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Term 2 - CVS and Resp > Blood Pressure > Flashcards

Blood Pressure Flashcards

1
Q

MAP (Mean Arterial Pressure) =

A

CO (cardiac output) x TPR (total peripheral resistance)

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2
Q

MAP is measures in

A

mmHg

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3
Q

If MAP is too high =

Too low =

A 
hypertension
fainting (syncope)
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4
Q

Inputs to medullary CVS centres are:

A
  1. cardiopulmonary baroreceptors
  2. central chemoreceptors
  3. muscle chemoreceptors
  4. joint receptors
  5. higher centres
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5
Q

Angiotensin II causes

A

arteriolar constriction

increased TPR

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6
Q

Aldosterone causes

A

increase Na+ reabsorption

increased plasma volume

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7
Q

Vasopressin is an

A

antidiuretic horome

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8
Q

Vasopressin causes

A

arteriolar constriction
increased TPR
increased Na+ excretion
decreased blood volume

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9
Q

Atrial and brain natriuretic peptide both cause

A

arteriolar dilation
decreased TPR
increase Na+ secretion
decreased blood volume

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10
Q

The effect of standing on BP causes an increase in

A

hydrostatic pressure

pooling of blood in legs/feet

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11
Q

The effect of standing on BP causes a decrease in

A

VR, EDV, preload, SV, CO , MAP, baroreceptor firing rate

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12
Q

The reflex response decreases

A

vagal tone

so, increase in HR and CO

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13
Q

The reflex response increases

A

sympathetic tone

so, increase in HR and CO

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14
Q

The reflex response also increases three other things:

A 
contractility (in turn SV and CO) 
venoconstriction (in turn VR, EDV, SV and CO) 
arteriolar constriction (in tun TPR)
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15
Q

The valsalva manoeuvre =

A

forced expiration against a closed glottis

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16
Q

Long term control of BP controlled by ______ and what three hormone systems?

A

plasma volume by the kidney

renin-angiotensin-aldosterone system
antidiuretic factor (ADH, vasopressin)
atrial natriuretic peptide
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17
Q

Functions of the kidney include

A

excretion of waste
maintaining ion balance
regulation of pH, osmolarity, plasma volume

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18
Q

A very permeable collecting duct =

A

small volume of hypo-osmotic urine

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19
Q

A very impermeable collecting duct =

A

large volume of hyper-osmotic urine

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20
Q

The release of ADH triggers an increase in _________ and a decrease in __________

A

osmolarity of interstitial fluid

blood volume

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21
Q

What does ADH do?

A

increases permeability of collecting duct to water
(reduces diuresis, increases plasma volume)

vasoconstriction, therefore increasing MAP

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22
Q

Where is atrial natriuretic peptide produced?

What happens when it is released?

A

myocardial cells in atria

increased distension of atrium

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23
Q

The function of ANP is to

A

increase secretion of Na+
inhibit release of renin
act on medullary centres to reduce MAP

24
Q

Name 4 drug treatments for hypertension

A

Ca2+ channel antagonists
B-adrenogenic receptor antagonists
Thiazide diuretics
Angiotensin converting enzyme inhibitors

25
Q

What is an atheroma/atherosclerosis?

A

formation of focal elevated lesion (plaques) in intimate of large and medium sized vessels

26
Q

The consequences of atheroma include

A

ischaemia
angina
myocardial infacrtion (by ischaemia)
complications by thromboembolism

27
Q

In a complicated atheroma, the following can happen

A

haemorrhage into plaque (calcification)
thrombosis
plaque rupture/fissuring

28
Q

Hypercholesterolaemia causes

A

plaque formation and growth in absence of any other risk factors

29
Q

Hyperlipidaemia may be due to

A 
drug relations
diabetes
obesity
alcoholism
total cholesterol (HDL and LDL)
30
Q

Physical signs of hyperlipidaemia include

A

discolouration of eyes

fatty lumps on knuckles/achilles or in skin/around eyes

31
Q

Major risk factors of atheroma include

A 
smoking
hypertension
diabetes mellitus
being male
being old
32
Q

The two steps in the formation of an atheromatous plaque are:

A
  1. injury to endothelial lining of artery

2. chronic inflammation/healing response of vascular wall to this injury

33
Q

Stenosis of 50-75% of lumen =

A

stable angina (reversible tissue ischaemia)

34
Q

Very severe stenosis of lumen =

A

unstable angina (ischaemic pain at rest)

35
Q

Total Occlusion of the lumen in the following areas leads to what?

  1. coronary artery
  2. carotid or cerebal arteries
  3. ileal, femoral, popliteal arteries
A
  1. myocardial infarct
  2. stroke
  3. lower limb gangrene
36
Q

Gradual dilation of a great vessel is caused by

A

the media beneath the atheromatous plaque being gradually weakened

37
Q

How to control risks of atheroma

A 
Stop smoking
Control of BP
Weight-loss
Regular exercise
Dietary modifications
38
Q

Drug control in people at risk of atheroma

A

Cholesterol lowering drugs (aspirin)

or surgical options

39
Q

What does aspirin do?

A

inhibits platelet aggregation to decrease risk of thrombosis on established atheromatous plaques

40
Q

How can BP vary during the day?

A

Physical stress
Mental stress
Exercise

41
Q

Stage 1 Hypertension is defined by

A

Clinical BP 140/90 mmHg or more

ABPM average 135/85 mmHg or more

42
Q

Stage 2 Hypertension is defined by

A

Clinical BP of 180 mmHg or more

ABPM average 150/95 mmHg or more

43
Q

Stage 3 Hypertension is defined by

A

Clinical systolic BP is 180 mmHg or more

Clinical diastolic BP is 110mmHg or more

44
Q

Primary Hypertension makes up how many of total cases?

A

95%

45
Q

The 5% of secondary causes of hypertension include?

A

chronic renal disease
renal artery disease
endocrine disease (Cushing’s, Chron’s)

46
Q

The activation of the sympathetic nervous system produces

A

vasoconstriction
reflex tachycardia
increased cardiac output

47
Q

Factors affecting blood pressure include

A 
age
genetics/family history
weight (and birth weight)
alcohol/salt intake
environment (stress)
race
48
Q

To treat hypertension in a young person, what would be used?

A

high renin (A) = ACE inhibitor/ARB

49
Q

To treat hypertension in an elderly person, what would be used?

A

low renin (C or D) = calcium channel blocker or thiazide-type diuretic

50
Q

What are the contraindications of angiotensin converting enzyme inhibitors?

A

renal artery stenosis
renal failure
hyperkalaemia

51
Q

What adverse drug reactions can ACEIs cause?

A 
cough
first dose hypotension
taste disturbance
renal impairment
angioneurotic oedema
52
Q

How to calcium channel blockers work?

A

vasodilate
block L type calcium channels
reduce cardiac output

53
Q

Contraindications of Ca2+ channel blockers?

A

acute MI
heart failure
bradycardia

54
Q

Adverse drug reactions of Ca2+ channel blockers?

A

flushing
headache
ankle oedema
indigestion/reflux oesophagitis

55
Q

Thiazide-type diuretics are used in

A

first line treatment in Afro-Caribbeans

combo with any other antihypertensive drug

56
Q

Thiazide-type diuretics work by

A

blocking reabsorption of Na+

enhance urinary sodium loss

57
Q

Thiazide-type diuretics can cause

A

impotence

gout

Term 2 - CVS and Resp (8 decks)

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