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PODT- Pathology > 12. Hypertension > Flashcards

12. Hypertension Flashcards

1
Q

Define hypertension

A

High blood pressure

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2
Q

What is the diagnostic threshold for blood pressure?

A

Systolic 140mmHg

Diastolic 90mmHg

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3
Q

What are the major risks associated with hypertension?

A 
Stroke
MI
 heart failure
 chronic kidney disease
cognitive decline 
premature death
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4
Q

What is cause of primary (essential) hypertension?

A

90% of all cases

No single cause but number of risk factors

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5
Q

What is cause of secondary hypertension?

A

A specific cause of hypertension can be indified

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6
Q

What are risk factors of hypertension?

A 
Old age 
Family history  
African or Caribbean origin 
High amount of salt in your food 
Lack of exercise 
Overweight 
Smoking 
Excess alcohol 
Stress 
Urban dwelling
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7
Q

What are some specific renal causes of secondary hypertension?

A

Parenchymal and renovascular diseases

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8
Q

What are some specific endocrine causes of secondary hypertension?

A
  • Pheochromocytoma, Cushing Syndrome, Hyperaldosteronism
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9
Q

What are other causes of secondary hypertension?

A

Coarctation of the aorta
Medications- NSAIDs, oral contraception and steroids
Pregnancy

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10
Q

What is renal artery stenosis?

A

Decrease in blood flow through one or both of the main renal arteries or their branches

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11
Q

What is stenosis usually due to?

A

Atherosclerosis or fibromuscular dysplasia

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12
Q

What will chronic, progressive stenosis cause?

A

Refractory hypertension and may lead to chronic kidney disease

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13
Q

How is renovascular disease diagnosed?

A

Through imaging tests

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14
Q

What is atherosclerosis?

A

Usually develops >50 mainly men.

Usually affects the aortic orifice or proximal segment of the renal artery

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15
Q

What is fibromuscular dysplasia? (FMD)

A

Pathological thickening of the arterial wall, most often of the distal main renal artery or the intrarenal branches

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16
Q

What are some examples of hormones produced by the cortex of the adrenal gland?

A

Aldosterone
Cortisol
Testosterone precursor

17
Q

What are some examples of hormones produced by the adrenal medulla?

A

Adrenaline and noradrenaline

18
Q

What are some examples of hormones produced by the adrenal medulla?

A

Adrenaline and noradrenaline

19
Q

Why is aldosterone elevated?

A

Aldosteronoma - a benign tumour of the adrenal glans

20
Q

Why is noradrenaline and adrenaline elevated?

A

Due to phaeochromocytoma - a tumour of adrenal gland medulla (mainly benign but some malignant)

21
Q

What causes cushings syndrome or hypercortisolism?

A

Ectopic ACTH due to lung cancer
Pituitary microadenoma
Adrenal adenoma
Medication

22
Q

What is coarctation of the aorta?

A

Narrowing of the aorta reduces blood flow to the lower half of the body

leads to low BP in the legs and higher in the arms

23
Q

What organs have problems with hypertension?

A

CV system
Kidneys
Retina

24
Q

What is atherosclerosis?

A

Asymmetrical narrowing of the lumen (L) of LARGER VESSELS by lipid accumulation within the INTIMA

25
Q

What is arteriolosclerosis?

A

SYMMETRICAL narrowing of lumen (L) OF SMALLER VESSELS by depostion of protein within the wall of blood vessels

26
Q

What does a haemorrhagic stroke cause?

A

Rupture of small cerebral mucroaneurysm that have been weakened, primarily by chronic arterial hypertension

27
Q

What is nephrosclerosis?

A

Progressive renal impairmebt

28
Q

What causes hypertensive nephrosclerosis?

A

Chronic, poorly controlled hypertension

29
Q

How is hypertensive retinopathy brought about?

A

Thickened blood vessel walls leads to reduced blood flow which can cause ischaemia and infarction
Damaged blood vessels cause bleeding which leads to a loss of vision

PODT- Pathology (15 decks)

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