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MSoP 1003 CVD WORKSHOP Hypertension Worksheet Answers PP 2023

This document provides information on a cardiovascular workshop including objectives focused on hypertension and dyslipidemia guidance and patient education. It includes a series of multiple choice questions on hypertension management guidelines and appropriate lifestyle advice for patients.

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26 views10 pages

MSoP 1003 CVD WORKSHOP Hypertension Worksheet Answers PP 2023

This document provides information on a cardiovascular workshop including objectives focused on hypertension and dyslipidemia guidance and patient education. It includes a series of multiple choice questions on hypertension management guidelines and appropriate lifestyle advice for patients.

Uploaded by

qzmzqskty8
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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MSoP 1003

Cardiovascular Workshop
Mrs Teresa Ann Benniman
Lecturer in clinical and professional practice
Objectives:

• Looking at the national guidance for both hypertension and dyslipidaemia


and using these to extend your core knowledge of the conditions – group
work and worksheet questions
• Exploring the importance of patient decision making and education
• Case study focusing on establishing and responding to a patient's QRisk
score – mentimeter quiz and feedback on pre workshop task
Hypertension workshop questions

1. Which of the following is the most likely effect of amiloride?


• Hypercalciuria
• Hyperkalaemia
• Hypermagnesaemia
• Hypernatraemia
• Hyperphosphataemia
• B – hyperkalaemia
• potassium sparing diuretic
2. Which patients should not be offered amiloride?
• Patients with existing hyperkalaemia, severe renal impairment or Addisons disease
3. Which of the following is the most appropriate diuretic to start for patient >55yrs old with
hypertension?

A. Bendroflumethiazide 2.5mg once daily


B. Chlortalidone 12.5mg once daily
C. Chlortalidone 50mg once daily
D. Hydrochlorothiazide 12.5mg once daily
E. Indapamide 2.5mg SR once daily

B – newer thiazide like diuretic, Step 1 of NICE Guidance, Dose of 50mg too high initially.
Indapamide is either 2.5mg once daily or 1.5mg SR once daily – there isn’t a 2.5mg SR preparation.
Chlortalidone is now available in 25mg and 50mg tablets (25mg is imported USA)

4. At Step 4 of treatment for resistant hypertension what level does the potassium need to be less
than or equal to?

4.5mmol/l
5. Does being over the age of 80 affect the choice of drugs to be used for hypertension?

Not ordinarily, comorbidities should be considered but could have the same medication that are
offered to the 55-80 year old patient

6. What is the clinic blood pressure threshold for recommending ambulatory blood pressure
monitoring (ABPM)

140/90 mmHg – 179/119mmHg


7. What further investigations are recommended for patients with a diagnosis of hypertension
and why?
ACR and test for haematuria – establish renal impairment
Blood screening – HbA1C, eGFR, cholesterol, electrolytes – Co-morbidities and existing abnormal
levels.
Fundi examination – retinopathy
12 lead ECG – cardiac conditions contributing?
Answer: Discard the first day of readings and average the rest
Systolic: 159 mmHg (158.777778)
If answer given as 160mmHg (160.571429) then not discarded the first day of
readings!
Diastolic: 79.6 (to one decimal place 79.555555555556)
If answer given as 80.3 mmHg then not discarded the first day of readings!
9. List 5 examples of lifestyle advice you may offer to patients with a new or existing
diagnosis of hypertension

cutting your salt intake to less than 6g (0.2oz) a day – find out how you can reduce the
amount of salt in your diet
eating a low-fat, balanced diet – including plenty of fresh fruit and vegetables; get tips
on eating more healthily
being active – read some tips about getting more exercise
cutting down on alcohol – get tips on cutting down, including downloading a drinks diary and
keeping track of your drinking
losing weight – find out what your ideal weight is using the BMI healthy weight calculator and
read advice about losing weight if you're overweight
drinking less caffeine – found in coffee, tea and cola
stopping smoking – get help quitting
getting at least six hours of sleep a night if you can – read some tips for getting to sleep

‘Ctrl click’ on links to look at in depth advice and patient education


10. How would you treat a patient with a diagnosis of isolated systolic hypertension?

In the same way you would treat patients with both raised diastolic and systolic!
Resources and follow up MSCL
• https://bihsoc.org/resources/bp-
measurement/ POST-WORKSHOP MSCL:
• https://bihsoc.org/resources/bp-
measurement/abpm/
INVESTIGATE LIFESTYLE ADVICE FOR
• https://www.nice.org.uk/guidance/ CARDIOVASCULAR DISEASE
cg181/resources/patient-decision- PREVENTION AND/OR
aid-243780159 MANAGEMENT
• https://qrisk.org/three/ CORE DRUG TEMPLATES
• Scenario: Lipid therapy - primary COMPLETION
prevention of CVD | Management
| Lipid modification - CVD
prevention | CKS | NICE (inc. statin
intensity table)

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