Ch 11: Systemic Hypertension

Question 1

How can hypertension cause stroke?

Answer 1

Usually, stroke occurs due to thrombosis or hemorrhage from microaneurysms of the small penetrating intracranial arteries.
(p. 444)

Question 2

What might you see upon retinal examination of a pt with severe acute hypertension.

Answer 2

Severe hypertensive retinopathy can cause disk edema, intraretinal hemorrhages, nerve fiber layer infarcts (cotton-wool spots), and arteriovenous nicking.
Retinal arteries will show irregular narrowing (p. 445)

Question 3

When palpating pulses, what does radial-femoral delay suggest?

Answer 3

Coarctation of the aorta

p. 445

Question 4

Why might you want to check a serum uric acid when working-up a new pt with hypertension?

Answer 4

Hyperuricemia is a relative contraindication to diuretic therapy.
(p. 445)

Question 5

What nonpharmacologic approaches have a proven (but modest) effect of lowering BP?

Answer 5

weight loss
dietary sodium reduction
moderation of alcohol consumption
(p. 445)

Question 6

There is an association between lower blood pressure and _________ _______ in elderly patients subjected to intensification of antihypertensive treatment _____ __ ____.

Answer 6

cognitive decline
later in life
(p. 446)

Question 7

In general, statins should probably be…

Answer 7

…more widely used.

p. 447

Question 8

In the ASCOT trial, the effect of statins appeared to be synergistic with ___ and ___ but not with ___ and ___.

Answer 8

calcium channel blockers and ACE inhibitors

beta-blockers and diuretic regimens
p. 447