Hypertension Criteria Quiz
250 Questions
4 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is considered normal blood pressure according to the 2020 guidelines?

  • 140 to 159 over 90 to 99
  • Less than 130 over 85 (correct)
  • 130 to 139 over 85 to 89
  • Less than 120 over 80

    • What symptoms may indicate severe hypertension?

  • Chest pain and shortness of breath
  • Dizziness and fatigue
  • Headache, nausea, and blurry vision (correct)
  • Constant coughing and fever

    • Which of the following stages of hypertension is categorized by a reading of 140 to 159 over 90 to 99?

  • Elevated
  • Stage 2
  • Stage 1 (correct)
  • Normal

    • What differentiates a hypertensive emergency from a hypertensive urgency?

    <p>Presence of end organ damage</p> Signup and view all the answers

    What is the criteria for Stage 2 hypertension?

    <p>Greater than 160 over 100</p> Signup and view all the answers

    What type of examination can reveal symptoms of hypertension during its assessment?

    <p>Fundoscopy examination</p> Signup and view all the answers

    What blood pressure measurement indicates elevated hypertension?

    <p>130 to 139 over 85 to 89</p> Signup and view all the answers

    Which condition can be a symptom of severe hypertension?

    <p>Headache</p> Signup and view all the answers

    What is the criterion for hypertensive urgency?

    <p>Greater than 180 over 120 without symptoms of end organ damage</p> Signup and view all the answers

    What blood pressure reading indicates Stage 1 hypertension?

    <p>140 to 159 over 90 to 99</p> Signup and view all the answers

    What is a potential sign of end organ damage in hypertensive emergencies?

    <p>Renal failure</p> Signup and view all the answers

    What is the normal blood pressure range according to recent guidelines?

    <p>Less than 130 over 85</p> Signup and view all the answers

    What ocular findings might be present in severe hypertension?

    <p>Papilledema and copper wiring</p> Signup and view all the answers

    According to the 2020 guidelines, what defines Stage 2 hypertension?

    <p>Greater than 160 over 100</p> Signup and view all the answers

    What is generally true about the awareness of hypertension among individuals?

    <p>It can often be asymptomatic until severe</p> Signup and view all the answers

    What defines the category of hypertensive emergencies?

    <p>Indications of end organ damage at blood pressure greater than 180 over 120</p> Signup and view all the answers

    What is the blood pressure classification for Stage 1 hypertension?

    <p>140 to 159 over 90 to 99</p> Signup and view all the answers

    Which condition may accompany hypertensive urgency but not hypertensive emergency?

    <p>Headache</p> Signup and view all the answers

    Which of the following indicators is NOT a sign of severe hypertension?

    <p>Euphoria</p> Signup and view all the answers

    What is the diagnosis for blood pressure readings exceeding 180 over 120 without symptoms of end organ damage?

    <p>Hypertensive urgency</p> Signup and view all the answers

    In which hypertension stage do symptoms like renal failure typically occur?

    <p>Emergency</p> Signup and view all the answers

    What blood pressure range qualifies as elevated according to the recent guidelines?

    <p>130 to 139 over 85 to 89</p> Signup and view all the answers

    Which ocular sign is associated with severe hypertension?

    <p>Fundoscopy</p> Signup and view all the answers

    What is the characteristic blood pressure for someone diagnosed with Stage 2 hypertension?

    <p>160 or greater over 100 or greater</p> Signup and view all the answers

    Which of the following is a potential symptom of severe hypertension?

    <p>Headache</p> Signup and view all the answers

    What differentiates hypertension as a silent disease?

    <p>Many individuals show no symptoms</p> Signup and view all the answers

    What is the primary outcome of the renin-angiotensin system activation?

    <p>Increased blood pressure</p> Signup and view all the answers

    Which substances are primarily involved in the formation of angiotensin II from angiotensinogen?

    <p>Renin and ACE</p> Signup and view all the answers

    What role does aldosterone play in the regulation of blood pressure?

    <p>Promotes sodium and water reabsorption</p> Signup and view all the answers

    What percentage of hypertension cases is classified as essential or primary?

    <p>95 percent</p> Signup and view all the answers

    Which of the following is not typically a contributing factor to essential hypertension?

    <p>Acute injury</p> Signup and view all the answers

    What process is initiated by the combination of angiotensinogen and renin?

    <p>Formation of angiotensin I</p> Signup and view all the answers

    What is the primary effect of angiotensin II on blood vessels?

    <p>It leads to vasoconstriction, increasing blood pressure.</p> Signup and view all the answers

    Which factor is commonly associated with the majority of essential hypertension cases?

    <p>Genetic predisposition</p> Signup and view all the answers

    What physiological action does aldosterone promote in response to increased blood pressure?

    <p>Reabsorption of sodium and water</p> Signup and view all the answers

    What role does obesity play in relation to hypertension?

    <p>It is a contributing factor to hypertension.</p> Signup and view all the answers

    What is the primary effect of angiotensin II in the body?

    <p>Causes vasoconstriction</p> Signup and view all the answers

    Which of the following factors is NOT typically associated with essential hypertension?

    <p>Chronic kidney disease</p> Signup and view all the answers

    What physiological action is promoted by aldosterone in response to increased blood pressure?

    <p>Increased sodium and water reabsorption</p> Signup and view all the answers

    What is the process initiated when renin interacts with angiotensinogen?

    <p>Formation of angiotensin I</p> Signup and view all the answers

    Which statement correctly describes the nature of hypertension?

    <p>About 95 percent of hypertension cases are considered essential or primary</p> Signup and view all the answers

    What is the most common cause of secondary hypertension?

    <p>Renal artery stenosis</p> Signup and view all the answers

    Which of the following conditions is NOT typically associated with hypertension urgency or emergency?

    <p>Sleep apnea</p> Signup and view all the answers

    Which of these is a common cause of secondary hypertension?

    <p>Fibromuscular dysplasia</p> Signup and view all the answers

    What lifestyle choice could exacerbate hypertension according to the content?

    <p>Use of diet pills like fenfluramine</p> Signup and view all the answers

    Which condition is specifically mentioned as leading to secondary hypertension?

    <p>Addison's disease</p> Signup and view all the answers

    What condition is the primary cause of secondary hypertension?

    <p>Renal artery stenosis</p> Signup and view all the answers

    Which of the following factors is NOT associated with causing hypertension urgency or emergency?

    <p>Renal failure</p> Signup and view all the answers

    Which of the following is commonly associated with renal artery stenosis as a cause of secondary hypertension?

    <p>Fibromuscular dysplasia</p> Signup and view all the answers

    What is one of the effects of uncontrolled hypertension due to medication non-compliance?

    <p>Increased blood pressure</p> Signup and view all the answers

    Which of the following conditions is explicitly mentioned as contributing to the development of secondary hypertension?

    <p>Eclampsia</p> Signup and view all the answers

    Which substance is specifically mentioned as contributing to hypertension urgency or emergency when misused?

    <p>Pseudoephedrine</p> Signup and view all the answers

    Which condition can cause secondary hypertension but is not primarily linked to renal artery stenosis?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What lifestyle choice is linked with an increased risk of hypertension urgency?

    <p>Use of diet pills like fenfluramine</p> Signup and view all the answers

    Which of the following is considered a potential cause of secondary hypertension due to its hormonal influence?

    <p>Eclampsia</p> Signup and view all the answers

    What is the primary cause of secondary hypertension?

    <p>Renal artery stenosis</p> Signup and view all the answers

    Which of the following conditions can lead to hypertension urgency or emergency?

    <p>Medications leading to increased blood pressure</p> Signup and view all the answers

    What condition is closely associated with renal artery stenosis besides fibromuscular dysplasia?

    <p>Atherosclerosis</p> Signup and view all the answers

    Which of the following factors is NOT typically associated with secondary hypertension?

    <p>Excessive exercise</p> Signup and view all the answers

    What is a potential cause of secondary hypertension due to medication non-compliance?

    <p>Increased blood pressure from medication cessation</p> Signup and view all the answers

    Which condition is specifically mentioned as a cause of secondary hypertension?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which condition is NOT associated with causing hypertension urgency or emergency?

    <p>Anemia</p> Signup and view all the answers

    Which of the following medications is associated with inducing hypertensive reactions?

    <p>Diet pills like fenfluramine</p> Signup and view all the answers

    Which condition can lead to secondary hypertension alongside renal artery stenosis?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What effect can non-compliance with medication have on blood pressure?

    <p>It causes blood pressure to increase</p> Signup and view all the answers

    Which of the following is NOT a cause of secondary hypertension?

    <p>Essential hypertension</p> Signup and view all the answers

    What is a known risk factor for hypertension mentioned in the content?

    <p>Sleep apnea</p> Signup and view all the answers

    What blood pressure reading is required for a diagnosis of hypertension on three separate visits?

    <p>130 over 80</p> Signup and view all the answers

    Which diagnostic method is appropriate if renal artery stenosis is suspected?

    <p>Renal ultrasound</p> Signup and view all the answers

    What should be investigated if a patient has suspected pheochromocytoma?

    <p>Urinary catecholamines</p> Signup and view all the answers

    Which complication can arise from untreated hypertension?

    <p>Renal failure</p> Signup and view all the answers

    Which of the following tests would be least relevant for diagnosing primary hypertension?

    <p>Urinary catecholamines</p> Signup and view all the answers

    What reading is required to diagnose hypertension during three visits?

    <p>130 over 80</p> Signup and view all the answers

    Which diagnostic test is appropriate to assess for pheochromocytoma in a patient with suspected hypertension?

    <p>Urinary catecholamines</p> Signup and view all the answers

    Which of the following complications is NOT typically caused by untreated hypertension?

    <p>Carpal tunnel syndrome</p> Signup and view all the answers

    What might be indicated if a patient is unresponsive to multiple hypertension medications?

    <p>Renal ultrasound</p> Signup and view all the answers

    What condition should be suspected in a patient exhibiting symptoms of both sleep apnea and hypertension?

    <p>Polysomnography</p> Signup and view all the answers

    What is the minimum blood pressure reading required to establish a diagnosis of hypertension during three visits?

    <p>130 over 80</p> Signup and view all the answers

    What is a suggested test for diagnosing secondary hypertension if a pheochromocytoma is suspected?

    <p>Urinary catecholamines</p> Signup and view all the answers

    Which condition could potentially lead to renal failure as a secondary complication of untreated hypertension?

    <p>All of the above</p> Signup and view all the answers

    Which imaging study might be utilized if a patient is unresponsive to multiple antihypertensive medications?

    <p>Renal ultrasound</p> Signup and view all the answers

    What condition is linked to the suspicion of sleep apnea during hypertension evaluation?

    <p>Polysomnography</p> Signup and view all the answers

    If a patient exhibits symptoms of hypertension and cocaine use is suspected, which test is advised?

    <p>Drug screen</p> Signup and view all the answers

    Which of the following is NOT a secondary complication of untreated hypertension?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is the rationale for performing a thyroid panel in a patient suspected of having secondary hypertension?

    <p>To evaluate hormonal imbalances</p> Signup and view all the answers

    Which dietary approach is recommended for managing hypertension?

    <p>Dash diet or Mediterranean diet</p> Signup and view all the answers

    What is the recommended maximum alcohol intake for individuals managing hypertension?

    <p>Two drinks per day for men and one for women</p> Signup and view all the answers

    Which of the following pharmacological treatments for hypertension is classified as a diuretic?

    <p>Furosemide</p> Signup and view all the answers

    What is the target blood pressure goal for managing hypertension effectively?

    <p>130 over 80 or less</p> Signup and view all the answers

    Which medication is specifically used for treating a cocaine overdose?

    <p>Phentolamine</p> Signup and view all the answers

    What is the recommended amount of exercise for individuals managing hypertension?

    <p>150 minutes a week</p> Signup and view all the answers

    Which medication class is not typically used in the management of hypertension?

    <p>Antidepressants</p> Signup and view all the answers

    What type of diet is advised for individuals focusing on low salt intake for hypertension management?

    <p>Both A and C</p> Signup and view all the answers

    Which symptom is commonly associated with hypotension?

    <p>Lightheadedness</p> Signup and view all the answers

    What is the typical cause of orthostatic hypotension?

    <p>Dehydration</p> Signup and view all the answers

    Which condition results from a failure of vasoconstriction leading to low brain perfusion?

    <p>Cardiogenic syncope</p> Signup and view all the answers

    What diagnostic tool helps determine if hypotension is caused by arrhythmia?

    <p>EKG or Holter monitor</p> Signup and view all the answers

    Which medication is used to increase blood pressure?

    <p>Fludrocortisone</p> Signup and view all the answers

    What is a significant risk factor for hypotension in the elderly?

    <p>Dehydration</p> Signup and view all the answers

    Which condition can lead to cardiogenic shock due to decreased blood pressure?

    <p>Myocardial infarction</p> Signup and view all the answers

    What can a urinalysis help determine in a hypotensive patient?

    <p>Specific gravity indicating dehydration</p> Signup and view all the answers

    Which of the following is NOT a typical compensatory response to low blood pressure?

    <p>Decreased sweating</p> Signup and view all the answers

    What physical change signifies orthostatic hypotension?

    <p>Decrease in blood pressure upon standing</p> Signup and view all the answers

    What is the most common cause of orthostatic hypotension?

    <p>Dehydration</p> Signup and view all the answers

    Which of the following describes cardiogenic syncope?

    <p>Failure of vasoconstriction and low brain perfusion</p> Signup and view all the answers

    What is a sign of hypotension in elderly patients?

    <p>Chronic dehydration</p> Signup and view all the answers

    Which medication can increase blood pressure?

    <p>Fludrocortisone</p> Signup and view all the answers

    Which monitoring technique is useful in diagnosing arrhythmia-related hypotension?

    <p>Holter monitor</p> Signup and view all the answers

    What physiological response occurs in the body due to hypotension?

    <p>Increased secretion of aldosterone</p> Signup and view all the answers

    How is orthostatic hypotension defined?

    <p>A drop of 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing</p> Signup and view all the answers

    What condition may result from severe dehydration in the elderly?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    What cardiac condition is associated with very low blood pressure?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What clinical test can indicate chronic dehydration?

    <p>Urinalysis with high specific gravity</p> Signup and view all the answers

    What fasting lipid panel result indicates dyslipidemia regarding LDL levels?

    <p>LDL over 100</p> Signup and view all the answers

    Which of the following conditions is NOT considered a cause of dyslipidemia?

    <p>Regular exercise</p> Signup and view all the answers

    What physical exam finding could indicate the presence of dyslipidemia?

    <p>Xanthelasma</p> Signup and view all the answers

    In which situation is dyslipidemia likely to occur due to metabolic issues?

    <p>Chronic starvation due to anorexia</p> Signup and view all the answers

    What is the first-line treatment for dyslipidemia?

    <p>HMG-CoA reductase inhibitors</p> Signup and view all the answers

    Which of the following is a potential consequence of prolonged dyslipidemia?

    <p>Atherosclerosis</p> Signup and view all the answers

    What does Arcus senilis indicate in the context of dyslipidemia?

    <p>A gray ring around the iris</p> Signup and view all the answers

    What level of triglycerides is considered diagnostic for dyslipidemia?

    <p>Over 150</p> Signup and view all the answers

    Which group of individuals is at an increased risk for developing dyslipidemia?

    <p>Smokers and those with diabetes</p> Signup and view all the answers

    Which of the following statements about dyslipidemia is true?

    <p>Dyslipidemia is often a silent disease.</p> Signup and view all the answers

    What fasting lipid panel result is indicative of dyslipidemia?

    <p>Total cholesterol over 200</p> Signup and view all the answers

    Which lifestyle factor can contribute to the development of dyslipidemia?

    <p>High-fat diets</p> Signup and view all the answers

    Which of the following is a characteristic physical exam finding in dyslipidemia?

    <p>Xanthelasma</p> Signup and view all the answers

    What can prolonged dyslipidemia potentially lead to?

    <p>Atherosclerosis</p> Signup and view all the answers

    Which demographic is least likely to develop dyslipidemia?

    <p>Athletes with a balanced diet</p> Signup and view all the answers

    Which treatment is considered the first-line option for managing dyslipidemia?

    <p>Statins</p> Signup and view all the answers

    What is a common consequence of very high triglyceride levels?

    <p>Pancreatitis</p> Signup and view all the answers

    What condition might indicate a genetic predisposition to dyslipidemia?

    <p>Familial hypercholesterolemia</p> Signup and view all the answers

    Which of the following is a sign of dyslipidemia affecting the eye?

    <p>Arcus senilis</p> Signup and view all the answers

    What metabolic state can contribute to dyslipidemia in individuals with anorexia?

    <p>Starvation mode</p> Signup and view all the answers

    What is considered a high-risk level for LDL cholesterol indicating dyslipidemia?

    <p>Over 100</p> Signup and view all the answers

    Which of the following groups is least likely to develop dyslipidemia?

    <p>Regular athletes with balanced diets</p> Signup and view all the answers

    Which condition can lead to dyslipidemia due to the liver's inability to metabolize cholesterol?

    <p>Anorexia</p> Signup and view all the answers

    What is a physical exam finding commonly associated with prolonged dyslipidemia?

    <p>Arterial bruits</p> Signup and view all the answers

    What are xanthelasma typically indicative of?

    <p>Cholesterol deposits in the eye</p> Signup and view all the answers

    Which lipid level is a criterion for diagnosing dyslipidemia?

    <p>Triglycerides over 150</p> Signup and view all the answers

    What is the primary first-line treatment for dyslipidemia?

    <p>Statins</p> Signup and view all the answers

    What is the consequence of very high triglyceride levels?

    <p>Inducing pancreatitis</p> Signup and view all the answers

    What condition is characterized by a gray ring around the iris and associated with dyslipidemia?

    <p>Arcus senilis</p> Signup and view all the answers

    Dyslipidemia is often classified as which type of disease until symptoms manifest?

    <p>Silent disease</p> Signup and view all the answers

    What is a common symptom of advanced atherosclerosis?

    <p>Reduced exercise tolerance</p> Signup and view all the answers

    What is the sequence of the pathophysiological process of atherosclerosis?

    <p>Fatty streak, foam cells, fibrous plaque, inflammatory process, cap rupture</p> Signup and view all the answers

    Which of the following factors is NOT a risk factor for atherosclerosis?

    <p>Regular exercise</p> Signup and view all the answers

    Which demographic is most likely to experience atherosclerosis?

    <p>Women over 65</p> Signup and view all the answers

    What type of sounds may be indicative of severe atherosclerosis?

    <p>Bruits</p> Signup and view all the answers

    How does estrogen affect the risk of atherosclerosis in women?

    <p>Protects against atherosclerosis until menopause</p> Signup and view all the answers

    Which of the following is NOT a typical manifestation of atherosclerosis?

    <p>Exercise-induced asthma</p> Signup and view all the answers

    At what stage is atherosclerosis typically asymptomatic?

    <p>Until significant arterial narrowing occurs</p> Signup and view all the answers

    What lifestyle choice may exacerbate atherosclerosis risk?

    <p>High fat diet</p> Signup and view all the answers

    What percentage of Americans are estimated to have atherosclerosis?

    <p>36%</p> Signup and view all the answers

    What is the initial stage in the pathophysiological process of atherosclerosis?

    <p>Fatty streak</p> Signup and view all the answers

    Which of the following is a common symptom of advanced coronary atherosclerosis?

    <p>Reduced exercise tolerance</p> Signup and view all the answers

    At what stage do females begin to experience similar risk factors for atherosclerosis as males?

    <p>After menopause</p> Signup and view all the answers

    How does a severe case of atherosclerosis manifest in the patient?

    <p>Bruit</p> Signup and view all the answers

    What contributes significantly to the development of atherosclerosis?

    <p>Dyslipidemia</p> Signup and view all the answers

    What is one of the most common age groups affected by atherosclerosis?

    <p>Ages 60 and over for males</p> Signup and view all the answers

    Which of the following lifestyle factors is NOT a risk factor for atherosclerosis?

    <p>Moderate alcohol consumption</p> Signup and view all the answers

    What usually occurs after the cap of a fibrous plaque ruptures in atherosclerosis?

    <p>Occlusion of the artery</p> Signup and view all the answers

    Which anatomical areas are most commonly involved in bruits indicating severe atherosclerosis?

    <p>Carotid, renal, and abdominal arteries</p> Signup and view all the answers

    What is the primary pathological process that occurs in the formation of atherosclerosis?

    <p>Formation of fatty streaks</p> Signup and view all the answers

    Which age group is most likely to exhibit atherosclerosis in females?

    <p>60 years and older</p> Signup and view all the answers

    What symptom may suggest advanced atherosclerosis in a patient?

    <p>Reduced exercise tolerance</p> Signup and view all the answers

    Which of the following is NOT a common site for bruits associated with severe atherosclerosis?

    <p>Femoral artery</p> Signup and view all the answers

    Which of the following risk factors is NOT associated with the development of atherosclerosis?

    <p>Low cholesterol diet</p> Signup and view all the answers

    What physiological change occurs after the rupture of the fibrous cap in severe atherosclerosis?

    <p>A thrombus may form downstream</p> Signup and view all the answers

    What is the percentage of Americans currently affected by atherosclerosis?

    <p>36 percent</p> Signup and view all the answers

    How does estrogen impact the risk of atherosclerosis in females?

    <p>Provides protective benefits until menopause</p> Signup and view all the answers

    What is the main component that leads to the initial stages of foam cell formation in atherosclerosis?

    <p>Cholesterol accumulation</p> Signup and view all the answers

    Which dietary habit is considered a risk factor for the development of atherosclerosis?

    <p>High fat diet</p> Signup and view all the answers

    What is the most common cause of myocardial infarction?

    <p>Atherosclerosis in the coronary arteries</p> Signup and view all the answers

    Which medication is commonly used for controlling hypertension in patients with atherosclerosis?

    <p>Beta blockers</p> Signup and view all the answers

    What is the function of an endarterectomy in the treatment of atherosclerosis?

    <p>Scoop out atherosclerotic plaque</p> Signup and view all the answers

    In which case might a coronary artery bypass graft (CABG) be used?

    <p>In cases of atherosclerosis in the left main artery</p> Signup and view all the answers

    Which diagnostic procedure can assess the patency of coronary vessels?

    <p>Coronary angiography</p> Signup and view all the answers

    What is the role of calcium channel blockers in treating atherosclerosis?

    <p>To lower blood pressure</p> Signup and view all the answers

    Which statement accurately reflects a treatment option for managing lipid levels?

    <p>Statins to control lipids</p> Signup and view all the answers

    When might stents be utilized in treating atherosclerosis?

    <p>After a failed coronary bypass graft</p> Signup and view all the answers

    What is the primary goal of using anti-platelet medications in atherosclerosis treatment?

    <p>To stabilize atherosclerotic plaques</p> Signup and view all the answers

    What is a distinguishing feature of stable angina?

    <p>Pain relieved by nitroglycerin</p> Signup and view all the answers

    Which symptom is typically associated with unstable angina?

    <p>Increasing occurrence of pain at rest</p> Signup and view all the answers

    How long does unstable angina pain generally last?

    <p>15 to 20 minutes</p> Signup and view all the answers

    What key difference distinguishes unstable angina from a myocardial infarction?

    <p>Duration of pain episodes</p> Signup and view all the answers

    Which population is most commonly affected by angina?

    <p>Males aged 40 to 75</p> Signup and view all the answers

    Which of the following statements regarding cardiac biomarkers in angina is true?

    <p>Cardiac biomarkers remain normal in angina</p> Signup and view all the answers

    What commonly described symptom may indicate the progression from unstable angina to myocardial infarction?

    <p>Sensation of an elephant on the chest</p> Signup and view all the answers

    Which aspect contributes to the classification of angina as stable?

    <p>Pain consistently occurs with exertion</p> Signup and view all the answers

    What is a common physical indication of angina episodes?

    <p>Preference for upright position</p> Signup and view all the answers

    What triggers the transition from stable angina to unstable angina?

    <p>Pain occurring with minimal exertion or at rest</p> Signup and view all the answers

    What characterizes stable angina?

    <p>Pain relieved by rest or nitroglycerin</p> Signup and view all the answers

    What is the primary difference between unstable angina and myocardial infarction?

    <p>Duration of pain</p> Signup and view all the answers

    What symptom is associated with unstable angina?

    <p>Pain occurring at rest</p> Signup and view all the answers

    What common symptom might signal the progression of unstable angina to myocardial infarction?

    <p>Feeling of doom or heaviness</p> Signup and view all the answers

    Why might a patient prefer to be upright during an episode of angina?

    <p>To reduce pressure on the heart</p> Signup and view all the answers

    What distinguishes stable angina from unstable angina in terms of duration?

    <p>Stable angina lasts less than 15 minutes</p> Signup and view all the answers

    What physiological change occurs in the heart during an episode of angina?

    <p>Ischemia due to insufficient oxygen</p> Signup and view all the answers

    Which of the following statements about cardiac biomarkers is true during angina episodes?

    <p>There are no changes in biomarkers</p> Signup and view all the answers

    At what age range is angina most commonly diagnosed?

    <p>40 to 75 years</p> Signup and view all the answers

    What is a common characteristic of the pain experienced during stable angina?

    <p>Relieved by rest or nitroglycerin</p> Signup and view all the answers

    What diagnostic test can help assess the progression of angina before it leads to myocardial infarction?

    <p>Coronary angiography</p> Signup and view all the answers

    Which treatment option is primarily used to improve blood flow in patients with angina?

    <p>Vasodilators</p> Signup and view all the answers

    Which medication is used as an antiplatelet agent to prevent further clot formation in angina patients?

    <p>Clopidogrel</p> Signup and view all the answers

    What is a potential cause of chest pain that can mimic angina but is not related to the heart?

    <p>Acid reflux</p> Signup and view all the answers

    What procedure might be necessary for a patient with severe atherosclerosis?

    <p>Coronary artery bypass grafting</p> Signup and view all the answers

    What class of medication aims to slow the progression of atherosclerosis in angina patients?

    <p>Statins</p> Signup and view all the answers

    Which of the following is not a treatment option for unstable angina?

    <p>Hormone replacement therapy</p> Signup and view all the answers

    What component is included in a GI cocktail that may be administered for chest pain that is suspected to be esophageal spasm?

    <p>Viscous lidocaine</p> Signup and view all the answers

    Which is a common symptom of angina that may indicate a need for further investigation?

    <p>Shortness of breath</p> Signup and view all the answers

    What role do beta blockers play in the management of angina?

    <p>Decrease heart workload</p> Signup and view all the answers

    What does stable angina commonly cause in diagnostic tests?

    <p>ST depression</p> Signup and view all the answers

    Which of the following treatments is a vasodilator used for angina?

    <p>Nitroglycerin</p> Signup and view all the answers

    Which combination of medications is used in a GI cocktail that may relieve esophageal spasms?

    <p>Antacid, Viscous Lidocaine, and Donnatol</p> Signup and view all the answers

    What diagnostic test can assess the progression of angina to myocardial infarction?

    <p>Nuclear stress test</p> Signup and view all the answers

    Which condition can mimic angina and may be treated with a GI cocktail?

    <p>Esophageal spasm</p> Signup and view all the answers

    What is the purpose of using statins in patients with angina?

    <p>To slow the progression of atherosclerosis</p> Signup and view all the answers

    Which treatment may be necessary depending on the severity of atherosclerosis in patients with angina?

    <p>Percutaneous coronary intervention or bypass surgery</p> Signup and view all the answers

    Which of the following describes a main treatment option for both stable and unstable angina?

    <p>Antiplatelet therapy</p> Signup and view all the answers

    In the management of angina, which class of medication helps decrease heart workload?

    <p>Calcium channel blockers</p> Signup and view all the answers

    What is the role of beta blockers in angina treatment?

    <p>To decrease heart rate and blood pressure</p> Signup and view all the answers

    What is the purpose of a nuclear stress test in the context of angina?

    <p>To assess the progression of angina before myocardial infarction</p> Signup and view all the answers

    Which treatment option is considered a vasodilator for managing angina?

    <p>Nitroglycerin</p> Signup and view all the answers

    Which medication is NOT typically used as a treatment for unstable angina?

    <p>Diuretics</p> Signup and view all the answers

    What symptom may suggest that a patient is experiencing an esophageal spasm rather than angina?

    <p>Improvement after GI cocktail administration</p> Signup and view all the answers

    Which procedure may be necessary if a patient has severe atherosclerosis and angina?

    <p>Coronary artery bypass graft</p> Signup and view all the answers

    What might be a secondary goal in treating patients with angina?

    <p>Slow the progression of atherosclerosis</p> Signup and view all the answers

    Which medication works by preventing blood clots in patients with angina?

    <p>Antiplatelet</p> Signup and view all the answers

    What diagnostic test can be used to visualize coronary artery blockages?

    <p>Coronary angiography</p> Signup and view all the answers

    What is a common effect of nitroglycerin when used for angina management?

    <p>Relaxes blood vessels</p> Signup and view all the answers

    Which symptom is characteristic of angina rather than an esophageal spasm?

    <p>Chest pain during exertion</p> Signup and view all the answers

    What is a primary diagnostic test used for assessing angina?

    <p>Nuclear stress test</p> Signup and view all the answers

    Which medication type is primarily used as a vasodilator for treating angina?

    <p>Nitroglycerin</p> Signup and view all the answers

    Which treatment is aimed at slowing the progression of atherosclerosis in angina patients?

    <p>Statins</p> Signup and view all the answers

    In cases of unstable angina, what procedure might be necessary depending on the severity of atherosclerosis?

    <p>Percutaneous coronary intervention</p> Signup and view all the answers

    What is one of the main functional roles of antiplatelets in treating angina?

    <p>Prevent blood clot formation</p> Signup and view all the answers

    Which of the following is NOT a treatment option for either stable or unstable angina?

    <p>Vasopressors</p> Signup and view all the answers

    What would indicate that a patient's symptoms are not due to angina after treatment with a GI cocktail?

    <p>Improvement of symptoms</p> Signup and view all the answers

    What is one potential treatment option used to manage the symptoms of angina?

    <p>Aspirin</p> Signup and view all the answers

    Which condition is typically a concern for patients diagnosed with unstable angina?

    <p>Myocardial infarction</p> Signup and view all the answers

    What tests are typically used to diagnose angina and assess its progression?

    <p>Nuclear stress test, perfusion imaging, and coronary angiography</p> Signup and view all the answers

    Which treatment option is a vasodilator used for managing angina?

    <p>Nitroglycerin</p> Signup and view all the answers

    What condition might mimic angina symptoms and can be treated with a GI cocktail?

    <p>Esophageal spasm</p> Signup and view all the answers

    Which class of medication is prescribed to slow the progression of atherosclerosis?

    <p>Statins</p> Signup and view all the answers

    Which intervention may be necessary for patients with severe atherosclerosis?

    <p>Percutaneous coronary intervention or bypass surgery</p> Signup and view all the answers

    What combination of medications includes an antacid and an anti-spasmodic agent for treating esophageal spasms?

    <p>Gi cocktail: antacid, viscous lidocaine, and donnatol</p> Signup and view all the answers

    Which medication class is often used alongside beta blockers in the management of angina?

    <p>Calcium channel blockers</p> Signup and view all the answers

    Which is NOT a common symptom of stable angina?

    <p>Severe dizziness at rest</p> Signup and view all the answers

    What is a potential risk if untreated stable or unstable angina progresses?

    <p>Myocardial infarction</p> Signup and view all the answers

    Which antiplatelet medication is frequently used in angina management?

    <p>Aspirin</p> Signup and view all the answers

    Study Notes

    Hypertension Criteria

    • Guidelines from the American Heart Association and the 2020 International Society of Hypertension often have a five-year lag. Boards may test using criteria from both sources. Knowing both sets of criteria is important.
    • Hypertension is often a silent disease; meaning it may be present without any symptoms. Severe cases may cause symptoms such as headache, nausea, and blurred vision.
    • Severe hypertension may show fundoscopic signs, including arteriovenous nicking, copper and silver wiring, and papilledema.
    • Normal blood pressure is less than 130/85 mmHg.
    • Elevated blood pressure is 130-139/85-89 mmHg. (2020 guidelines)
    • Stage 1 hypertension is 140-159/90-99 mmHg. (2020 guidelines)
    • Stage 2 hypertension is greater than 160/100 mmHg. (2020 guidelines)
    • Hypertensive urgency is greater than 180/120 mmHg with no signs of end-organ damage.
    • Hypertensive emergency is greater than 180/120 mmHg with evidence of end-organ damage, such as renal failure or seizures.
    • Untreated hypertension causes secondary complications, including renal failure, retinopathy, myocardial infarction, and cerebrovascular accident.
    • To diagnose hypertension, the reading must be greater than 130/80 mmHg on three visits to rule out white coat hypertension.
    • Hypertension goal is 130/80 mmHg or less.

    Renin-Angiotensin System (RAS)

    • The renin-angiotensin system (RAS) plays a role in hypertension.
    • Angiotensinogen, when acted upon by renin, produces angiotensin I.
    • ACE (angiotensin converting enzyme) converts angiotensin I to angiotensin II.
    • Angiotensin II causes vasoconstriction, increasing blood pressure.
    • Angiotensin II stimulates aldosterone release, leading to sodium and water reabsorption, further increasing blood pressure.

    Causes and Contributing Factors

    • Approximately 95% of hypertension cases are essential (primary) hypertension, often linked to genetics, obesity, diabetes, and heart disease.
    • Angiotensinogen + renin increases angiotensin I leading to angiotensin II forming vasoconstriction increasing blood pressure and stimulating aldosterone release.
    • Aldosterone increases sodium and water reabsorption, further increasing blood pressure.
    • Essential (primary) hypertension is linked to genetics, obesity, diabetes, and heart disease.

    Dyslipidemia

    • Dyslipidemia is very common, affecting approximately 15% of Americans.
    • A fasting lipid panel is the diagnostic test.
    • A diagnosis of dyslipidemia includes: LDL over 100 mg/dL, HDL under 40 mg/dL, total cholesterol over 200 mg/dL, and triglycerides over 150 mg/dL. These are also risk factors.
    • Dyslipidemia can stem from genetics, diabetes, smoking, anorexia (due to the liver's inability to metabolize cholesterol during starvation), and very high-fat diets.
    • Dyslipidemia is often silent, causing no symptoms until advanced.
    • Physical exam findings for dyslipidemia can include:
      • Xanthelasma: cholesterol deposits on the inside of the eye.
      • Arterial bruits: narrowing of arteries caused by atherosclerotic plaque.
      • Arcus senilis: a gray ring around the iris due to cholesterol deposits.
    • Prolonged dyslipidemia can lead to atherosclerosis, causing numerous cardiovascular problems.
    • Very high triglycerides can induce pancreatitis.
    • Treatment for dyslipidemia includes:
      • First-line therapy: HMG-CoA reductase inhibitors (statins).
      • Alternatives: Bile acid sequestrants (if statins are not tolerated), and fibrates (if triglycerides are high).

    Atherosclerosis

    • Atherosclerosis, a common arterial narrowing, is caused by dyslipidemia and affects both coronary and non-coronary arteries.
    • Symptoms, like reduced exercise tolerance or angina (if coronary), are often asymptomatic until advanced.
    • Severe cases can cause bruits (abnormal sounds heard during auscultation due to turbulent blood flow). Common locations for bruits include carotid, renal, or abdominal arteries.
    • The pathophysiology involves fatty streaks, foam cells, fibrous plaque formation, inflammation, vascular remodeling, and eventual cap rupture, leading to downstream artery blockage.
    • Risk factors for atherosclerosis include smoking, high triglycerides, high lipids, hypertension, obesity, diabetes, alcohol use, sedentary lifestyle, and a high-fat diet.
    • Atherosclerosis prevalence is 36% in Americans and increases with age, particularly after females reach menopause and males over 60. Estrogen provides a protective effect.
    • Atherosclerosis is the most common cause of myocardial infarction.
    • Diagnosis might include carotid ultrasounds to evaluate coronary lumen narrowing, nuclear stress tests or coronary angiographies to assess vessel patency.
    • Treatment for atherosclerosis includes nitroglycerin, anti-platelet medications (aspirin, Plavix), managing hypertension (beta blockers, calcium channel blockers, diuretics, ACE inhibitors), and lipid control (statins). Non-coronary atherosclerosis can be treated with endarterectomy (plaque removal). Stents can be used, and if stents are unsuccessful or for left main artery blockages, coronary artery bypass grafts (CABGs) are an option.

    Additional Considerations

    • Renal artery stenosis, either from fibromuscular dysplasia or atherosclerosis, is a significant cause of secondary hypertension. This can also be caused by pheochromocytoma, Addison's disease, sleep apnea, and hyperthyroidism.
    • Factors contributing to hypertensive urgency or emergency include non-compliance with medication, increasing blood pressure, use of diet pills (e.g., phentermine), over-the-counter pseudoephedrine, cocaine use, and eclampsia.
    • To differentiate primary from secondary hypertension, consider a thyroid panel, urinary catecholamines (if pheochromocytoma suspected), renal ultrasound (if unresponsive to medications), and polysomnography (if sleep apnea suspected). A drug screen is also important if cocaine use is suspected.
    • Diagnosing HTN requires readings greater than 130/80 mmHg on at least three separate visits to rule out white coat hypertension.
    • Untreated hypertension can lead to secondary complications such as renal failure, retinopathy, myocardial infarction, and cerebrovascular accident.
    • Consider a thyroid panel, urinary catecholamines (pheochromocytoma), renal ultrasound (medication non-response), and polysomnography (sleep apnea). A drug screen is advisable if cocaine use is suspected.
    • Hypotension: Dizziness, blurry vision, lightheadedness, palpitations, and syncope are common symptoms, especially with standing. Insufficient blood in arteries or water in the body leads to faster breathing, a faster heart rate, and clammy skin. Orthostatic hypotension occurs when systolic blood pressure drops 20 mmHg or diastolic drops 10 mmHg within three minutes of standing. Orthostatic hypotension is sympathetic nervous system failure causing blood pooling in legs. Dehydration is a common cause.
    • Cardiogenic syncope: Vasoconstriction failure, low ventricle filling results in insufficient brain perfusion.
    • Cardiogenic shock: Severe drop in blood pressure and heart's inability to pump blood effectively, causes include myocardial infarction, ventricular tachycardia, and ventricular fibrillation.
    • Elderly and Hypotension: Dehydration is a frequent cause of hypotension in the elderly due to inadequate fluid intake.
    • Diagnosis of Hypotension: ECG or halter monitor to check for arrhythmias. Urinalysis can detect dehydration through high specific gravity.
    • Medications increasing blood pressure: Fludrocortisone and desmopressin increase blood pressure.

    Angina: Stable & Unstable

    • Angina is chest pain caused by myocardial ischemia, not infarction, resulting from coronary artery disease. Angina progresses from stable to unstable, and then potentially to myocardial infarction (MI).
    • Stable angina is triggered by exertion or stress, relieved by rest or nitroglycerin, lasting less than 15 minutes.
    • Unstable angina is more severe, occurring at rest, without a consistent trigger, lasting 15–20 minutes, and not relieved by nitroglycerin.
    • The key difference between unstable angina and myocardial infarction is the duration. Unstable angina lasts 15-20 minutes, while myocardial infarction lasts longer than 30 minutes.
    • Unstable angina may progress into myocardial infarction, which can cause a feeling of chest pain ("elephant on the chest"), a "levine" or clenched fist pain, and a sense of impending doom. Patients with angina, stable or unstable, often prefer an upright position and may be sweaty.
    • Cardiac biomarkers (CK-MB, troponin) are normal during angina. Angina most commonly affects males aged 40-75. Angina can cause ST depression. Diagnostic tests can include nuclear stress tests, perfusion imaging, and coronary angiography to determine the progression from stable to unstable angina and to rule out myocardial infarction. A GI cocktail (antacid, viscous lidocaine, and donnatol) can differentiate esophageal spasm from angina.
    • Treatments for stable and unstable angina include nitroglycerin (vasodilator), antiplatelets (aspirin, clopidogrel), beta blockers, calcium channel blockers, diuretics, ACE inhibitors, and statins (to slow atherosclerosis progression). Depending on the severity of atherosclerosis, treatment may include stents, percutaneous coronary intervention, or coronary artery bypass grafts (CABGs).
    • Angina can cause ST depression. Diagnostics include nuclear stress tests, perfusion imaging, and coronary angiography to determine progression to unstable angina and rule out myocardial infarction. A GI cocktail (antacid, viscous lidocaine, and donnatol) is helpful to distinguish angina from esophageal spasm.
    • Angina can be differentiated from esophageal spasm using a GI cocktail (antacid, viscous lidocaine, and donnatol). If symptoms improve after the GI cocktail, it was likely an esophageal spasm, not angina.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Test your knowledge on the criteria for hypertension as outlined by the American Heart Association and the International Society of Hypertension. This quiz will cover normal blood pressure ranges, stages of hypertension, and urgent versus emergency situations. Determine how well you understand this silent yet serious disease.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser