Blockers
What drugs are contraindicated with cocaine/pheochromocytoma?
No beta blockers
Pregnancy is a compelling indication for what drugs in a pt with HTN U/E?
Labetolol

Hydralazine (no ACEIs/ARBs)

Magnesium Sulfate
What is the Tx strategy for Hypertensive Urgency?
Short-acting anti-hypertensives

Observe

Discharge

Follow Up in 1-2 days
What is the Tx strategy for Hypertensive Emergency?
ICU admission

IV agents used

First Hour: 25% reduction in MAP

Following Six Hours: SBP 160mmHg and DBP 100-110mmHg

Following 24-48 hrs: trend towards normotension
Why should you avoid dropping BP too quickly during a HTN E?
Possibility of stroke,

hypotension/syncope, MI/angina, and

renal failure