3 - Vascular Disease and Hypertension

Question 1

vascular disease is most responsible for _ than any other category of human disease

Answer 1

mortality

Question 2

2 cellular components that are involved in vascular disease process:

Answer 2

endothelial cells

vascular smooth muscle cells

Question 3

endothelial cells act as semipermeable membrane, have antithrombotic properties, and intercellular junctions are typically impermeable –
these junctions can be altered due to (2)

Answer 3

chemical mediators

hemodynamic factors such as blood pressure

Question 4

endothelial cells can alter their properties to:

• contract
• leukocyte _
• cytokine _
• vasoactive mediator release

Answer 4

adhesion

secretion

Question 5

vascular smooth muscle can vasoconstrict or vasodilate, it can synthesize (2), and it can migrate and proliferate

Answer 5

collagen and elastin

Question 6

thickening of arteries and loss of elasticity

Answer 6

arteriosclerosis

Question 7

predominate type of atherosclerosis

Answer 7

arteriosclerosis

Question 8

atherosclerosis is responsible for _ deaths

Answer 8

more deaths in developed world than any other;

more than 1/2 in western world

Question 9

most common manifestation of atherosclerosis is development of intimal plaques called _, that protrude into the lumen of the affected vessel

Answer 9

atheromas

Question 10

risk factors for arteriosclerosis:
males or females?
age?
smoking?

Answer 10

males especially before menopause
inc incidence with age, possible at young age
yes - inc incidence in females

Question 11

risk factors for arteriosclerosis:
diabetics?
hypertension?

Answer 11

less control = hypercholesterol = inc incidence

MAJOR risk factor

Question 12

can arteriosclerosis have genetic predisposition?

Answer 12

yes

Question 13

_lipidemia is major risk factor for atherosclerosis

Answer 13

hyper

Question 14

major lipid in vessel plaques is _

Answer 14

cholesterol

Question 15

significant correlation with _ lipoproteins and symptomatic and fatal atherosclerosis
-improvement with decreased intake?

Answer 15

LDL

yes

Question 16

_ lipoprotein decreases incidence of atherosclerosis

Answer 16

HDL (removes cholesterol from plaques)

Question 17

soft risk factors for atherosclerosis:

Answer 17

reduced physical activity, obesity, birth control, stress

Question 18

stages of atherosclerosis:

1. localized endotheliam injury
2. inc permeability, _ and _ adhesion and emigration
3. _ into vessel wall
4. tunica _ to tunica _
5. fatty streaks
6. atheroma
7. late stage complication: _

Answer 18

leukocyte and monocyte
HDL and LDL
media, intima
thrombosis

Question 19

HPB is considered sustained systolic of > _ and diastolic of > _

Answer 19

140, 90

Question 20

ideal BP is _

Answer 20

120/80

Question 21

BP depends on 2 variables?

Answer 21

cardiac output and total peripheral resistance

Question 22

cardiac output is influenced by _ and _,

volume is dependent on _, controlled by kidneys

Answer 22

heart rate and blood volume

sodium

Question 23

BP =

Answer 23

HR x stroke volume x total peripheral resistance

Question 24

total peripheral resistance depends on _,

which vessels are most important and why?

Answer 24

lumen size of blood vessels

arterioles - ability to change size

Question 25

hypertension can be _ or _ and malignant or benign

Answer 25

primary (genetic) or secondary (to other pathology)

Question 26

primary/essential HTN represents _% of cases, | most are _

Answer 26

95 | idiopathic

Question 27

primary HTN could possibly be related to increased _ and _ secretion

Answer 27

angiotensinogen and aldosterone

Question 28

secondary HTN represents _% of cases, | most are due to _ related diseases

Answer 28

5 | kidney!!! (endocrine and cardiovascular too)

Question 29

slow insidious increase in blood pressure over time, many don't even know they have it

Answer 29

benign HTN

Question 30

acceleration of disease leading to rapid increase and very high blood pressure

Answer 30

malignant

Question 31

malignant HTN often has _ involvment

Answer 31

renal (therefore secondary)

Question 32

``` risk factors for HTN include: hereditary gender? race? agE? degree of _ (similar to atherosclerosis) ```

Answer 32

M>F african americans, higher obesity rate older age hyperlipidemia

Question 33

with HTN, rapid _ occurs

Answer 33

atherosclerosis

Question 34

localized abnormal dilation of blood vessel

Answer 34

aneurysm

Question 35

true vs false aneurysm?

Answer 35

true - bounded by arterial wall | false - breach in vessel wall (hematoma)

Question 36

most frequent cause of aneurysms?

Answer 36

atherosclerosis

Question 37

2 most common locations for aneurysms?

Answer 37

1. abdominal aoritc 2. common iliac arteries 2. ascending aortic

Question 38

spherical aneurysm involving only a short section

Answer 38

saccular

Question 39

aneurysm involving long segment

Answer 39

fusiform

Question 40

aneurysms are common in aortic vessels why?

Answer 40

tunica media destruction secondary to plaque formation

Question 41

most aneurysms are _, can present as abdominal mass like tumor

Answer 41

insidious

Question 42

dissection of blood along laminar planes of the media due to vessel wall weakness from plaque

Answer 42

aortic dissection

Question 43

aortic dissections are often associated with _

Answer 43

sudden onset and severe pain

Question 44

fatal forms of aortic dissection are associated with _

Answer 44

dissection into body cavities