Mastering Hypertension Treatment
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Questions and Answers

Which class of drugs is commonly used to treat hypertension?

  • ACE inhibitors and ARBs (correct)
  • Diuretics
  • Antihypertensive therapeutics
  • Calcium channel blockers

Which diagnostic method is used to determine hypertension?

  • Clinic BP
  • Ambulatory blood pressure monitoring (ABPM)
  • Home blood pressure monitoring (HBPM)
  • All of the above (correct)

What are the side effects of ACE inhibitors?

  • Dizziness
  • Persistent dry cough
  • Tiredness
  • All of the above (correct)

What are the four classes of antihypertensive therapeutics mentioned in the text?

<p>i. ACE inhibitors and Angiotensin II receptor blockers (ARBs) ii. Diuretics iii. Calcium channel blockers iv. b1-Adrenoceptor antagonists</p> Signup and view all the answers

What is the recommended diagnostic method for determining hypertension?

<p>Clinic BP and ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) average daytime</p> Signup and view all the answers

What are the side effects of ARBs?

<p>Dizziness, headache</p> Signup and view all the answers

What are the side effects of calcium channel blockers?

<p>Flushes, headaches, ankle edema</p> Signup and view all the answers

What are the side effects of ACE inhibitors?

<p>Persistent dry cough, dizziness, tiredness, headaches</p> Signup and view all the answers

What are the side effects of thiazide diuretics?

<p>Dizziness, tiredness, headaches</p> Signup and view all the answers

What are the side effects of b1-adrenoceptor antagonists?

<p>Dizziness, tiredness, headaches</p> Signup and view all the answers

What are the side effects of K+ sparing diuretics?

<p>Gout, renal impairment, hyperkalemia, impotence</p> Signup and view all the answers

What are the risks associated with thiazide diuretics?

<p>Back/leg pain, hyperkalemia, renal impairment, teratogenic, risk of angioedema (Afro-Caribbean), hyponatremia, risk of hyperkalemia</p> Signup and view all the answers

What are the risks associated with K+ sparing diuretics?

<p>Gout, renal impairment, hyperkalemia, impotence</p> Signup and view all the answers

What are the functions of the Carotid Sinus and Carotid Body?

<p>Carotid Sinus: Baroreceptor - reacts to change in arterial blood pressure Carotid Body: Chemoreceptor - monitors the partial pressure of CO2</p> Signup and view all the answers

What is the innervation of the Carotid Sinus and Carotid Body?

<p>Carotid Sinus: Afferent - glossopharyngeal nerve Carotid Body: Afferent - glossopharyngeal nerve</p> Signup and view all the answers

Which artery is covered by the carotid sheath?

<p>Internal Carotid Artery</p> Signup and view all the answers

What structures does the Internal Jugular Vein drain?

<p>Intracranial structures, superficial parts of face and neck</p> Signup and view all the answers

What are the potential spaces between the fascias?

<p>The potential spaces between the fascias are the carotid sheath, pretracheal space, alar fascia, and prevertebral space.</p> Signup and view all the answers

What is the clinical relevance of the retropharyngeal space?

<p>The retropharyngeal space is a major pathway for the spread of infection to the mediastinum. Retropharyngeal abscesses can occur as a result of infections in the nasopharynx, paranasal sinuses, or middle ear. Dental abscesses can also spread into the mediastinum through the retropharyngeal space.</p> Signup and view all the answers

What are the borders of the posterior triangle of the neck?

<p>The borders of the posterior triangle of the neck are the anterior border of the trapezius muscle, the posterior border of the sternocleidomastoid muscle, and the middle third of the clavicle.</p> Signup and view all the answers

Describe the general structure of the neck as composed of vertical columns surrounded by fascial sheets with potential spaces between

<p>The neck is composed of vertical columns surrounded by fascial sheets. These columns contain various structures such as muscles, blood vessels, nerves, and lymph nodes. The fascial sheets create potential spaces between the columns, allowing for movement and accommodation of these structures.</p> Signup and view all the answers

Describe the concept of the anterior and the posterior triangles of the neck, and their boundaries

<p>The neck can be divided into two triangles: the anterior triangle and the posterior triangle. The anterior triangle is bounded by the midline of the neck, the lower border of the mandible, and the anterior border of the sternocleidomastoid muscle. The posterior triangle is bounded by the posterior border of the sternocleidomastoid muscle, the anterior border of the trapezius muscle, and the middle third of the clavicle.</p> Signup and view all the answers

Describe the form and position of the common and internal carotid arteries and the internal jugular vein

<p>The common carotid artery is a major blood vessel located in the neck. It arises from the brachiocephalic trunk on the right side and the aortic arch on the left side. It travels vertically in the neck, giving off branches along its course. The internal carotid artery is a branch of the common carotid artery and supplies blood to the brain. The internal jugular vein is a major vein located in the neck. It runs alongside the common carotid artery and drains blood from the head, face, and neck.</p> Signup and view all the answers

What are some systemic conditions that can affect the cardiovascular system?

<p>Diabetes mellitus, Hypertension, Chronic obstructive pulmonary disease, Amyloidosis, Rheumatoid arthritis, Vasculitides &amp; SLE, Thyroid disease, Sarcoidosis, Nutrition, Drugs</p> Signup and view all the answers

What is the dominant cause of mortality in diabetic patients?

<p>Cardiovascular complications</p> Signup and view all the answers

What are some metabolic disorders associated with oxidative stress in diabetic patients?

<p>Hyperglycemia, Hypertriglyceridemia, Hypercholesterolemia, Hypoalphalipoproteinemia, Increased levels of advanced glycation end products, Glycated and oxidized lipoproteins</p> Signup and view all the answers

What is the link between hypertension and cardiovascular damage?

<p>Hypertension can cause cardiovascular damage</p> Signup and view all the answers

What is the mechanism for the susceptibility of diabetic patients to cardiovascular disorders?

<p>Elevated oxidative stress</p> Signup and view all the answers

What is the relationship between diabetes, familial disease, hypertension, and vascular damage?

<p>Diabetes, familial disease, and hypertension cause vascular damage.</p> Signup and view all the answers

What is the risk of cardiovascular disease for people with Rheumatoid Arthritis?

<p>People with Rheumatoid Arthritis have a 50% to 70% higher risk for cardiovascular disease than the general population.</p> Signup and view all the answers

What is the risk of cardiovascular disease for people with Osteoarthrosis?

<p>People with Osteoarthrosis face a 24% higher risk for cardiovascular disease than the general population.</p> Signup and view all the answers

How does under-nutrition during postnatal periods of development affect cardiovascular health in adult life?

<p>Exposure to under-nutrition during postnatal periods of development, including adolescence, may affect cardiovascular health in adult life.</p> Signup and view all the answers

What is the cardiovascular safety of non-steroidal anti-inflammatory drugs?

<p>The cardiovascular safety of non-steroidal anti-inflammatory drugs was studied in a network meta-analysis.</p> Signup and view all the answers

What are the four classes of drugs used in the treatment of hypertension?

<p>The four classes of drugs used in the treatment of hypertension are ACE inhibitors, beta blockers, calcium antagonists, and diuretics.</p> Signup and view all the answers

What is the recommended treatment sequence for hypertension in patients ≤ 55 years old?

<p>The recommended treatment sequence for hypertension in patients ≤ 55 years old is to start with an ACE inhibitor (A), then add a calcium antagonist (C) if necessary, followed by a diuretic (D) if necessary, and finally consider adding a beta blocker (B) or an alpha-blocker if necessary.</p> Signup and view all the answers

What is the recommended treatment sequence for hypertension in patients > 55 years old?

<p>The recommended treatment sequence for hypertension in patients &gt; 55 years old is to start with a calcium antagonist (C), then add an ACE inhibitor (A) if necessary, followed by a diuretic (D) if necessary, and finally consider adding a beta blocker (B) or an alpha-blocker if necessary.</p> Signup and view all the answers

What are the four pillars of drug treatment for chronic heart failure?

<p>The four pillars of drug treatment for chronic heart failure are ACE inhibitors or ARBs, beta blockers, aldosterone receptor blockers (e.g., spironolactone or eplerenone), and SGLT2 inhibitors.</p> Signup and view all the answers

What are the common drug classes used in the treatment of hypertension, heart failure, angina, myocardial infarction, atrial fibrillation, and strokes?

<p>The common drug classes used in the treatment of hypertension, heart failure, angina, myocardial infarction, atrial fibrillation, and strokes include ACE inhibitors, beta blockers, calcium antagonists, diuretics, and anti-thrombotic drugs.</p> Signup and view all the answers

What are the treatment options for chronic heart failure?

<ol> <li>Cardiac Resynchronisation Therapy (Biventricular Pacing) for long QRS patients. 2. Implantable Cardiac Defibrillators for highly selected patients. 3. Sacubitril-Valsartan to replace ACEI/ARB in severe heart failure.</li> </ol> Signup and view all the answers

What are the different treatments available for chronic angina pectoris?

<p>To relieve symptoms: 1. Beta Blocker 2. Calcium Antagonist or Nitrates 3. New antianginals (Ivabradine, Ranolazine) 4. Coronary artery surgery 5. Coronary Angioplasty. To prolong survival: 1. Aspirin or Anti-platelet 2. Statin 3. ACE Inhibitor 4. Beta Blocker</p> Signup and view all the answers

What is the treatment for acute chest pain?

<p>For Cardiac Troponin Positive (MI): Emergency treatment, including Aspirin, Angioplasty (if near hospital), Thrombolysis (if far away), Low MW Heparin or Fondaparinux, Statin, ACE Inhibitor, Beta Blocker. For Non Cardiac Troponin Negative (Unstable Angina/ACS): Aspirin or Anti-platelet, Statin, ACE Inhibitor, Beta Blocker.</p> Signup and view all the answers

What are the treatment options for Atrial Fibrillation?

<ol> <li>Prevent emboli: Warfarin/Rivaroxaban/NOACs. 2. Control Rate: Beta Blocker, Digoxin. 3. Control Rhythm (seldom done): DC Cardioversion acutely, Amiodarone if heart failure, Sotalol (II/III) possible, Flecainide (Ic) only if heart structure/function normal, Radioablation.</li> </ol> Signup and view all the answers

What are the treatment options for stroke (CVA)?

<p>For Cerebral Thrombosis or Cerebral Embolus: Thrombolysis, Thrombectomy, Aspirin (acutely &amp; for 2 weeks), Anti-platelet, Statin, ACE Inhibitor. For Cerebral Haemorrhage: CT scan to differentiate haemorrhage from clot, emergency management, Aspirin (acutely &amp; for 2 weeks), Anti-platelet, Statin, ACE Inhibitor.</p> Signup and view all the answers

What are the lymph drainage routes of the left side of the head and neck?

<p>Left Jugular Lymph Trunk</p> Signup and view all the answers

What are the lymph drainage routes of the left upper limb?

<p>Left Subclavian Lymph Trunk</p> Signup and view all the answers

What are the lymph drainage routes of the left thorax?

<p>Left Bronchiomediastinal Trunk</p> Signup and view all the answers

What are the lymph drainage routes of the right side of the head and neck?

<p>Right Jugular Lymph Trunk</p> Signup and view all the answers

What are the lymph drainage routes of the right upper limb?

<p>Right Subclavian Lymph Trunk</p> Signup and view all the answers

What are the lymph drainage routes of the right thorax?

<p>Right Bronchiomediastinal Trunk</p> Signup and view all the answers

What is the lymphatic structure that carries lymph from most of the body, except the upper right thorax, right upper limb, and right head and neck?

<p>Thoracic Duct</p> Signup and view all the answers

Where does the Thoracic Duct start?

<p>Cisterna chyli</p> Signup and view all the answers

What is the anatomical location of the Thoracic Duct?

<p>Between the aorta and azygos vein in the posterior mediastinum</p> Signup and view all the answers

What promotes lymph flow in the Thoracic Duct?

<p>Pulsation of the Aorta</p> Signup and view all the answers

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