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M3 > Cardio: Hypertension > Flashcards

Cardio: Hypertension Flashcards

1
Q

BP <120 S; AND <80 D

A

Normal

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2
Q

BP >=140 S AND <90 D

A

Isolated systolic hypertension

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3
Q

Stage 1 HPN BP

A

140-159 S OR 90-99 D

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4
Q

Prehypertension BP

A

120-139 S OR 80-89 D

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5
Q

Stage 2 HPN BP

A

> =160 S OR >=100 D

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6
Q

Macroalbuminuria

A

random urine albumin/creatinine ratio >300mg/g

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7
Q

Microalbuminuria

A

randum urine/albumine/creatinin ration 30-300 mg/g

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8
Q

ABI diagnostic of PAD

A

<0.90

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9
Q

ABI <0.90 is assocatied with __% stenosis?

A

50

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10
Q

What is the most common congenital cardiovascular cause of hypertension?

A

Coarctation of the aorta

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11
Q

Characterize the murmur that could be heard with coarctation of the aorta

A

Blowing systolic murmur heard in the posterior left infrascapular areas

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12
Q

confirmation of coarctation of the aorta by which tests

A

CXR

Transesophageal echocardiography

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13
Q

Treatment of coarctation of the aorta

A

Surgical repair

Balloon Angioplasty

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14
Q

2 main mechanisms of hypertension

A

cardiac output

peripheral resistance

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15
Q

Peripheral resistance is mainly determined by

A

arterioles

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16
Q

Primary determinant of Extracellular volume

A

sodium

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17
Q

____= pressure accross vascular bed/ vascular resistance

A

blood flow

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18
Q

Hypertension has ___ to ___% heritability

A

30-40%

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19
Q

True of pressure natriuresis except

a. Subtle increase in the glomerular filration rate
b. increase in absorbing capacity of renal tubules
c. involvment of ANP
d. AOTA

A

B. decrease in absorbing capacity of renal tubules

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20
Q

The following statements are false

a. Greater increase in arterial pressure is needed to achieve natriuresis and sodium balance when there’ impaired capacity to excrete sodium.
b. Na-Cl dependent hyper tension is a consequence of decreased capacity of kidney to excrete sodium
c. Intrinsic renal disease can impair sodium secretion
d. NOTA
e. AOTA

A

D

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21
Q

The following statement is false

a. NE has more affinity to alpha receptors than E
b. E has more affinity to beta receptors than NE
c. Clonidine is an alpha 2 antagonist
d. Beta 2 adrenergic receptor activaton has vasodilatory effect

A

C; clonidine is an alpha2 agonist

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22
Q

The following statement is true

a. Beta 1 has chronotropic but no inotropic effect on heart
b. Beta 2 activation is for bronchoconstriction
c. Phaeochromocytoma may cause downregulation of adrenergic receptor
d. Chronic use of beta blockers can downregulate receptor

A

C;
Beta 1 both chronotropic and inotropic effect
Beta 2 bronchodilation
chronic use of beta blockers may upregulate receptors

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23
Q

The following statement is true EXCEPT

a. Orthostatic hypotension in phaeochromocytoma is due to upregulation of adrenergic receptor
b. In phaeochromocytoma, BP can be lowered by surgical excision of tumor
c. In phaeochromocytoma, inhibition of tyrosine hydroxylase can be decrease bp
d. Tyrosine hydroxylase is the rate limiting step in catecholamine biosynthesis

A

A

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24
Q

The following statements are true:

a. 17 alpha hydroxylase deficiency is a saltwasting disease
b. Cortisone has affinity to mineralocorticoid receptros
c. 11 B hydroxysteroid dehydrogenase deficiency can cause hypertension
d. Angiotensin AT2 receptor activation cause increase in renin secretion

A

C; cortisol will not be converted to cortisone therefore there is increase in mineralocorticoid receptor activationl thus increase sodium retention, increase bp

AT2 receptor decrease renin secretion and vasodilation

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25
Q

3 primary stimuli for renin:

1. decrease NaCl transport in the ____________ that abuts the macula densa

A

distal portion of the thick ascending limb of loop of Henle

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26
Q

3 primary stimuli for renin:
2. ______ pressure or stretch within ______ arteriole

a. decrease; afferent
b. increase; efferent
c. decrease; efferent
d. increase; afferent

A

A

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27
Q

3 primary stimuli for renin:

3. Sympathetic nervous system stimulation of renin secreting cells via ____ adrenoreceptros

A

B1

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28
Q

An aldosterone antagonist that act on aldosterone dependent na-K exchange site in distal tubules resulting in increase excretion of sodium and chloride and water and retention of potassium and hydrogen

A

Spironolactone

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29
Q

Low dose spironolactone decrease risk for heart failure and sudden death by ___%

A

30%

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30
Q

Obstruction of renal artery causes the ff

a. increase in renal perfusion pressure
b. decrease in renal perfusion pressure
c. inhibit renin secretion
d. NOTA

A

B;

it cause decrease in renal perfusion pressure and stimulate renin secretion

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31
Q

2 important determinants of arterial pressure

A
  1. vascular radius

2. compliance of resistance arteries

32
Q

3 Lumen diameter changes in hypertension

A
  1. structural
  2. mechanical
  3. functional
33
Q

3 mechanisms of vascular remodeling in hypertension

A

VAL
vascular fibrosis
apoptosis
low grade inflammation

34
Q

non-invasive determination of pulse wave velocity between carotid and femoral arteries

A

index of arterial stiffness

35
Q

Increased ph will cause

a. increased bp
b. decreased bp

A

A

36
Q

Endothelin is a

a. vasoconstrictor
b. vasodilator

A

A

37
Q

surrogate index of arterial stiffening calculated as ratio of central arterial pressure-to-puse pressure

A

aortic augmentation index

38
Q

Determinant in set point of renal pressure natriuresis curve

A

ROS in renal medulla

39
Q

increase afterload causes abnormal

a. systolic function
b. diastolic function

A

B?

40
Q

__% of stroke is due to infarction

A

85%

41
Q

T/FTreatment of hypertension decreases incidence of ischemic but not hemorrhagic stroke

A

F; decrease both

42
Q

Cerebral blood flow remains unchanged with what range of MAP?

A

50-150

43
Q

mechanism for maintenance of cerebral blood flow in spite of varying MAP within 50-150 mmHg

A

autoregulation

44
Q

The most common etiology of secondary hypertension

A

Primary renal disease

45
Q

Renal risk is more closely related to ____ hpn

a. systolic
b. diastolic

A

A

46
Q

in hypertension, there is direct damage to glomerulus due to _______

A

hypoperfusion

47
Q

Renal lesion associated with malignant hypertension

A

fibrinoid necrosis of afferent arterioles

48
Q

macroalbuminuria

A

> 300mg/g

49
Q

microalbuniuria

A

30-300mg/g

50
Q

Classic symptome of PAD

A

intermittent claudication

51
Q

<0.90 ABI

A

PAD

52
Q

level of bp at which institution of treatment tx to decrease bp related morbidity and mortality

A

clinical definition of hypertension

53
Q

Definition of hypertension for children and adolescents

A

> 95th percentile for age, sex, ht

54
Q

Definition of prehypertension for children and adolescents

A

90-95th percentile

55
Q

T/F home bp and average 24 h ambulatory bp is generally lower than clinic bp

A

T

56
Q

Night time BP is _____ lower than day time bp

A

10-20%

57
Q

24 hr monitoring:

average awake bp

A

> = 135/85mmHg

58
Q

24 hr monitoring:

average asleep bp

A

> =120/75mmHg

59
Q

elevated bp at office but ambulatory bp is <135/85

A

white coat hypertension

60
Q

normal office bp; elevated bp outside

A

masked hypertension

61
Q

True of primary hypertension

a. prevalence increase with age
b. cardiac output is increased
c. peripheral resistance is increased
d. 10-15% have high plasma renin activity

A

C; normal

62
Q

High renin patients: what form of hypertension?

A

vasoconstrictor

63
Q

Low renin patients: what for of hypertension?

A

volume dependent hpn

64
Q

effective antihypertensive agent for some patients with primary hypertension, including some px with drug resistant hpn

A

Spironolactone

65
Q

Obese defn

A

> 30kg/m2

66
Q

more important determinant of BP than body fat

A

centrally located fat

67
Q

24 hr monitoring:

average awake bp

A

> = 135/85mmHg

68
Q

24 hr monitoring:

average asleep bp

A

> =120/75mmHg

69
Q

elevated bp at office but ambulatory bp is <135/85

A

white coat hypertension

70
Q

normal office bp; elevated bp outside

A

masked hypertension

71
Q

True of primary hypertension

a. prevalence increase with age
b. cardiac output is increased
c. peripheral resistance is increased
d. 10-15% have high plasma renin activity

A

C; normal

72
Q

High renin patients: what form of hypertension?

A

vasoconstrictor

73
Q

Low renin patients: what for of hypertension?

A

volume dependent hpn

74
Q

effective antihypertensive agent for some patients with primary hypertension, including some px with drug resistant hpn

A

Spironolactone

75
Q

Obese defn

A

> 30kg/m2

76
Q

more important determinant of BP than body fat

A

centrally located fat

M3 (66 decks)

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