25 CV Hypertension

Question 1

when are you considered to be hypertensive?

Answer 1

above 140/90

Question 2

what percentage of individuals suffer from hypertension at the age of 75?

Answer 2

70%. The older you get the higher the risk

Question 3

T/F Men are at higher risk for hypertension than women?

Answer 3

True and False. This is a trick question. Before menopause women have a lower risk for hypertension. After menopause, they are at a higher risk.

Question 4

Which 3 organs are most affected by hypertension?

Answer 4

1) brain
2) heart
3) kidneys

Question 5

T/F individuals with a BP of 130/85 for a prolonged period of time are likely to have significant cardiac hypertrophy?

Answer 5

True. (BP of 130-140/85-90 can cause major problems)

Question 6

what is the consequence of not treating just mild hypertension?

Answer 6

severe health problems such as cardiac hypertrophy and atherosclerosis.

Question 7

How do you calculate BP?

Answer 7

BP=C.O X TPVR

Question 8

what are the two major determinants of blood pressure?

Answer 8

cardiac output and TPVR

Question 9

what are the 3 major systems involved with regulating BP?

Answer 9

kidneys
adrenal glands
Autonomics

Question 10

what are the two ways of classifying hypertension?

Answer 10

1) cause

2) pressure

Question 11

what two forms of “cause” hypertension are there?

Answer 11

1) essential (unknown cause)

2) secondary (known cause)

Question 12

what two forms of “pressure” hypertension are there?

Answer 12

1) benign (moderate increase in SAP)

2) malignant (high increase in SAP)

Question 13

a diastolic pressure of ________ is considered the line between benign and malignant hypertension?

Answer 13

diastolic of 120 mmhg

>120 is malignant, <120 is benign

Question 14

T/F malignant hypertension is considered to be severe pressure increase, rapid progression, have severe tissue damage, and respond poorly to treatment?

Answer 14

True

Question 15

There are many different factors that cause secondary hypertension, but the 2 organs that cause most of the problems are the?

Answer 15

1) kidney

2) adrenal glands

Question 16

what is more prevalent, essential or secondary hypertension?

Answer 16

essential. (89% of the cases)

Question 17

renal vascular disease includes renal artery stenosis. Why is this important to know about?

Answer 17

Because it is one of only a few ways in which surgery can fully treat hypertension. Others may include pheochromocytoma and coarctation of the aorta.

Question 18

what happens if you have renal artery stenosis only on one side?

Answer 18

The kidney that is lacking perfusion continues to release renin. This causes systemic hypertension with the affected kidney undergoing atrophy and the contralateral kidney undergoing hypertrophy?

Question 19

what is Goldblatt hypertension?

Answer 19

Hypertension caused by renal artery stenosis.

Question 20

what is the leading cause of renal artery stenosis?

Answer 20

atherosclerosis (70% of the cases)

Question 21

what is the second most common cause for renal artery stenosis?

Answer 21

fibromuscular dysplasia

Question 22

which part of the vessel is mainly affected in fibromuscular dyplasia of an artery?

Answer 22

The tunica media. This can be seen because it becomes very thickened.

Question 23

what causes a pheochromocytoma?

Answer 23

A tumor of the adrenal medulla that secretes epi.

Question 24

what effects on the left ventricle are seen histologically with an increase in after-load?

Answer 24

1) hypertrophy of the cardiac myocytes

2) fibrosis

Question 25

Which groups of individuals have predisposing factors for an aortic dissection? (4)

Answer 25

1) patients with systemic hypertension
2) women during pregnancy
3) 40-60 years of age
4) males (3x more likely than women)

Question 26

What percentage of aortic dissections are caused by hypertension?

Answer 26

over 90%

Question 27

Which types of aortic dissections are the most dangerous and difficult to treat?

Answer 27

Types I and II

Question 28

What part of the aorta is involved in type 1 aortic dissection? Type 2? Type3?

Answer 28

Type I is all of the aorta
Type II is just the proximal ascending aorta
Type III is the distal aorta (thoracic and abdominal)

Question 29

what is hyaline arteriolosclerosis?

Answer 29

small vessel disease that generally develops from benign hypertension. It is caused by a proteinaceous material that is deposited (hyaline) into the arterial wall which leads to narrowing.

Question 30

where is the best place to look for/find hyaline arteriolosclerosis caused from hypertension?

Answer 30

in the kidneys

Question 31

what is nephrosclerosis?

Answer 31

multiple micorinfarcts in the kidney due to ischemia giving the kidney a grain leathery look. (ischemia from hypertension/atherosclerosis)

Question 32

what causes hyperplastic arteriolitis?

Answer 32

malignant hypertension (with inflammation)

Question 33

what causes hyaline arteriolosclerosis?

Answer 33

benign hypertension (with hyaline deposit)

Question 34

The condition known as “onion skin arteriolitis” results in the concentric hyperplasia of smooth muscle cells in the tunica media. What is the real name for this onion skin arteriolitis?

Answer 34

hyperplastic arteriolitis.

Question 35

What causes necrotizing arteriolitis?

Answer 35

It is caused by malignant hypertension (like hyperplastic arteriolitis) but with fibrinoid necrosis of the vessel wall.

Question 36

What is the normal artery to vein ratio caliber in the retina with a healthy eye? Grade I?

Answer 36

normal is 2:3 ratio
Grade I is 1:2 ratio
(so this means that the artery gets smaller)

Question 37

what do you see in grade II hypertensive retinopathy?

Answer 37

splinter like hemorrhages.

Question 38

what is characteristic of grade III hypertensive retinopathy?

Answer 38

Similar to grade II but more severe.

You also see numerous whitish/yellow plaque like lesions.

Question 39

The small whitish/yellow plaque like lesions found in grade III retinopathy represent what?

Answer 39

Exudate and small infarcts

Question 40

what is characteristic of Grade IV hypertensive retinopathy?

Answer 40

swelling of the optic nerve head.

Question 41

when do you usually see type I hypertensive retinopathy?

Answer 41

during the early stages of hypertension

Question 42

when do you usually see type IV hypertensive retinopathy?

Answer 42

during prolonged malignant hypertension.

Question 43

where are the 3 most likely spots for cerebral hemorrhage?

Answer 43

1) basal ganglia
2) pons
3) cerbellum

Question 44

what is a charcot-buchard aneurysm?

Answer 44

an aneurysm that occurs in the arteries supplying the basal ganglia or brain stem due to hypertension.