Cardio part 2.1

Question 1

what is a hTN emergency

Answer 1

anything over 180 systolic and 120 or above

pt may have severe HQ , retinal hemorrhage and papilledema

changes in sensorwmun and decreased levels or consciousness and seizure can occur
* go to emergency with any of these findings

Question 2

what is primary hypertension-

Answer 2

• silent killer
• (0-95%)
• HTN with no underlying causes

Question 3

what causes secondary HTN

Answer 3

d.t chronic renal failure and or stenosis of renal arteries

Question 4

what happens to the kD during HTN

Answer 4

increases renin and angiotensin

Question 5

reasons for 2 HTN

Answer 5

There are multiple etiologies for secondary hypertension including but not limited to:
Medications such as NSAIDs
Sleep apnea
Pheochromocytoma
Hyperaldosteronism (Conn's syndrome)
Cushing's syndrome 
Hyperparathyroidism
Acromegaly
Hyperthyroidism/ Hypothyroidism

Question 6

Reno vascular HTN

Answer 6

high blood pressure caused by narrowing of the arteries supplying the kidneys. It is a form of secondary hypertension - a form of hypertension whose cause is identifiable. RAS induces renin secretion that causes the angiotensin conversion, causing aldosterone release and then water retention and potassium depletion.

Question 7

potential mechanisms for 1 HTN

Na+

Answer 7

• abn NA+ transport d.t defect in or inhibition of the Na-K pump
• Inc, cellular perm. to Na+
• net result is an increased intracellular sodium which may make the cell more sen
• SM contracts stronger

Question 8

Potential cause of 1 HTN ca+

Answer 8

genetic condition inherited as a dominant trait that results in abnormal connective tissue, due to production of abnormal fibrillin-1 protein.
This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
Individuals with Marfan’s syndrome tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta

Question 9

Potential cause of HTN

renin-angiotension

Answer 9

genetic condition inherited as a dominant trait that results in abnormal connective tissue, due to production of abnormal fibrillin-1 protein.
This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
Individuals with Marfan’s syndrome tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta

Question 10

What is the most common cause of renal disease

the second most common cause

Answer 10

HTN

DM

Question 11

how does renal dz contribute to HTN

Answer 11

increased production of renin which results in salt retention and systemic vasoconstriction

Question 12

HTN is the leading cause of what

Answer 12

ischemic heart dz, PVD, cerebrovascular dz, ventricular hypertrophy and CHF

Question 13

What are the 3 types of hypertension

Answer 13

labile, benign, accelerated

Question 14

Labile HTN

Answer 14

BP elevations which are inconsistent. Individuals that have increased Catecholamines form seeing doc “white coat HTN”

-can occur with pheochromocytoma ( usu dramatic event)

Question 15

how do pt with pheochromocytoma present

Answer 15

• paroxysmal HA, sweats, palpitations, HTN and orthostatic hypotension

Question 16

what is pheochromocytoma?

Answer 16

tumor on the adrenal gland

Question 17

Benign HTN

Answer 17

• potential sequelae of long standing HTN include MI, stroke, renal disease and renal failure, peripheral vascular disease and blindness,

Question 18

What is an Aneurysm

Answer 18

ballooning out” of an a vessel wall due to underlying weakness of the wall and/ or the force of increased blood pressure.

Question 19

Where to Aneurysms occur

Answer 19

• in any vessel but arteries more common.
• aorta and the circle of Willis are vessels in which aneurysm development has the greatest potential for increased morbidity and mortality

Question 20

what is a berry aneurysm

Answer 20

occurs where there is a greater degree force compared to the surrounding ares. I.e circle of willis, where there are a lot od branches

Question 21

describe an aortic dissection

Answer 21

extremely severe and potentially life threatening comp. HTN
Dissection usu. through the medial tissue layer of the aorta and can affect the ascending aorta, the aortic arch, descending aorta and abdominal aorta.

Question 22

how does a pt with aortic dissection ptc

Answer 22

excruciating pain the may be resistant to tx w/ very large morphine

-immediate blood pressure control must be achieved

Question 23

MArfans- diseases

Answer 23

• genetic condition dominant- production of abnormal fibrillin-1 protein.
• This syndrome is noted in 5–9% of all individuals who develop aortic dissection.
• tend to have aneurysms that are localized to the aorta relative to other vessels and are more prone to proximal dissections of the aorta

Question 24

Marfans characteristics

Answer 24

Marfan’s patients are often very tall individuals with long extremities and especially long digits.
Collagen abnormalities in the vessel wall result in the vessel becoming extremely vulnerable to damage and particularly susceptible to aortic dissection.

Question 25

what are the most serious signs of marinas

Answer 25

The most serious signs and symptoms associated with Marfan’s syndrome involve the cardiovascular system and include new onset fatigue, shortness of breath, heart palpitations, tachycardia and new onset murmur.
The signs of regurgitation from prolapse of the mitral or aortic valves can occur as a result of collagen degeneration of the root of these valves.

Question 26

Define CHF

Answer 26

condition in which the heart is unable to pump enough blood to meet the body’s metabolic

the heart’s must pump blood coming into the ventricles from the lower pressure venous system against the higher pressure arterial system.

• you can have forward to backward failure- can’t push blood forward. can get blood out thats coming in

Question 27

what does CHF cause

Answer 27

inadequate emptying of blood at the venous side and inadequate blood delivery to both the pulmonary and system circulation

Question 28

LCHF

Answer 28

pulmonary edema