Hypertensive crisis

Question 1

Normal BP

Accepted Answer

< 120 and < 80

Question 2

Elevated BP

Accepted Answer

120-129 and < 80

Question 3

Stage 1 HTN

Accepted Answer

130-139 OR 80-89

Question 4

Stage 2 HTN

Accepted Answer

≥140 or ≥90

Question 5

HTN urgency -- BP

Accepted Answer

>180 and /or DBP >120

Question 6

BP SBP >180 or DBP >120 without target organ damage

Accepted Answer

restart oral antiHTN med

Question 7

HTN urgency -- tx

Accepted Answer

oral antiHTN

Question 8

HTN urgency -- reduce gradually over ____

Accepted Answer

24-48 hours

Question 9

SBP >180 or DBP > 120 with target organ damage --> term

Accepted Answer

HTN emergency

Question 10

HTN emergency -- step 1 -- admit to ___

Accepted Answer

ICU

Question 11

HTN urgency -- if no severe conditions

Accepted Answer

dec BP by 25% over 1st hr, and normal over next 24-48 hours

Question 12

HTN emergency -- conditions considered

Accepted Answer

aortic dissection severe preeclampsia / eclampsia pheochromocytoma

Question 13

HTN emergency -- if a severe condition

Accepted Answer

dec SBP < 140 during first hours and to < 120 in aortic dissection

Question 14

BP goals -- ischemic stroke -- before thrombolytics

Accepted Answer

<180/110

Question 15

BP goals -- ischemic stroke -- after thrombolytic

Accepted Answer

<180/105

Question 16

BP goals -- ischemic stroke -- no thrombolytics

Accepted Answer

<220/120 - dec by 15% in 24 hours if over the gial

Question 17

BP goals -- hemorrhagic stroke

Accepted Answer

SBP 150-220; ok <140 SBP >220 --> aggressively reduce

Question 18

BP goals -- hemorrhagic stroke -- tx options

Accepted Answer

labetalol, hydralazine, nicardipine, clevidipine

Question 19

Sympathetic crises -- recreational drug use

Accepted Answer

cocaine, amphetamine, phencyclidine

Question 20

Sympathetic crises -- avoid ______ (drug class)

Accepted Answer

ß blockers

Question 21

Sympathetic crises -- tx options

Accepted Answer

nicardipine, clevidipine, phentolamine

Question 22

Acute aortic dissection -- aggressively lower BP to ≤_______ in ______ mins

Accepted Answer

≤120 20 minutes

Question 23

Acute aortic dissection -- tx options

Accepted Answer

esmolol +/- vasodilator (nitroprusside/nicardipine)

Question 24

Preeclampsia -- tx general

Accepted Answer

volume expansion, magnesium sulfate, seizure prophylaxis, BP control

Question 25

Eclampsia / preeclampsia -- BP control prevents (2)

Accepted Answer

hemorrhage and cardiac failure

Question 26

Eclampsia / preeclampsia -- BP goals ACOG

Accepted Answer

140-160 / 90-105

Question 27

Eclampsia / preeclampsia -- tx options

Accepted Answer

hydralazine, labetalol, nicardipine, methyldopa

Question 28

Eclampsia -- tx

Accepted Answer

delivery of newborn

Question 29

Eclampsia / preeclampsia -- CI to use (2) drug classes

Accepted Answer

nitroprusside ACEi

Question 30

Clevidipine -- not in who

Accepted Answer

soy/egg allergy or HLD

Question 31

Nicardipine -- not used in ____

Accepted Answer

advanced aortic stenosis

Question 32

Esmolol -- not used in pts with

Accepted Answer

ß blocker, bradycardia, decompensated HF

Question 33

Labetalol -- not used in pts with

Accepted Answer

- not in restrictive airway disease / COPD - may worsen HF - not in 2-3rd degree heart block

Question 34

NTG -- not in ___ Pts

Accepted Answer

volume-depleted

Question 35

Nitroprusside -- considerations

Accepted Answer

- intra-arterial BP monitoring - tachyphylaxis common with extended use - cyanide tox

Question 36

Fenoldopam -- considerations

Accepted Answer

CI in inc IOP and sulfite allergy

Question 37

Phentolamine -- used in _______ excess

Accepted Answer

catecholamine

Question 38

Enalaprilat -- do not use in _____

Accepted Answer

pregnancy, MI, bilateral renal artery stenosis

Hypertensive crisis

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