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Malignant HTN (Diagnosis (Investigations (Bedside
Obs - DBP>120
ECG -…
Malignant HTN
Diagnosis
Examination
Cardio - ?signs of HF/dissection
Neuro - ?reduced GCS, focal signs, seizures
Fundoscopy - flame haemorrhages, cotton wool spots,
hard exudates, papilloedema
Investigations
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Urine
Dipstick - protein, blood
Bloods
FBC, U+E, LFTs,
glucose, lipids, clotting
Imaging
CXR - dissection
CT head - oedema, haemorrhage
History
PC: headache, visual change
PMH: HTN, risk factors
DH: anti-HTNs, compliance
FH: HTN, CVD
SH: smoking, alcohol, diet
Pathophysiology
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End organ
damage
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Eyes
Retinal haemorrhage
Cotton wool spots, hard exudates
Papilloedema
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Management
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Definitive
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Medical
Anti-HTNs
E.g. PO atenolol, amlodipine
MOA: PO to lower BP over 1-2d
(IV too quick, can cause cerebral infarction)
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