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Question 1

What is hypertension and its associated risks?

Answer 1

Sustained blood pressure >130/90 (normal <120/80). Major risk factors include:

Stroke
Coronary artery disease
Peripheral vascular disease
Heart failure
Chronic kidney disease

Question 2

What are the two types of hypertension?

Answer 2

Essential (primary): 90-95% of cases, no clear cause.
Secondary: Caused by conditions like kidney disease or pregnancy complications (e.g., pre-eclampsia).

Question 3

Why is hypertension called the “silent killer”?

Answer 3

It’s generally asymptomatic, even with prolonged elevated blood pressure.

Question 4

What determines blood pressure?

Answer 4

Blood pressure is the product of:

Heart rate: Controlled by autonomic activity.
Stroke volume: Depends on preload, afterload, and contractility.
Systemic vascular resistance: Reflects vascular tone.

Question 5

What regulates blood pressure in normotensive and hypertensive states?

Answer 5

Cardiac output
Systemic vascular resistance
Venous capacitance
Intravascular fluid volume (kidney function)

Question 6

What mechanisms contribute to hypertension?

Answer 6

Genetics and lifestyle factors
Sympathetic nervous system and renin-angiotensin-aldosterone system activation
Endothelial dysfunction and vascular remodeling

Question 7

What are the first-line treatments for hypertension?

Answer 7

Lifestyle modifications:
Weight loss, physical activity, smoking cessation, low-fat/sodium diet.
Eliminate exogenous agents (e.g., alcohol, oral contraceptives).
Pharmacological strategies:
Diuretics, β-blockers, ACE inhibitors, ARBs, calcium channel blockers.

Question 8

What is an arrhythmia?

Answer 8

Abnormal electrical activity in the heart, leading to irregular heartbeat.

Question 9

What is normal sinus rhythm?

Answer 9

Heart rate: 60-100 bpm.
Variations:
Sinus tachycardia: >100 bpm.
Sinus bradycardia: <60 bpm.

Question 10

What are common causes of arrhythmias?

Answer 10

Impulse formation defects: Ectopic beats or interrupted SA-node automaticity.
Impulse conduction defects:
Conduction block (slowed/blocked impulses).
Re-entry circuits (damaged pathways).

Question 11

How are arrhythmias classified?

Answer 11

By the site of origin:

SAN/AV node
Atrial
Junctional
Ventricular

Question 12

What are the four classes of antiarrhythmic drugs?

Answer 12

Class I: Na+ channel blockers (reduce slope and peak of action potential).
Class II: β-blockers (reduce rate and conduction).
Class III: K+ channel blockers (prolong repolarization and action potential duration).
Class IV: Ca2+ channel blockers (reduce rate and conduction).

Question 13

What does the P wave represent in an ECG?

Answer 13

Atrial depolarization.

Question 14

What do the QRS and T waves represent in an ECG?

Answer 14

QRS wave: Ventricular depolarization.
T wave: Ventricular repolarization.

Question 15

What do the PR and QT intervals measure in an ECG?

Answer 15

PR interval: Conduction time from atrium to ventricle.
QT interval: Duration of the ventricular action potential.

Question 16

What is pump-based hypertension, and in whom is it most often seen?

Answer 16

Increased cardiac output with normal systemic vascular resistance, commonly seen in younger patients with essential hypertension.

Question 17

How do the kidneys contribute to volume-based hypertension?

Answer 17

Excessive sodium and water retention due to:

Increased renin secretion
Elevated angiotensin II and aldosterone

Question 17

What causes vascular resistance-based hypertension?

Answer 17

Increased systemic vascular resistance with normal cardiac output, common in the elderly. Factors include:

Endothelial dysfunction
Abnormal response to sympathetic stimulation

Question 18

How does the neuroendocrine system contribute to hypertension?

Answer 18

Abnormal sympathetic tone regulation
Dysfunctional baroreceptor responses
Overproduction of hormones regulating circulation

Question 19

What is arteriolosclerosis, and how is it linked to hypertension?

Answer 19

Damage to arterioles due to high blood pressure leads to:

Hyaline arteriosclerosis (plasma protein deposition in vessel walls) which leads to
Vascular remodeling and reduced lumen size

Question 20

How does hypertension accelerate atherosclerosis?

Answer 20

It increases localized endothelial damage, promoting distinct lesions and the risk of aortic aneurysms.

Question 21

What lifestyle changes help manage hypertension?

Answer 21

Weight loss
Increased physical activity
Smoking cessation
Low-fat, low-sodium diet
Reducing alcohol and exogenous agents (e.g., contraceptives)

Question 22

How do diuretics lower blood pressure?

Answer 22

They inhibit sodium and chloride reabsorption, reducing intravascular volume and cardiac output.

Question 23

What are ACE inhibitors and ARBs, and how do they work?

Answer 23

ACE inhibitors: Prevent conversion of angiotensin I to angiotensin II, reducing vasoconstriction.
ARBs: Block angiotensin II from binding to AT1 receptors, reducing blood pressure and vascular proliferation.

Question 24

How do calcium channel blockers lower blood pressure?

Answer 24

They reduce systemic vascular resistance and cardiac output by:

Blocking calcium entry into cells
Acting as arterial vasodilators, negative inotropes, and/or chronotropes

Question 25

What is the difference between tachycardia and bradycardia?

Answer 25

Tachycardia: Heart rate >100 bpm.
Bradycardia: Heart rate <60 bpm.

Question 26

What is the difference between atrial and ventricular fibrillation?

Answer 26

Atrial fibrillation: Rapid, irregular atrial impulses.
Ventricular fibrillation: Life-threatening, chaotic ventricular impulses leading to cardiac arrest.

Question 27

What happens in a conduction block?

Answer 27

Electrical impulses are slowed or blocked, typically at the AV node. A complete (third-degree) block causes ventricles to beat at 30-40 bpm.

Question 28

What are re-entry circuits, and how do they cause arrhythmias?

Answer 28

Damage to conduction pathways causes impulses to circulate repeatedly, leading to tachycardias or fibrillation.

Question 29

Summarize the four classes of antiarrhythmic drugs

Answer 29

Class I: Na+ channel blockers (reduce slope of action potential).
Class II: β-blockers (reduce heart rate and conduction).
Class III: K+ channel blockers (prolong repolarization).
Class IV: Ca2+ channel blockers (reduce rate and conduction).