Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Echo 2 > C12: Systemic Hypertension > Flashcards

C12: Systemic Hypertension Flashcards

1
Q

define systemic hypertension

A

high BP reading of >140/90 on 2 separate occasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
Values for:
pre-HTN
Stage 1 HTN
Stage 2 HTN
Isolated systolic HTN
A

pre-HTN: 130-139 / 85-89
Stage 1 HTN: 140-159 / 90-99
Stage 2 HTN: >160 / 100
Isolated systolic HTN: >/= 140 / <90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Isolated systolic HTN is more common in which demographic

why is it dangerous

A

older patients

dangerous for stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe primary hypertension

A 
due to metabolic causes:
metabolic syndromes
obesity
diabetes mellitus
sedentary lifestyle
mental stress

this type is hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

another name for primary hypertension

A

essential HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe secondary hypertension

A 
due to:
renal disease - increased angiotension
endocrine/hormonal causes 
pituitary/hypothalamic syndrome - cushings syndrome
thyroid - hyperthyroidism
CNS - increased sympathetic tone
AO coarctation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

endocrine/hormonal causes of secondary hypertension

A

increased catecholamines
primary aldosteronism
adrenal hyperplasia
increased cortisol - cushings disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

risk factors for essential HTN

A 
age
ethnicity (African decent)
male
obesity
dyslipidemia
diabetes mellitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

lifestyle factors that can lead to essential HTN

A 
stress
excessive sodium and alcohol intake
inadequate calcium and potassium
sedentary lifestyle
smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the mean pressure

2 forumlas

A

avg pressure over the cardiac cycle

MAP = [ (2 x diastolic BP) + systolic BP ] / 3
MAP = CO x SVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does the length of systole change with tachy and Brady cardia

A

tachy: systole occupies > 1/3 of the cycle
diastole: systole occupies < 1/3 of the cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pulse pressure

A

SBP - DBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what happens to pulse pressure w/ severe AO regurg

A

it will increase b/c systolic press must increase to get blood out and diastolic BP will go down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what 2 factors can increase BP

A

CO and any factors that increase systemic vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how can HTN appear in a clinical setting

A

can appear as:
heart failure w/ preserved EF… will have compensatory hyper dynamic contraction, hypertensive hypertrophic cardiomyopathy… main mechanism is diastolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

1 symptom of HTN

A

dyspnea… also a sign of diastolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

1 way to alter peripheral resistance

A

alter the vessel diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

formula for BP

A

BP = peripheral resistance x cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 things that affect BP

A

peripheral resistance
stoke volume and isotropy
heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what can cause vasodilation in the high resistance vascular beds

A

exercise and relaxation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how does pulse pressure relate to compliance

A

more compliant vessel = lower pulse pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how does inspiration and expiration affect right heart filling

A 
inspiration = increased R heart filling
expiration = decreased R heart filling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

term for total blood volume

how does it affect BP

A

volemia

more volume = more press

24
Q

factors that increase volemia

A

water retention

total body mass

25
Q

how does salt alter BP

A

higher salt intake leads to water retention in order to maintain proper salinity of blood…. more water leads to more pressure on the arterial walls and higher BP

26
Q

what is salinity

A

water, sodium ratio

27
Q

how many mg or sodium a day

A

1500 mg - 2300 mg

28
Q

high BP is equal to what

A

high afterload

29
Q

effects of HTN… what can it cause

A

CHF - HTN increases the workload to an already overworked heart
CAD
PVD
renal failure -press is too high for kidneys to function well
angina - increased workload to muscle and decreased coronary artery profusion

30
Q

how can HTN cause PVD

A

increased pressure and velocity in the arteries speeds up the process of athersclerosis…. same for CAD

31
Q

what is the function of endothelium relaxation factor

A

allows the smooth muscle cells of the tunica intimal and media to relax and will lower BP

32
Q

main factors of HTN that need to be addressed

A

blood volume
CO (SV and HR)
peripheral arterial resistance

33
Q

first step to HTN management

A 
lifestyle modifications:
exercise
control salt and fat intake
stop smoking
reduce stres
34
Q

how does exercise help to reduce BP

A

muscle contraction leads to vasodilation to provide more 02 to muscles and remove C02, this dilation leads to lower systemic vascular resistance which lowers BP

35
Q

how does smoking affect BP

A

stress makes people want to smoke…. smoking decreases 02 to the brain and introduces toxins… this stressed the body and causes the release of catecholamines in order to try to get more 02, leading to higher BP and HR.. feeling more stressed

36
Q

after the first year of smoking, risk of an MI and CVA is reduced by how much

… 5 years?

A

50%

50%

37
Q

irreversible lung damage occurs after how many years

A

5

38
Q

main effect of diuretics

A

lower total blood volume to reduce preload, afterload and excrete salt w/ urine

39
Q

main effect of beta blockers

A

lower HR which reduced SBP and DBP and allow more effective contraction and more time for perfusion

40
Q

main effect of calcium channel blockers and ACE inhibitors

A

vasodilation

calcium: block calcium from entering muscle cells and lowers afterload

ACE: prevent angiotensin from causing arterial contrition… lowers afterload

41
Q

which areas of the heart in specific are we assessing for size

A

LV, LA, IVS, LVPW

AO: root, ascending and descending, also look at abdo AO

42
Q

what should we assess w/ HTN

A 
systolic function
diastolic function
values
dilation of ventricles
size
43
Q

what does dilation mean w/ HTN

A

the heart is failing and compensatory mechanisms arent enough anymore

44
Q

what kind of LVH is seen w/ early HTN

A

concentric remodelling

45
Q

2D echo findings w/ HTN patient

A 
LVH
AO root &amp; ascending dilated
\+/- AV sclerosis or MAC
LA enlargement
RV dilation due to high RVSP
46
Q

strain findings w/ HTN patient

A

reduced global strain

47
Q

diastolic dysfunction findings w/ HTN patient

A

increased LV filling press
PV flow reversal
reduced longitudinal motion w/ TDI
RVSP increase in late HTN

48
Q

if a patient has increase peripheral resistance, how will the diastolic flow change in the descending and AO arch

A

it will be reversed.. so much resistance that flow cant go forwards.

no AR seen

49
Q

in what circumstance could a patient go from normal geometry to eccentric geometry

A

from an MI

50
Q

what type of LV geometry will you always see w/ late heart failure

A

eccentric

51
Q

how can asymmetric LVH affect the MV

A

can cause SAM - systolic anterior motion of the mitral valve… b/c the suction from the LV contraction is so strong the it pulls the leaflet up… will see aliasing in the ventircle

52
Q

what variables are needed to calculate the LV mass linear technique

simplified formula

A

PWd, IVSd, LVIDd, LVID

LV mass index = total LV mass / BSA

53
Q

when can the LV mass be too high, but the LV mass index be normal?

what can you do instead

A

due to increased BSA

use height to index LV mass instead

54
Q

how do you do LV mass using the area length method

A

trace around the epicardium and the endocardium… subtract the 2 areas to get the area of the myocardium, then add the length of the LV measured in A4CH view

55
Q

forumla for relative wall thickness

why do we use PW and not IVS

A

RWT = 2 (LVPW)/LVIDd

often the IVS is thickened in the basal segment of the LV in older patients

56
Q

normal RWT

A

<0.42

Echo 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions