Makindo Medical Notes.com Comprehensive Medical Encyclopedia | Education for Healthcare Professionals

@About this App @Contributers @Developer ACTH (Adrenocorticotropic hormone)AFP (Alpha-fetoprotein) Testing AIDS Dementia Complex (HIV)AIDS HIV Infection APGAR Scoring (Children)APTT and Coagulation Abacavir Abatacept Abbreviated Mental Test Score (AMTS)Abciximab Abdominal Aortic Aneurysm Abdominal paracentesis for ascites Abducent Nerve Abetalipoproteinaemia Abnormal Vaginal bleeding Acamprosate Acanthocytosis Acanthosis Nigricans Acarbose Accelerated Idioventricular Rhythm Acetazolamide Acetylcholine Receptor Antibodies Acetylcholinesterase inhibitors Achalasia Achilles Tendon rupture Achondroplasia (Children)Aciclovir Acid maltase deficiency (Pompe disease)Acne Rosacea Acne Vulgaris Acoustic Neuroma (Schwannoma)Acrodermatitis enteropathica (Children)Acromegaly and Giantism Acromio-clavicular joint Actinomyces israeli Action Potential Activated Charcoal Actrapid (Insulin)Acute Abdominal Pain - Acute Peritonitis Acute Acalculous Cholecystitis Acute Anaphylactoid Reactions Acute Anaphylaxis Acute Angle Closure Glaucoma Acute Appendicitis Acute Bacterial Meningitis Acute Bronchitis Acute Cholangitis Acute Cholecystitis Acute Colonic Pseudo-obstruction Acute Coronary Syndrome (ACS) General Acute Coronary Syndrome (ACS) NSTEMI USA Acute Coronary Syndrome (ACS) STEMI Acute Coronary Syndrome (Cardiac Troponins)Acute Coronary Syndrome Grace score Acute Delirium Acute Disc lesions Acute Disseminated Encephalomyelitis Acute Diverticulitis - Diverticular disease Acute Dystonic Reaction Acute Encephalitis Acute Eosinophilic Pneumonia Acute Epiglottitis Acute Exacerbation of COPD Acute Hepatitis Acute Hydrocephalus Acute Hypotension Acute Inflammation Acute Intermittent Porphyria (AIP)Acute Interstitial nephritis Acute Kidney Injury (AKI)Acute Limb Ischaemia Acute Liver Failure Acute Lymphoblastic Leukaemia (ALL)Acute Mastoiditis Acute Monoarthritis Acute Myeloid Leukaemia (AML)Acute Myocarditis Acute Pancreatitis Acute Pelvic Inflammatory Disease Acute Pericarditis Acute Phase reactants Acute Porphyrias Acute Promyelocytic Leukaemia Acute Respiratory Distress Syndrome (Adults)Acute Retroviral Syndrome (HIV)Acute Rhabdomyolysis Acute Rheumatic fever Acute Rotator cuff tear Acute Severe Asthma Acute Severe Colitis Acute Sinusitis Acute Stroke Assessment (ROSIER&NIHSS)Acute Tonsilitis Acute Urinary Retention Acute and Chronic Gout Acute and Chronic Heart Failure Acute on Chronic Liver Disease Decompensation Acutely Ill Patient Adalimumab Addenbrooke's Cognitive Examination-Revised (ACER)Addison Disease (Adrenal Insufficiency)Adefovir Adenosine Adenosine deaminase deficiency Adhesive Capsulitis (Frozen Shoulder)Adjustment - Anxiety disorders Adrenal Antibodies Adrenal Physiology Adrenaline (Epinephrine)Adrenoleukodystrophy Adrenomyeloneuropathy Adult Onset Still's Disease African Trypanosomiasis (Sleeping sickness)Age related macular degeneration Aicardi syndrome Air Embolism Albumin Albumin-Protein Creatinine Ratio (PCR)Alcohol Abuse Alcohol Withdrawal (Delirium Tremens)Alcoholic (Steato)Hepatitis Alcoholic Ketoacidosis Aldosterone Physiology Alendronate (Alendronic acid)Alfacalcidol Alkaline phosphatase (ALP)Alkalinisation of urine Alkaptonuria Allergic Bronchopulmonary Aspergillosis Allogeneic stem cell transplantation Allopurinol Alogliptin (Vipidia)Alopecia Alpha Fetoprotein Alpha Thalassaemia Alpha subunit (ASU) of TSH Alpha-1 Antitrypsin (AAT) deficiency Alport's Syndrome Alteplase Altitude sickness Aluminium and Magnesium Antacids Alveolar Gas Equation Alzheimer disease (Dementia)Amantadine Amenorrhoea American Trypanosomiasis (Chagas Disease)Amiloride Amino acids Aminoglycosides Aminophylline Aminosalicylates Amiodarone Amiodarone and Thyroid disease Amitriptyline Amlodipine Ammonia Encephalopathy Amnestic syndromes Amoebiasis (Entamoeba histolytica)Amoxicillin Amphetamine toxicity Amphotericin B Ampicillin Anaemia of Chronic Disease Anagrelide Anakinra Anal Cancer Andexanet alfa Androgen insensitivity syndrome Aneurysms Angina bullosa haemorrhagica Angiodysplasia Angiomyolipoma Angioneurotic Oedema Angiotensin Converting Enzyme Inhibitors Angiotensin Converting enzyme (ACE)Angular Stomatitis - Cheilitis Anion Gap Ankle and Foot fractures and Injuries Ankle-Brachial pressure Index (ABPI)Ankylosing spondylitis Anorexia Nervosa Antacid medication Antepartum haemorrhage Anterior Horn Cell diseases Anterior circulation Anti Dementia Drugs Anti-Cyclic Citrullinated Peptide (CCP) Antibody Anti-D immunoglobulin Anti-Hu antibodies Anti-OKT3 antibodies Anti-RNP Antibody Anti-Yo antibodies Anti-neutrophilic cytoplasmic antibodies (ANCA)Antibiotics for Abdominal Infections Anticholinergic Burden Anticholinergic syndrome Anticipation Anticoagulation and Antithrombotics Antidiuretic hormone (Vasopressin)Antigen presenting cells Antimicrobial Choices Antimuscarinic drugs Antiphospholipid syndrome Antithrombin III deficiency (AT3)Aorta anatomy Aortic Dissection Aortic Regurgitation (Incompetence)Aortic Sclerosis Aortic Stenosis Aortoenteric fistula Apathetic thyrotoxicosis Apixaban Aplastic anaemia Apomorphine Appendix Cancer Tumours Approach to Assessing Sick Child Approach to child with Acute Gastroenteritis Approach to child with respiratory Distress Arnold Chiari malformation Arrhythmogenic Right ventricular Cardiomyopathy Artemisinins Arterial Blood gas analysis Arterial Pulse assessment Arterial blood gas sampling Arterial vs Venous vs Other Leg Ulcers Arteriovenous malformations Artery of Percheron stroke Artery-to-artery embolic stroke Artesunate Asbestos Related Lung disease Ascites Assessment and Management Aspergilloma Aspergillus fumigatus Aspirin Aspirin Salicylates toxicity Assessing Abdominal Pain Assessing Breathlessness Assessing Chest Pain Assessing Falls Asteatotic eczema Asthma Astigmatism Astrocytomas Asystole Ataxia Telangiectasia Atazanavir Atenolol Atherosclerosis Atopic Eczema or Atopic Dermatitis Atorvastatin Atracurium Atrial Ectopic beats Atrial Fibrillation (Chemical cardioversion)Atrial Natriuretic Peptide (ANP)Atrial fibrillation (AF)Atrial flutter Atrial myxoma Atrial septal defect (ASD)Atrioventricular nodal reentrant tachycardia Atropine Sulfate Autoantibodies Autoimmune Haemolytic anaemia (AIHA)Autoimmune Hepatitis Autonomic neuropathy Autosomal Dominant Autosomal Dominant Polycystic kidney disease Autosomal Recessive Azathioprine Azithromycin B lymphocytes BRCA genes (Familial Breast Cancer)Bacillus anthracis Bacillus cereus poisoning Backpain / Backache Baclofen Bacteria Bacteroides fragilis Balanitis (Adults)Balanitis (Children)Balkan endemic nephropathy (BEN)Balsalazide (Aminosalicylate)Barrett's oesophagus Bartonella Bartters syndrome Basal Cell Carcinoma (BCC)Basic Fracture management Basilar artery thrombosis Becker Muscular dystrophy Beclometasone Beer Potomania Behavioural and Psychological Symptoms of Dementia Behcet's syndrome Bell's palsy Bendroflumethiazide (Bendrofluazide)Benign Paroxysmal Positional Vertigo (BPPV)Benign Prostatic Hyperplasia Benign recurrent intrahepatic cholestasis Benzodiazepine Toxicity Benzodiazepines Benzylpenicillin Sodium (Penicillin G)Berg Balance Scale Beriplex Berylliosis Beta Agonists Beta Blocker toxicity Beta Thalassaemia Beta-2 Microglobulin Beta-lactamases Betahistine (Serc)Bezafibrate Biceps rupture Bilateral adrenalectomy Biliary atresia Bilirubin Biochemical Lab values Bisacodyl Bisoprolol Bisphosphonates Bladder Cancer Bladder Stones Bleeding Bleeding disorders Bleeding due to Drugs Bleomycin Blindness - global causes Blood products - Packed cells blood transfusion Blood Products - Cryoprecipitate Blood Products - Fresh Frozen Plasma Blood Products - Platelets Blood film interpretation Blood gas values Bloody Diarrhoea Blotting Techniques: Gel Electrophoresis Bone Marrow Transplantation Bone disease Lab results Bone metabolism RANK RANKL OPG pathway Bone scintigraphy (Bone scan)Bordetella pertussis - Whooping cough Borrelia burgdorferi Borrelia recurrentis Botulism Brachial neuritis (neuralgic amyotrophy)Brachial plexus anatomy Brachial plexus and associated injury Brain Abscess Brain Anatomy and function Brain MRI Brain Natriuretic Peptide (BNP)Brain Physiology Brain Tumours (Cancer)Brainstem anatomy Branchial cleft cyst Breast Cancer Breast Fibroadenoma Bretylium Broad complex Tachycardia Bromocriptine Bronchial adenoma Bronchiectasis Bronchiolitis Bronchoscopy Brown-Sequard syndrome Brucella Brugada syndrome Budd-Chiari syndrome Budesonide Buerger disease (Thromboangiitis obliterans )Bulbar vs Pseudobulbar palsy Bulimia Nervosa Bullous Pemphigoid Bumetanide Bunions Buprenorphine Bupropion Burkholderia cepacia Burkitt's lymphoma Burns Busulphan (Busulfan)Byssinosis C reactive protein (CRP)CADASIL CARASIL CHADS2 - CHA2DS2-VASc score CMV retinitis CNS fungal Infections CNS infections CSF Rhinorrhoea CT Head Basics (Stroke)CT Pulmonary angiogram (CTPA)CT imaging basics for Stroke CURB 65 score Cabergoline Caecal Volvulus Caisson Disease - Decompression sickness Calcitonin Calcitriol (1,25 Dihydroxycholecalciferol)Calcium Chloride or Gluconate Calcium Physiology Calcium Pyrophosphate Deposition (Pseudogout)Calcium Resonium Calcium channel blockers toxicity Calot's triangle Campylobacter Cancer of Unknown Primar Candesartan Candidiasis Cannabis toxicity Capecitabine Capnocytophaga canimorsus Capnography Capreomycin Captopri Carbamazepine Carbapenemase-producing Enterobacteriaceae Carbimazole Carbon monoxide poisoning Carcinoembryonic antigen (CEA)Carcinoid Heart Disease Carcinoid Tumour Syndrome Carcinoma of the Bile Duct Carcinoma of the Gallbladder Cardiac Amyloid heart disease Cardiac Anatomy and Physiology Cardiac Catheter ablation Cardiac Infections Cardiac MRI Cardiac Resynchronisation Therapy (CRT) Pacemaker Cardiac Valve replacement Cardioembolic stroke Cardiogenic Pulmonary Oedema Cardiogenic shock Cardiology - History Taking Cardiology Exam List Cardiology Examination Cardiology Valves Summary Cardiopulmonary bypass Carmustine Carotid Artery anatomy Carotid Body Tumour Carotid Endarterectomy Carotid Sinus Syncope Carotid Stenting Carotid artery Dissection Carotid sinus massage Carpal tunnel syndrome Carvedilol Case 01 Sudden weakness Case 02 Loss of speech Case 03 Adult male weak legs Case 04 High calcium Case 05 High Potassium and heart failure Case 06 High calcium and weight loss Case 07 Weak eyes Case 08 Weak face Case 09 A cause of Delirium Case 10 Older patient presenting post stroke Case 11 Young patient with acute headache Case 20 Young patient with acute headache Case 21 Hypoglycaemia Case 22 Case 23 Old man with tremor Case 24 Cancer and weak Case 99 (Acute breathlessness)Case Template Cat Scratch Disease Cataract Catheter Related Urinary Tract infection UTI Catheter related Blood stream infection Catheter related UTI Cauda equina syndrome Caudate Nucleus Causes of Airway Obstruction Causes of Avascular Necrosis of Femoral head Causes of Sore throat Causes of Weakness Cavernous angiomas (Cavernomas)Cavernous sinus Cavernous sinus thrombosis Cefaclor Cefalexin Cefotaxime Ceftazidime Ceftriaxone Cefuroxime Celecoxib Cell Response to Injury Cellular Anatomy and Physiology Cellulitis Central Cord Syndrome Central Retinal Vein Occlusion (CRVO)Central Retinal artery Occlusion (CRAO)Central Venous line Insertion Central pontine myelinolysis Cephalosporins Cerebellar Anatomy Physiology Signs Disease Cerebellar Haemorrhage Cerebellar Stroke Cerebral Amyloid angiopathy (CAA)Cerebral Aneurysms Cerebral Angiitis Cerebral Atrophy vs Hydrocephalus Cerebral Cortex Cerebral Metastases Cerebral Palsy Cerebral Perfusion Cerebral Salt Wasting Cerebral Venous Sinus thrombosis Cerebral arteritis Cerebral microbleeds Cervical Cancer screening Cervical Spine injury Cervical cancer Cervical spondylosis Cetirizine Chancroid Charcot Foot Syndrome (CFS)Charcot Marie Tooth (CMT) disease Chediak Higashi syndrome Chest Abdomen anatomy Chest X Ray #1 Chest X Ray Interpretation Chest drain Insertion Chlamydia - Chlamydophila pneumoniae Chlamydia psittaci Chlamydia trachomatis Chlorambucil Chloramphenicol Chlordiazepoxide Chloroquine Chlorphenamine(Chlorpheniramine)Chlorpromazine Cholangiocarcinoma Cholera (Vibrio cholera)Cholestatic Jaundice Cholesteatoma Cholesterol - Lipids Cholinergic crisis-syndrome Chondrocalcinosis Chorea - Ballismus Choreoacanthocytosis Chromosome instability syndromes Chronic Bronchitis Chronic Hepatitis Chronic Inflammation Chronic Inflammatory Demyelinating polyneuropathy Chronic Interstitial Nephritis Chronic Kidney Disease (CKD)Chronic Lymphocytic leukaemia (CLL)Chronic Myeloid Leukaemia (CML)Chronic Obstructive Pulmonary Disease (COPD)Chronic Pancreatitis Chronic Peritonitis Chronic Radiation Enteritis Chronic Urinary Retention Chronic Vision Uni-Bilateral loss (Blindness)Chronic and recurrent Meningitis Chronic liver disease Chronic mucocutaneous candidiasis Chronic stable angina Chylomicrons Ciclosporin Cimetidine Cinacalcet Ciprofloxacin Cirrhosis Cisplatin Citalopram Cladribine Clarithromycin Cleft lip or palate Clindamycin Clopidogrel Clostridium botulinum Clostridium difficile Clostridium perfringens Clostridium tetani - Tetanus Clotrimazole cream Clotting pathways Clozapine Co Careldopa (Sinemet)Co-Amoxiclav (Augmentin)Co-Beneldopa (Madopar)Co-codamol Co-trimoxazole Coagulopathy Coal Worker's Pneumoconiosis Coarctation of the Aorta (CoA aortopathy)Cocaine abuse Cocaine induced chest pain Cocaine toxicity Coccidioidomycosis Codeine Coeliac disease Cogan Syndrome Colchicine Cold Agglutinin Disease (CAD/AIHA)Collagen Colloid cyst in the third ventricle Colloids Colonic (Large bowel) Obstruction Colonoscopy Colorectal cancer Colorectal polyps Colposcopy Coma management Combined Oral contraceptive pill (COCP)Common Peroneal Nerve (CPN)Common variable immunodeficiency Comparing Rheumatoid and Osteoarthritis Complement Comprehensive Geriatric Assessment (CGA)Confirming Death Congenital Acyanotic Heart Disease (Children)Congenital Adrenal hyperplasia Congenital Complete Heart Block Congenital Cyanotic Heart Disease (Children)Congenital Hypothyroidism Congenital Talipes Equinovarus - Clubfoot Constipation Constrictive Pericarditis Contact allergic dermatitis Continuous Positive Airways Pressure (CPAP)Continuous ambulatory peritoneal dialysis Contraception Conus Medullaris syndrome Cor Pulmonale Coronary artery bypass graft surgery Coronavirus SARS-CoV-2 COVID 19 Corticobasal degeneration (Dementia)Corticosteroid-related psychosis Corticosteroids Corynebacterium diphtheriae Cotard delusion Coxiella Burnetii Cranial nerves and examination Craniopharyngioma Creatinine Clearance Cremation forms (UK)Creutzfeldt Jakob disease (Dementia)Crimean-Congo haemorrhagic fever Critical illness neuromuscular weakness Crohn's disease Croup Cryptococcus neoformans infections Cryptogenic Fibrosing Alveolitis Cryptogenic Organising Pneumonia (COP-BOOP)Cryptosporidiosis Crysal arthritis Crystalloids Cushing disease Cushing syndrome Cutaneous Leishmaniasis Cyanide toxicity Cyanosis - Central and Peripheral Cyclizine Cyclo-oxygenase (COX) enzymes Cyclophosphamide Cycloserine Cys leukotriene receptor antagonists Cystic Fibrosis Cystinosis Cystinuria Cytokines Cytomegalovirus infections D Dimer DNA and RNA short notes DNA replication Dabigatran Dalteparin Dandy Walker syndrome Dantrolene Dapagliflozin Darier's Disease Darunavir DeQuervain's thyroiditis Death Certificates (UK)Deep brain stimulation Deep vein thrombosis (DVT)Dehydration Physiology Delayed Puberty Criteria Demeclocycline Dementia with Lewy bodies Dementias Demyelinating Diseases Dengue Fever Denosumab (Prolia)Dental Anatomy Dentatorubral pallidoluysian atrophy Depression Dermatitis Herpetiformis Dermatology terms Dermatomes Dermatomyositis Dermoid cysts Desferrioxamine Desmopressin (DDAVP)Desogestrel (Progestogen Only Pill)Developmental Dislocation (Dysplasia) of the Hip Developmental Milestones Dexamethasone DiGeorge syndrome (thymic aplasia)Diabetes Insipidus (Cranial and Nephrogenic)Diabetes Mellitus Type 1 Diabetes Mellitus Type 1 and DKA (children)Diabetes Mellitus Type 2 Diabetes Mellitus in pregnancy Diabetes on the ward Diabetic Autonomic Neuropathy (DAN)Diabetic Ketoacidosis (DKA) Adults Diabetic Ketoacidosis (DKA) with SGLT2 Inhibitors Diabetic Nephropathy Diabetic Retinopathy Diabetic amyotrophy Diabetic foot Diamond-Blackfan anaemia Diamorphine Diaphragmatic disorders Diarrhoea Diazepam Didanosine (ddI)Diethylstilbestrol Differentials causes of Foot Drop Differentials of ABC Differentials of Generalised lymphadenopathy Differentials of Painful thigh Differentials of XXX Diffuse Oesophageal spasm Diffuse large B-cell lymphoma Diffusion Capacity Digoxin Digoxin Toxicity Dihydrocodeine Dilated cardiomyopathy Diltiazem Diphtheria Dipyridamole Discharges against advice Discoid lupus erythematosus (DLE)Disease template Diseases with associated cancers Dislocation Sternoclaivcular joint Disopyramide Disseminated Intravascular Coagulation (DIC)Distributive Shock Disulfiram (Antabuse)Dobutamine Dog Bites Dog Bites Hand Dominant R wave in V1 Domperidone Donepezil (Aricept)Donovanosis Dopamine Hydrochloride Dopamine agonists Down's syndrome (Trisomy 21)Doxapram Doxazosin (Cardura)Doxepin Doxorubicin (Adriamycin)Doxycycline Driving Drowning Drug Induced Parkinson disease Drug Reaction Eosinophilia Systemic Symptoms DRESS Drug Template Drug Toxicity - clinical assessment Drug Toxicity with Specific Antidotes Drug induced Lupus Erythematosus Drug induced liver disease Drugs Drugs List Drugs to Avoid in Acute Renal failure Drugs to avoid Elderly Drugs to avoid in Liver failure Dry and Wet Gangrene Dual X-ray absorptiometry (DEXA)Duchenne muscular dystrophy Dulaglutide GLP-1 agonist Duloxetine Duodenal Atresia (Children)Dupuytrens contracture Dysentery Dysphagia ECG - Acute Coronary Syndrome ECG - Acute ST Elevation Myocardial Infarction ECG - Atrial fibrillation ECG - Atrial flutter ECG - Basics ECG - Broad complex tachycardia (possible VT)ECG - Brugada syndrome ECG - Causes of a Dominant R wave in V1 ECG - Early Repolarisation vs STEMI ECG - First degree AV Block ECG - Heart Block ECG - Hyperkalaemia ECG - Interpretation ECG - Ischaemic Heart Disease ECG - Left Axis Deviation ECG - Left Bundle Branch Block LBBB ECG - Left Ventricular Hypertrophy ECG - Low Voltage Complexes ECG - Narrow complex tachycardia ECG - Normal appearance ECG - Pathological Q waves ECG - QT interval ECG - Right Axis Deviation ECG - Right Bundle Branch Block RBBB ECG - ST-T T waves changes ECG - Supraventricular tachycardia ECG - The QRS complex ECG - Tutorial from Queens University ECG - Ventricular fibrillation ECG - Ventricular tachycardia ECG - Wolff Parkinson White syndrome (WPW)ECG - short PR interval ECG - sinus pause ECG - tall R wave V1 ENT Exam - Assessing hearing ENT infections Ebola Virus Disease Ebstein anomaly Echinocytes Echocardiogram Ecstasy toxicity Ectopia lentis (subluxation of the lens)Ectopic Pregnancy Ectropion Eculizumab Edoxaban (Lixiana)Edward syndrome (trisomy 18 syndrome)Efavirenz (Sustiva) EFV Ehlers-Danlos syndromes Ehrlichiosis Eikenella corrodens Eisenmenger's syndrome (Children)Elbow fractures and Injuries Electrical injury Eloquent brain Emergency Drugs Emphysema Empty sella syndrome Emtricitabine (Emtriva) FTC Enalapril End of Life Care Prescribing Endocarditis and Stroke Endocrinology Lab values Endometrial (Uterine) Cancer Endometriosis Endoscopic Retrograde Cholangiopancreatography X Endothelins Enfuvirtide Enoxaparin Sodium (Clexane-Lovenox)Enoximone Entacapone Enterococci Enteropathic Spondyloarthritis Enzyme inducers and inhibitors Eosinophilic granulomatosis (Churg Strauss)Ependymoma Epidural Haematoma Epidural abscess Epilepsy - General Management Epilepsy - Idiopathic Generalised Epilepsy Epilepsy - Mesial temporal lobe epilepsy Epilepsy - Post Traumatic Epilepsy in Pregnancy Episcleritis Epistaxis Eplerenone Eponymous brainstem strokes Epstein-Barr Virus infection Equivalent doses of Opiates Erb Palsy Ergocalciferol (Calciferol)Erlotinib (Tarceva)Erysipelothrix rhusiopathiae Erythema Multiforme Erythema Nodosum Erythrocyte Sedimentation rate (ESR)Erythrocytes Erythrodermic Psoriasis Erythromycin Escherichia coli Escitalopram Esomeprazole Essential Thrombocythaemia (ET)Essential Tremor Etanercept Ethambutol Ethanol Ethanol toxicity Ethylene glycol toxicity Etomidate Etravirine (intelence) ETR Ewing sarcoma Exenatide (Byetta) GLP1 agonist Exercise stress test Exploding head syndrome Extradural haematoma Extrapyramidal symptoms Extrinsic Allergic alveolitis (Hypersensitivity)Eye infections Ezetimibe Fabry disease Facial Nerve Facioscapulohumeral muscular dystrophy Factor V Leiden Deficiency Faecal Calprotectin Fahr syndrome Failure to thrive or Faltering growth Familial Adenomatous polyposis (FAP)Familial Amyloidosis Familial Hypercholesterolaemia Familial Mediterranean Fever (FMF)Familial hypocalciuric hypercalcaemia (FHH)Family Tree (Pedigree)Famotidine Fanconi Anaemia Fanconi Syndrome Fat embolism Fatigue - Causes Fatty acids Febrile seizures Felodipine (Dihydropyridine)Femoral Hernia Femoral triangle Femur fractures and Inuries Fentanyl - Fentanil Ferritin Ferrous Fumarate - Gluconate - Sulphate Fetal Alcohol Syndrome Fetal circulation Fever - Pyrexia of unknown origin (FUO PUO)Fever in a traveller Fibrates Fibrinogen Fibromuscular dysplasia Fibromyalgia Fidaxomicin Finasteride (5 alpha-reductase inhibitor)First Seizure Fitz-Hugh Curtis Syndrome Flail Chest Flecainide Acetate Flexor sheath infection (flexor tenosynovitis)Flucloxacillin Fluconazole Flucytosine Fludrocortisone Fluid balances status Flumazenil (Annexate - Romazicon)Fluoxetine Focal Segmental Glomerulosclerosis (FSGS)Foix-Alajouanine syndrome Folate (Folic) acid Folate deficiency Folinic acid (Leucovorin)Fomepizole Fondaparinux Food borne disease Foscarnet Sodium Fosfomycin Fosphenytoin Foster Kennedy Syndrome Fournier's gangrene Fracture Template Fractured Clavicle Fractured Neck of Femur Fractured Pubic Ramus Fractured Scapula Fractured Shaft Femur Fractured Tibia and Fibula Fractures Shaft Humerus Fractures in Children Fractures of Upper humerus Fragile X syndrome Frailty Fraser guidelines and Gillick Competence Free Radicals Friedreich's Ataxia Frontotemporal dementia Full or Complete Blood Count (FBC CBC)Fungi Furosemide (Frusemide)Fusidic acid Fusobacteria - Tropical ulcer Fusobacterium G protein-coupled receptors GP Emergency Drugs Carried Gabapentin Galactorrhoea Galantamine Gamete intra-fallopian tube transfer (GIFT)Gamma Glutamyl Transferase (GGT)Gamma hydroxy butyrate (GHB) toxicity Ganciclovir - Valganciclovir Gardner syndrome Gardnerella vaginalis Gas Gangrene Gastric (MALT) Lymphoma Gastric Cancer Gastric Outlet obstruction (pyloric stenosis)Gastrinoma Gastro Intestinal Stromal Tumours (GIST)Gastro-Oesophageal Reflux (Adult GORD)Gastro-Oesophgeal Reflux (Paediatrics GORD)Gastroenteritis Gastroenterology Exam Lists Gastroenterology Examination Gastroenterology History Gastroenterology assessment - Jaundice Gastrointestinal anatomy and physiology Gastrointestinal perforation Gastrostomy (PEG) tubes Gaucher's disease Gene components Genetic Diseases Gentamicin Giardiasis Gilbert's syndrome Gingival (Gum) hyperplasia-hypertrophy Gitelman's syndrome Glasgow Blatchford Score Glasgow Coma scale Glatiramer acetate (Copaxone)Glibenclamide Gliclazide Glimepiride Glipizide Globus Pallidus Glomerulonephritis Glossitis Glucagon Glucagonoma Glucose 6 phosphate dehydrogenase deficiency Glucose Tolerance Test Glutamate Glycated Haemoglobin Glyceryl Trinitrate (GTN)Glycogen storage diseases Glycolysis_Krebs_Electron_Transport_Chain Glycopyrronium Bromide Goitre Golfer's Elbow Golimumab (Simponi)Goodpasture's syndrome (Anti GBM disease)Goserelin (Zoladex)Gradenigo's syndrome Grades of Recommendation Gram Stain Granuloma annulare Granulomatosis with Polyangitis GPA (Wegener)Graves Disease Griseofulvin Growth Hormone Deficiency Guillain Barre Syndrome Gum hypertrophy Guthrie test New Born blood spot Gynaecological History Taking Gynaecomastia HAS-BLED score HIV and Post-Exposure Prophylaxis (PEP)HIV and Pre-exposure prophylaxis HIV associated nephropathy (HIVAN)HIV disease Assessment HTLV-1 Associated myelopathy Haematemesis Haematology Examination - Splenomegaly Haematology Lab values Haematuria Mild to Severe Haemodialysis Haemoglobins Haemolysis Haemolytic Anaemia Haemolytic Uraemic syndrome Haemolytic disease of the newborn Haemophilia A Haemophilia B Haemophilus aegyptius Haemophilus ducreyi Haemophilus influenzae Haemophilus parainfluenzae Haemopoiesis Haemorrhagic Transformation Haemorrhagic stroke Haemorrhoids (Piles)Hairy Cell Leukaemia Hairy Leukoplakia Hallervorden-Spatz disease (PKAN)Haloperidol Hamman-Rich syndrome Hand foot and mouth disease Hand fractures and Injuries Hantavirus infections Hartmann's solution (Ringer's lactate)Hartnup disease*Hashimoto's (Steroid responsive) Encephalopathy Hashimoto's thyroiditis HbA1c Head (Brain) Injury Head and Neck Cancers Headache - Analgesic overuse Headache - Assessing Acute and Severe Headache - Basilar Migraine Headache - Cluster Headache - Low CSF pressure Headache - Migraine Headache - Tension Headaches - General Hearing aids Heat Stroke Helicobacter pylori Helvetica Spotted fever Hemicraniectomy Henoch-Schonlein purpura Heparin - General Heparin - Low Molecular Weight Heparin Heparin - Unfractionated Heparin Heparin-induced thrombocytopenia (HIT)Hepatic Encephalopathy Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Hepatocellular Carcinoma Hepatorenal syndromes Hereditary Elliptocytosis Hereditary Haemochromatosis Hereditary Haemorrhagic Telangiectasia Hereditary Spastic Paraparesis Hereditary Spherocytosis Hereditary angio-oedema Hereditary neuropathy with pressure palsies Hereditary non polyposis coli (Lynch syndrome)Herpes Gestationis Herpes Simplex Herpes Simplex Encephalitis (HSV)Herpes Viruses Herpes Zoster Ophthalmicus (HZO) Shingles Herpes simplex keratitis (HSK)Heyde syndrome Hiatus hernia Hiccups (Singultus)High Dose Dexamethasone Suppression Test Hip pain in children Hirschsprung disease (congenital megacolon)Hirsuitism XXX Histones Histoplasmosis Hodgkin Lymphoma Holt-Oram syndrome Holter monitor (tape) 24-72 h Homocystinuria Hookworm Horner's syndrome Hospital acquired Pneumonia (NICE 139)Human albumin solution (HAS)Human prion diseases Humeral fractures and injuries Hunter's syndrome (MPS-2)Huntington Chorea Hurler's syndrome (MPS-1)Hydatid disease (Echinococcus)Hydatidiform mole Hydralazine Hydrocortisone Hydrogen Bonds Hydrops fetalis Hydroxocobalamin Hydroxocobalamin - Cyanocobalamin (B12)Hydroxychloroquine Hydroxyurea-Hydroxycarbamide Hyoscine (Buscopan)Hyper IgM syndrome Hyperbaric Oxygen therapy Hypercalcaemia Hyperglycaemic Hyperosmolar State (HHS)Hyperinsulinaemic-euglycemic therapy (HIET)Hyperkalaemia Hyperkalaemic and Hypokalaemic Periodic Paralysis Hypermagnesaemia Hypernatraemia Hyperphosphataemia (High phosphate)Hyperprolactinaemia Hypersensitivity reactions Hypertension Hypertension in Pregnancy Hypertriglyceridaemia (HTG)Hypertrophic cardiomyopathy (HCM - HOCM)Hyperventilation Syndrome Hyperviscosity syndrome Hypocalcaemia Hypoglycaemia Hypogonadism (Female)Hypogonadism (male)Hypokalaemia Hypokalaemic Periodic Paralysis Hypomagnesaemia Hyponatraemia Hypoparathyroidism Hypophosphataemia (Low phosphate)Hypopituitarism (Pituitary Failure)Hypospadias Hypothermia Hypothyroidism Hypovolaemic or Haemorrhagic Shock IL-12 receptor deficiency IV Immunoglobulin Ibandronic acid (Bisphosphonate)Ibuprofen Icatibant Idiopathic Intracranial hypertension Idiopathic Parkinson disease Idiopathic Pulmonary Fibrosis IgA Nephropathy (Berger's disease)Images - Spot diagoses Imatinib mesylate Imipenem (Primaxin) with Cilastin Immune Reconstitution Syndrome Immune(Idiopathic) Thrombocytopenic Purpura (ITP)Immunoglobulin G4-related disease (IgG4-RD)Impetigo Implantable cardioverter defibrillator (ICD)Impulse control disorders Inclusion Body Myositis Incubation periods Indapamide Indinavir (IND)Infection screening in Septic patient Infections and their Microbial cause Infectious Mononucleosis Infective Conjunctivitis Infective Endocarditis Infertility Infliximab Influenza Inguinal Hernia Initial Trauma Assessment Injury Severity Score (ISS)Insomnia - sleep issues Insulin Insulinoma Interferon Beta Intermittent Claudication Internal Capsule Internuclear Ophthalmoplegia Interpreting Haematinics Interstitial Keratitis Intestinal obstruction (Children)Intra Aortic Balloon Pump Intraabdominal abscess Intracerebral Haemorrhage (ICH) Score Intracranial HypertensionX Intravenous Iron Replacement (Ferrous)Intraventricular haemorrhage (neonates)Intubation and Mechanical Ventilation Intussusception (Adults)Intussusception (Children)Iodine deficiency Goitre Ipratropium Bromide (Atrovent)Irbesartan Iron Salts Iron deficiency Anaemia Iron toxicity Irritable bowel syndrome Ischaemic Colitis Ischaemic Stroke Ischaemic heart disease Isoniazid Isoprenaline Isosorbide Dinitrate Isosorbide mononitrate Isotretinoin (Accutane)Ispaghula Husk (Fybogel)Ivabradine Jansen Disease Janus kinase 2 Jervell and Lange-Nielsen syndrome Job Syndrome (Hyper IgE syndrome)Jugular Venous Pressure (JVP)Junctional Tachycardia Juvenile Dermatomyositis Juvenile Idiopathic arthritis (Stills Disease)Juvenile Myoclonic epilepsy (JME)Kallmann's syndrome Kaposi sarcoma (KS)Karnofsky performance status scale Kawasaki disease Kennedy Syndrome Keratoconus Kernicterus Ketamine Ketoconazole Klebsiella pneumonia Klinefelter Syndrome (Children)Klumpke palsy Knee fractures and Injuries Koebner phenomenon Kugelberg Welander syndrome Kwashiorkor L-Thyroxine (T4)Labetalol (Trandate)Labyrinthitis - Vestibular Neuronitis Lactate Lactate dehydrogenase (LDH)Lactic acidosis Lactobacillus acidophilus Lactose Intolerance Lactulose Lady Windermere syndrome Lambert-Eaton syndrome (LEMS)Lamivudine (3TC)Lamotrigine Langerhans Cell Histiocytosis X Lansoprazole Lanthanum Lateral Medullary Syndrome Laxatives Le Fort Fractures Lead toxicity Leber hereditary optic neuropathy (LHON)Leflunomide Legal definition of Blindness Legionella pneumophila Leishmaniasis (Cutaenous and Visceral)Lemierre's syndrome Lenalidomide (Revlimid)Length Dependent Polyneuropathy Lennox-Gastaut syndrome Lenticulostriate branch occlusion Leprosy Leptin Leptospira interrogans Leptospirosis (Weil's Disease) (Notifiable)Leriche syndrome (aortoiliac occlusive disease)Lesch-Nyhan syndrome (Children)Leukaemia Leukaemias in General Leukoariosis Leukocytoclastic vasculitis Leukotrienes Levetiracetam (Keppra)Levodopa Levomepromazine Levosimendan Li Fraumeni syndrome Lichen Planus Liddle's syndrome Lidocaine(Lignocaine)Lightning strike Limb girdle dystrophy Limbic Encephalitis Linagliptin (Trajenta)Linezolid Linkage Liothyronine Sodium L-Triodothyronine (T3)Lipid emulsion therapy - Intralipid Lipid management [NICE 2014]Lipoatrophy Lipoprotein lipase deficiency Liraglutide (Victoza)Lisinopril Listerial Meningitis Listeriosis Lithium Lithium toxicity Livedo Reticularis Liver Anatomy Physiology Liver Biopsy Liver Function Tests Liver Transplantation Liver abscess Liver disease in Pregnancy Localisation of cortical function Lofepramine Long QT syndrome (LQTS) Acquired Long QT syndrome (LQTS) Congenital Long term Oxygen therapy (LTOT)Loop diuretics Looser's zones Loperamide Lopinavir Loratadine Lorazepam Losartan Low Dose Dexamethasone Suppression Test Lower Gastrointestinal Bleeding Lugol iodine Lumbar puncture and CSF interpretation Lumbrosacral radiculopathy Lung Abscess Lung Cancer Lung Compliance Lung Empyema Lung Transplant Lupus Nephritis Lupus Vulgaris Lyme disease Lymphocytic Hypophysitis Lymphogranuloma Venereum (LGV)Lyonization Lysosomal storage diseases MCune Albright syndrome MELAS Macrocytic anaemia Macroglossia Magnesium Physiology Magnesium Sulphate - Sulfate Magnetic resonance cholangiopancreatography Magnetic resonance imaging Major Histocompatibility complex Malabsorption - small intestine Malaria (non falciparum)Malaria Falciparum Male Infertility Male Urethral Catheterisation Male erectile dysfunction Malignant Ascites Malignant Hyperpyrexia (Malignant Hyperthermia)Malignant Hypertension Malignant Melanoma Malignant pleural mesothelioma Mallet Finger Mallory-Weiss Tear Malnutrition Universal Screening Tool Mania Mannitol Mantle cell lymphoma Marantic Endocarditis Marasmus Maraviroc (Celsentri)Marfan syndrome Marginal Zone Lymphoma Massive Haemoptysis Maturity Onset Diabetes of the Young (MODY)McArdles disease (type V)Measles (notifiable)Mebeverine Meckel's diverticulum Meconium Median Nerve Medical Mnemonics Basic Sciences Medical Mnemonics Cardiology Medical Mnemonics Endocrine Medical Mnemonics Mental Health Medical Mnemonics Miscellaneous Medical Mnemonics Neurology Medical Procedures Medical Teeth Medullary Sponge kidney Medulloblastoma Mefenamic acid Mefloquine (Larium)Megaloblastic anaemia Melatonin Melioidosis Memantine Hydrochloride Membranous Glomerulonephritis Menetrier disease Meniere disease Meningioma Meningitis in the Immunocompromised Menopause Menstrual cycle Mental Capacity Act 2005 Mental Health Act 1983 Mental State Examination Mercaptopurine Meropenem Mesalazine (Aminosalicylate)Mesangiocapillary Glomerulonephritis Mesenteric infarction Metabolic Syndrome X Metabolic acidosis Metabolic alkalosis Metachromic leucodystrophy Metastatic Adenocarcinoma Metastatic bone disease Metformin Methaemoglobinaemia Methanol Toxicity Methodone Methods to reduce toxin absorption Methotrexate Methylcellulose Methylprednisolone Metoclopramide Metolazone Metoprolol Metronidazole (Flagyl)Metyrapone (Metopirone)Miconazole Microangiopathic Haemolytic anaemia Microcytic anaemia Microscopic Polyangiitis Microscopic colitis Microstomia Midazolam Middle East Resp Syndrome (MERS) Coronavirus Midodrine Migraine Disability Assessment (MIDAS)Miller-Fisher syndrome Milwaukee shoulder syndrome Mini Mental State Examination (MMSE)Minimal Change Disease Glomerulonephritis Minocycline Minoxidil Mirabegron Mirizzi syndrome Mirtazapine Miscarriage Misoprostol Mitochondrial diseases Mitral Regurgitation (Incompetence)Mitral Stenosis Mitral Stenosis vs Regurgitation - Dominance Mitral Valve prolapse Mittleschmerz Mixed Connective Tissue Disease (MCTD)Mobility aids Modified Duke Criteria for Endocarditis Modified Oxford Handicap Scale (MOHS)Modified Rankin Score Molluscum contagiosum Monoclonal gammopathy of undetermined significance Monocular loss of vision Monocytes Monosodium glutamate (MSG) syndrome Montelukast Montreal Cognitive Assessment (MOCA)Moraxella catarrhalis Morphine Sulphate Mosquito borne diseases Motor Neuron Disease (MND-ALS)Moyamoya disease Mucormycosis Multifocal Atrial Tachycardia Multifocal Motor Neuropathy with Conduction block Multiple Antithrombotics Anticoagulants Multiple Endocrine Neoplasia type 1 (MEN1)Multiple Endocrine Neoplasia type II (MEN2)Multiple Myeloma Multiple Pregnancy Multiple Sclerosis (MS) Demyelination Multiple System Atrophy (MSA)Mumps (Notifiable)Muscles of the Abdominal Region Muscles of the Back Muscles of the Head and Neck Muscles of the Lower Limb Muscles of the Pelvis and Perineum Muscles of the Thoracic Region Muscles of the Upper limb Myasthenia Gravis Mycobacterium Tuberculosis Mycophenolate mofetil Mycoplasma pneumoniae Mycoplasmas Mycosis Fungoides (Sezary Syndrome)Myelodysplastic syndrome (Myelodysplasia)Myelofibrosis Myelofibrosis vs CML Myelopathy Myeloproliferative disorders Myobacterium avium Complex Infection Myocardial perfusion Myoclonus Myotonic dystrophy - Dystropica myotonica Myxoedema coma N-Acetylcysteine (Parvolex)NEWS Reacting to Low Oxygen Saturations NICE Guidelines Links NICE Trauma Guidance Summary 2016 NSAID toxicity Naloxone (Narcan) Opiate antagonist Naproxen Narcolepsy Nasal polyps Nasogastric tube insertion Natalizumab (Tysabri)National Early Warning Score NEWS 2 Score Neck Pain Neck swellings and lumps Necrotising Enterocolitis (Infants)Necrotising fasciitis Needlestick injury Nefopam Neisseria gonorrhoeae Neisseria meningitidis Nelson Syndrome Neomycin Neonatal Abstinence Syndrome NAS Neonatal Jaundice Neonatal Lupus Erythematosus Neonatal meningitis Neostigmine Nephritic syndrome Nephroblastoma (Wilm's tumour)Nephrotic syndrome Nephrotoxic drugs Nerve conduction studies Nerve fibres Neuroanatomy 101 Neuroanatomy images Neuroblastoma Neurocysticercosis Neuroferrinopathy Neurofibromatosis Type 1 Neurofibromatosis Type 2 Neuroleptic Malignant Syndrome Neurological - Relative Afferent pupillary defect Neurological - Vision and Eye movements Neurological Examination - 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Administer IV Injection OSCE - Blood culture OSCE - Venepuncture OSCE - Venous Cannula Insertion Obsessive-Compulsive disorder Obstetric definitions Obstructive Shock Obstructive Sleep Apnoea Octreotide Oculomotor Nerve (IIIrd Cranial Nerve)Oedema Oesophageal Carcinoma Oesophageal Perforation - Rupture Oesophageal Variceal Bleeding Oesophagogastroduodenoscopy Olanzapine Olfactory Nerve (I)Oligodendroglioma Olmersartan Olsalazine (Aminosalicylate)Omalizumab Omeprazole Onchocerciasis Oncogenic viruses Oncological emergencies Ondansetron One Table Template Ophthalmology Exam Lists Opiate Toxicity Opiates Opicapone Opioid toxicity Optic Neuritis-Neuropathy Optic atrophy Optic tract anatomy Oral Aphthous Ulcers Oral Candidiasis Oral Leukoplakia Orbital vs Preorbital Cellulitis Organism and sensitivities Organophosphate (OP) Poisoning Orphenadrine Orthopaedic infections Orthostatic - Postural hypotension Oscillopsia Oseltamivir - Tamiflu Osteoarthritis Osteogenesis Imperfecta Osteogenic sarcoma (Osteosarcoma)Osteomalacia-Rickets-Vitamin D Osteomyelitis Osteonecrosis of the jaw Osteopetrosis Osteoporosis Otitis Externa (Malignant)Otitis Media Otosclerosis Ottawa rules for ankle and foot x-ray Ovarian Cancer Ovarian Cyst Ovary Oxford community stroke project (Bamford)Oxybutynin (Ditropan)Oxycodone (Oxycontin-Oxynorm)Oxygen delivery devices Oxytetracycline PEDIS Score for Diabetic Foot Ulcers POEMS syndrome Pabrinex Pacemaker DDD Pacemaker VVI Pacemaker syndrome Pacemakers Pacing - 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Paratyphoid fever (Enteric Fever)Tyrosine Kinase receptors US vs UK Drug names Ubiquitin Ulcerative Colitis Ulnar nerve Ultrasound - Echo basics Undifferentiated Inflammatory Arthritis (Children)Unexplained symptoms Upper Gastrointestinal Bleed (GI Bleed)Upper-Lower Motor Neurone signs Urea and Electrolytes Urethral syndome Urinary Catheterisation Urinary Incontinence (Stress and Urge)Urinary Tract Infection (UTI Children)Urinary Tract Infections Urinary Tract Obstruction Urinary UTI Antibiotic guidance Urine Analysis Urothelial tumours Urticaria Uterus VIPomas VTE DVT PE in Pregnancy Vaginal Carcinoma Valaciclovir Valsartan Vancomycin Variable rate intravenous insulin infusion VRIII Variant (Prinzmetal) Angina Varicella-Zoster (Chickenpox Shingles) Infection Variegate Porphyria Vascular Dementia Vasculitis - General Issues and Classification Vasopressin (AVP) Antidiuretic hormone Vasovagal syncope Vaughan-Williams Classification Vecuronium Vedolizumab (Entyvio)Venlafaxine Venous Insufficiency and Leg Ulcers Venous access Venflons and Central lines Ventilator associated pneumonia (VAP)Ventricular Fibrillation Ventricular Septal defect (VSD) (Children)Ventricular Tachycardia Ventricular ectopic beats Verapamil Vertebral artery dissection Vertigo Vesicoureteric reflux (VUR) (Children)Vibrio parahaemolyticus Vibrio vulnificus Vibrio vulnificus Vigabatrin (Sabril)Vinblastine Vincristine Viral Meningitis Viral associated cancers Viruses Visual acuity Vitamin A deficiency (Children)Vitamin B1 Thiamine deficiency Vitamin B12 deficiency Vitamin B12 excess Vitamin C deficiency (Scurvy)Vitamin D (1,25 OH2)Vitamin D (25 OH D)Vitamin D deficiency Vitamin D resistant rickets (Children)Vitamin K (Phytomenadione)Vitamin K deficiency Vitiligo Voltarol (Diclofenac)Von Gierke Disease (Children)Von Hippel Lindau Von Willebrand Disease Waardenburg's syndrome (Children)Wagner Classification Diabetic foot ulcers Waldenstrom Macroglobulinaemia (WM)Wallerian Degeneration Warfarin Warfarin and Bleeding Water Physiology Watershed Infarcts Werdnig Hoffman Disease (Children)Wernicke Korsakoff Syndrome White Blood Cells - Leukocytes Williams Syndrome (Children)Wilson disease Wiskott-Aldrich syndrome (Children)Wolff-Parkinson White syndrome (WPW)Wolfram syndrome (DIDMOAD)Wound healing X linked Agammaglobulinaemia (Bruton)X linked Hypophosphataemic rickets X-linked Ichthyosis X-linked lymphoproliferative disease (Children)Xeroderma pigmentosum Yellow Fever Yellow Nail Syndrome Yersinia enterocolitica Yersinia pestis - Bubonic Plague Yersinia pseudotuberculosis ZZAAA ZZ_Abnormal char Zabramski Classification of Cavernomas Zidovudine (Retrovir) AZT - ZDV Zieve's syndrome Zika virus Zinc deficiency Zoledronic acid Zollinger Ellison syndrome Zolpidem Zopiclone eGFR

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Simple definition is BP > 140/90 mmHg.
In > 95% of cases there is no specific underlying cause of hypertension.
This is essential hypertension.

Risk factors

Ethnic origin: Black, Japanese, Genetic factors.
High salt intake. Alcohol excess
Obesity. Sedentary
Impaired intrauterine growth.
Low birth weight

Clinical

Clues to cause
- Radio femoral delay and murmur - Coarctation
- Bruit over renal artery - renal artery stenosis
- Acromegalic/Cushingoid appearance
- Episodes of sweating, anxiety, HTN due to Phaeochromocytoma
- Renal masses - polycystic kidneys
Effects
- High BP
- Fundoscopy: hypertensive retinopathy grades III-V, haemorrhages/exudates and/or papilloedema indicate accelerated hypertension
- LVH: forceful/displaced apex beat, loud A2
- Acute pulmonary oedema
- Stroke
- Proteinuria

Measuring BP

Measure - appropriately sized cuff and patient not been smoking or taking caffeine for 30 mins
The patient should sit quietly for 5 minutes before measuring
Repeat at another opportunity unless markedly elevated
Ambulatory BP measurements can also be done to confirm
White coat hypertension

Grading HTN

Grade	Systolic BP (mmHg)	Diastolic BP (mmHg)	Clinical Significance
Normal	< 120	< 80	Blood pressure is within the normal range. No hypertension. Recommend healthy lifestyle practices.
Elevated	120-129	< 80	Early indication of elevated blood pressure. Increased risk of progressing to hypertension without lifestyle intervention.
Grade 1 Hypertension	130-139	80-89	Mild hypertension. Lifestyle changes are recommended, and medication may be required if there are additional cardiovascular risk factors.
Grade 2 Hypertension	140-159	90-99	Moderate hypertension. Lifestyle changes and antihypertensive medications are usually necessary to control blood pressure.
Grade 3 Hypertension	> 160	> 100	Severe hypertension. Aggressive management, including multiple antihypertensive agents, is required to prevent complications such as stroke, heart disease, and kidney failure.
Hypertensive Crisis	> 180	> 120	Emergency situation. Immediate medical attention is required to prevent life-threatening complications like stroke, heart attack, or organ damage.

Hypertensive retinopathy

Grade	Retinal Findings	Clinical Significance
Grade 1	Mild arteriolar narrowing and thickening of the arteriolar walls. "Copper wiring" or "silver wiring" may be noted due to arteriolar sclerosis.	Early stage of hypertensive retinopathy. Often asymptomatic, but indicates mild, chronic hypertension. May not cause significant visual impairment at this stage.
Grade 2	Moderate arteriolar narrowing with more pronounced focal arteriolar constriction and arteriovenous (AV) nicking (Gunn’s sign).	Indicates more severe and sustained hypertension. Risk of developing more severe hypertensive complications such as heart and kidney damage increases.
Grade 3	Severe arteriolar narrowing, along with retinal hemorrhages, cotton wool spots (microinfarctions of nerve fibers), and exudates (lipid deposits).	Significant damage to the retina is present, reflecting dangerously high blood pressure. There is an increased risk of stroke, heart attack, and kidney disease. May cause visual disturbances.
Grade 4	All the features of Grade 3, plus optic disc swelling (papilledema), indicating severe damage to the optic nerve.	A Possible Medical emergency. This stage is indicative of malignant hypertension and requires urgent treatment. There is a high risk of permanent visual loss, stroke, heart failure, and renal failure.

We see many older patients over 80 with high blood pressure often asymptomatic and would not regard this as malignant hypertension. Take advice. It is important not to lower the BP too quickly.

When to screen

Age <40 years or Sudden worsening BP
Uncontrolled despite compliant + 3 med.
BP>180/110 papilloedema/haemorrhage
Stroke Age <50 years

Exclude secondary causes

Cause	Clinical Features	Investigations	Management
Renal Artery Stenosis	Resistant hypertension Abdominal bruit Sudden worsening of renal function	Doppler ultrasound of renal arteries CT/MR angiography Renal function tests	Angioplasty with or without stenting Antihypertensive therapy Surgical revascularization
Primary Aldosteronism (Conn's Syndrome)	Hypertension with hypokalaemia Muscle weakness Fatigue	Serum aldosterone-to-renin ratio Adrenal CT scan 24-hour urinary aldosterone	Adrenalectomy for unilateral disease Mineralocorticoid receptor antagonists (e.g., Spironolactone) Potassium supplementation
Pheochromocytoma	Paroxysmal hypertension Headaches, palpitations, sweating Orthostatic hypotension	24-hour urinary metanephrines and catecholamines Plasma free metanephrines Abdominal MRI/CT scan	Surgical removal of tumour Preoperative alpha-blockade (e.g., Phenoxybenzamine) Beta-blockers post alpha-blockade
Cushing's Syndrome	Central obesity, moon face Buffalo hump, striae Proximal muscle weakness	24-hour urinary free cortisol Dexamethasone suppression test Adrenal CT/MRI	Surgical resection of tumour Medical therapy to control cortisol levels (e.g., Ketoconazole) Radiation therapy for pituitary tumours
Coarctation of the Aorta	Hypertension in upper limbs Weak/absent femoral pulses Delayed brachial-femoral pulse	Chest X-ray (rib notching) Echocardiography CT/MR angiography	Surgical correction Balloon angioplasty Antihypertensive therapy
Thyroid Disease (Hyperthyroidism/Hypothyroidism)	Symptoms of hyperthyroidism (e.g., tachycardia, weight loss) or hypothyroidism (e.g., bradycardia, weight gain) Goiter Heat/cold intolerance	Thyroid function tests (TSH, T3, T4) Thyroid ultrasound Radioactive iodine uptake test (for hyperthyroidism)	Thyroid hormone replacement (for hypothyroidism) Antithyroid drugs, radioactive iodine, or surgery (for hyperthyroidism) Beta-blockers (for symptomatic hyperthyroidism)
Obstructive Sleep Apnea (OSA)	Loud snoring Daytime sleepiness Observed apneas during sleep	Polysomnography (sleep study) Home sleep apnea testing Oxygen saturation monitoring	Continuous Positive Airway Pressure (CPAP) Weight loss Surgical options (e.g., UPPP)

Investigations and overall vascular assessment

Assess Blood glucose, Lipids, Age, sex, smoking, family history.
FBC, ESR, CRP
U&E - look for hypokalaemia and impaired renal function
Urinalysis - protein or blood which may suggest renal disease
ECG - LVH, AF, IHD
Blood glucose and lipids
Echocardiogram

Organ Damage due to Chronic Hypertension

Complication	Description	Pathophysiology	Clinical Consequences
Stroke	Hypertension is a major risk factor for both ischaemic and haemorrhagic strokes.	Chronic hypertension can cause damage to the blood vessels in the brain, leading to narrowing, blockage, or rupture.	Results in neurological deficits, paralysis, speech difficulties, and may lead to death or long-term disability.
Renal Failure	Hypertension can lead to chronic kidney disease (CKD) and end-stage renal disease (ESRD).	Increased blood pressure damages the small blood vessels in the kidneys, impairing their ability to filter waste from the blood.	Leads to the need for dialysis or kidney transplantation, and is associated with increased cardiovascular risk.
Congestive Cardiac Failure (CCF)	Hypertension is a leading cause of left ventricular hypertrophy, which can progress to heart failure.	Increased afterload from hypertension causes the heart to work harder, leading to hypertrophy and eventually failure to pump efficiently.	Symptoms include shortness of breath, fluid retention, fatigue, and reduced exercise tolerance.
Myocardial Infarction	Hypertension accelerates the development of atherosclerosis, leading to coronary artery disease and myocardial infarction (heart attack).	Chronic high blood pressure damages arterial walls, leading to plaque formation and the risk of rupture and thrombosis.	Results in chest pain, heart failure, arrhythmias, and can be fatal if not treated promptly.
Atrial Fibrillation	Hypertension is a significant risk factor for the development of atrial fibrillation (AF).	Increased pressure causes left atrial enlargement and fibrosis, leading to electrical disturbances and AF.	Results in irregular heart rhythm, increased risk of stroke, and may lead to heart failure.
Central Retinal Vein Thrombosis	Hypertension can lead to central retinal vein occlusion, a common cause of vision loss.	High blood pressure can cause damage to the retinal veins, leading to thrombosis and impaired venous outflow.	Leads to sudden, painless vision loss, and can result in permanent blindness if untreated.

British Hypertensive society Guidelines
Step	White Male < 55	Black or Over 55
1	ACEI or ARB	CCB or Diuretic(Thiazide)
2	ACEI or ARB + CCB or Diuretic(Thiazide)	ACEI or ARB +CCB or Diuretic(Thiazide)
3	ACEI or ARB + CCB + Diuretic	ACEI or ARB + CCB + Diuretic
4	Add alpha blocker/another diuretic	Add alpha blocker/another diuretic

Management

Non-drug
- Correct Obesity
- Reducing alcohol intake
- Reduce salt intake
- Regular exercise
- More fruit and vegetables
- Low saturated fats
- Stop smoking

Medications Used

Drug Class	Drug Name	Typical Dose	Mechanism of Action	Pharmacology
ACE Inhibitors	Ramipril	2.5-10 mg once daily	Inhibits angiotensin-converting enzyme, reducing the formation of angiotensin II, leading to vasodilation and reduced blood pressure.	Reduces blood pressure by decreasing vasoconstriction. Reduces aldosterone secretion, leading to reduced sodium and water retention. Commonly used in patients with diabetes or chronic kidney disease due to renal protective effects.
Angiotensin II Receptor Blockers (ARBs)	Losartan	50-100 mg once daily	Blocks the angiotensin II receptor, preventing vasoconstriction and aldosterone secretion.	Reduces blood pressure by preventing the effects of angiotensin II. Often used as an alternative to ACE inhibitors, especially in patients who develop a cough. Favored in patients with heart failure or chronic kidney disease.
Calcium Channel Blockers	Amlodipine	5-10 mg once daily	Inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle cells, leading to vasodilation.	Reduces peripheral vascular resistance, lowering blood pressure. Commonly used as a first-line treatment, especially in older patients or those of African or Caribbean origin. May cause peripheral edema as a side effect.
Thiazide-like Diuretics	Indapamide	1.5 mg once daily (prolonged release)	Inhibits sodium reabsorption in the distal convoluted tubule, increasing sodium and water excretion.	Reduces blood pressure by decreasing blood volume. Particularly effective in older patients. May cause electrolyte imbalances, such as hypokalemia.
Beta-Blockers	Atenolol	25-100 mg once daily	Blocks beta-adrenergic receptors, reducing heart rate and cardiac output, leading to lower blood pressure.	Reduces sympathetic nervous system activity, lowering heart rate and myocardial contractility. Less commonly used as first-line therapy; more often used in patients with concurrent conditions like ischaemic heart disease. May cause bradycardia, fatigue, and cold extremities.
Aldosterone Antagonists	Spironolactone	25-50 mg once daily	Blocks the effects of aldosterone, reducing sodium reabsorption and potassium excretion.	Used as an add-on therapy in resistant hypertension. Helps in reducing blood volume and pressure. May cause hyperkalemia and gynecomastia.

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Makindo