HYPERTENSION

HYPERTENSION

HYPERTENSION

Ques. 1     What is meant by Hypertension?

Ans.          Hypertension may be systemic or pulmonary. Systemic hypertension is the persistent rise of basal blood pressure above the arbitrary level of 150/90 mm of Hg. Irrespective of age.

Ques. 2     Classify hypertension on different grounds.

Ans.          Aetiological classification :

  1. Primary or Idiopathic or essential by far majority of cases (90%)
  2. Secondary :
  3. Extra renal- Cohn’s syndrome, Cushing’s syndrome, Phacechromocytoma, Climacteric hypertension, Diabetes mellitus, Thyrotoxicosis, A ortic stenosis, A ortic incompetence, Gout and osteoarthritis, Lead poisoning, chronic alcoholism. Enlarged prostate, Brain tumour, Polycythemia, Arteriosclerosis of pancreatic vessels.
  4. Renal – Acute and chronic glome rulonephritis, chronic pyelonephritis, polycystic kidneys, renal stones tuberculosis tumours of the kidney, injury, toxaemia of pregnancy.

III. Pathological :

  • Malignant : when the blood pressure above the level of 220/130 mm of Hg. (Tetinopathy with papilloedema, Encephalopathy).
  • Predisposing factors :
  • obesity, Heredity, emotional upset, Psychological disturbances.

    Clinical Features : Symptoms –

  • Insomnia and headache, vertigo.
  • Easy fatigue.
    • Dizziness, impairment of memory, mental deterioration.
  • Breathlessness on exertion.
  • Transient paralysis, C.V.A.
  • Dimness of vision, blindness.
  • May be asymptomatic,
  • Nervousness & irritability (palpitation).
  • Ques. 3     What are the Various signs of Hypertension?

    Ans.

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             Signs –

  • Age – usually above 40 years, Sex-commonly males, Build-usually robust.
  • Blood pressure, grades depend upon the diastolic pressure :
  • (i)

    Mild

    95-110 mm. Hg.

    150-200 mm. Hg.

    (ii)

    Moderate

    110-125 mm. Hg.

    180-230 mm. Hg.

    (iii)

    Severe

    125-140 mm. Hg.

    210-260 mm. Hg.

    (iv)

    Gross

    Beyond 140 mm. Hg.

    240-300 mm. Hg.

    Diastolic pressure

    Systolic pressure

     

    3) Hypertensive Retinopathy which consists of 4 types :

    Type

    I

    Narrowing of retinal vessles

    II

    (Type I) + exudates.

    III

    (Type I and Type II) + Heamorrhage

    IV

    (Type I, Type II and Type III) + papilloedema.

     

    4)   Renal – Oliguria, uraemia, haematuria, polyuria also may be anuria.

    5)   Haemorrhage- Haematuria, heamatemesis and melaena, epistaxis, haemoptysis, menorrhagia etc.

    6)   Cardiac findings – (i) cardiac impulse heaving, (ii) presystolic gallop rhythm, (iii) second sound at the base accentuated and high pitched–Treatment is necessary. (iii) not to inform the patient.

  • Rest-physical, mental.
  • Homoeopathic Remedies.
  • Ques. 8     Which Homoeopathic Remedies are useful?

    Ans.          The Homoeopathic Remedies are :

    (i) DIGITALIS – Sensation as if heart would stop beating if one moved. Palpitation excited by talking, motion or on lying down. Short, hurried breathing.

    (ii) GELSEMIUM – Desires to be alone. Dullness, drowsiness and dizziness trembling are the keynotes of this remedy. Vertigo and giddiness. Excessive action of the heart, palpitation, Sensation as if heart’s action would ceases. Pulse slow & full, frequent soft and weak, almost imperceptible, intermittent. Fear of death.

    (iii) CONIUM – Especially for old people. Weak memory, forgetfulness, vertigo. Headache. Violent palpitation of heart, irregular pulse. Trembling gait. Want of sound sleep, sleep full of frightful dreams.

    (iv) CACTUS GR, - Palpitation with vertigo, loss of consciousness. Dyspnoea ; worse at night, lying on left side, from exertion. Sensation of constriction in heart, as if an iron hand prevented its normal action.

    .
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    Comments

    # Aayush 2017-10-26
    Hii, I am from Thane, plz let me know What is gonorrhoea ?
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    # Dr. Naresh 2017-10-27
    Hello, Gonorrhoea is a sexually transmitted disease caused by the Neisseria gonorrhoea,This disease is caused in the genitourinary tracts, for more details plz visit good gynec in Thane, find list of Gynecologist in Thane
    Reply | Reply with quote | Quote
    # Himmat Older than three months
    Can gonorrhoea be caused by the infected towels, also provide the list of good gynecologist in Sirohi?
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    # Dr. Pooja Older than three months
    Gonorrhoea can be transmitted by the infected towels, handkerchiefs of the infected person, But most cases are due to sexual contacts, find here list of good Gynecologist in Sirohi.
    Reply | Reply with quote | Quote
    # Aarush Older than three months
    Hii, I am from Anekal, I want to know can cigerrete sharing can lead to syphilis ?
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    # Dr. Pooja Older than three months
    yes,sharing cigerette,drinking cups,common spoons etc can also lead to syphilis, Generally whenever the fluid of a person who has syphilis is shared,the infection can occur, you should also consult with good Gynecologist in Anekal
    Reply | Reply with quote | Quote
    # Aarush Older than three months
    Hello, plz let me know What is menarche, I want to consult with gynec in Kolasib, plz suggest ?
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    # Dr. Naresh Older than three months
    the process of starting of the menstrual cycle in females is called menarche, plz find good Gynecologist in Kolasib.
    Reply | Reply with quote | Quote
    # Payal Older than three months
    Hii, can you plz tell me,What changes can occur in skin in syphilis patient, also suggest good obstertrician in Zind ?
    Reply | Reply with quote | Quote
    # Dr. Naresh Older than three months
    Rashes can occur on the skin in the near areas,rashes can be discrete and also symmetrical in nature, Rashes can also be pustular, you can consult with Obstetrician in Zind.
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