Circulatory disorders lecture 2 TEST 2 Flashcards
What is essential hypertension?
-Primary hypertension or it has no identifiable underlying cause
What is secondary hypertension?
-It is secondary to a separate underlying medical condition such as congestive heart failure
What are some common causes of secondary hypertension?
- Endocrine (steroid, thyroid, or pheochromocytoma)
- Drugs
- Pregnancy
- Renal failure
- Sleep apnea
- Renal artery stenosis
- Pain
What is the most common type of hypertension?
-Essential hypertension
What are the causes of essential hypertension?
- Increased sodium
- Narrowing of arteries
What are some hypertension induced problems?
- Accelerated atherosclerosis
- MI
- Stroke
- Peripheral vascular disease
- Aneurysms
- Heart failure
- Renal failure
- hemorrhages
- Decrease arterial density
- Malignant hypertension
What is the main cause of left ventricular hypertrophy?
-Hypertension
What is malignant hypertension?
-Sudden increase in BP and is most common in African Americans
What is hyperlipidemia a risk factor for?
-Many atherosclerotic diseases
What are secondary cause for hyperlipidemia?
- Diabetes especially type 2
- Sedentary lifestyle
- Poor diet
- Obesity
- Heavy alcohol use
What is the main type of hyperlipidemia?
-Hypercholesterolemia
What causes familial hypercholesterolemia?
-Interaction of genetic and environmental factors
What percent of use adults have hypercholesterolemia more than 200mg/dL
50%
What does HDL deliver lipids to?
-Periphery to liver
What does LDL deliver lipids to?
-Liver to periphery
What does VLDL do?
-Deliver lipids from liver to periphery
What are the major core lipids in VLDL and chylomicrons?
-Triglycerides
What are the major core lipids in HDL or LDL?
-Cholesteryl ester
Where do chylomicrons deliver lipids to and from?
-From gut to the liver
What does reverse cholesterol transport?
-HDL
What do lipids induce?
-Atherosclerosis
What does atherogenic mean?
-From liver
What does anti-atherogenic mean?
-Back to the liver
If a person has higher HDL what are they less likely to have?
-Atherosclerosis
What should you total cholesterol be under?
-200 mg/dL
What do you want to keep your LDL under if you are high risk?
-70 mg/dL
What is a good HDL?
80 mg/dL
What is the goal of triglycerides that you should have?
less than 150 mg/dL
What is the leading cause of death?
-Atherosclerosis (causes 80% of heart diseases)
What is the main cause of a stroke?
-Atherosclerosis
What is the hardening of arteries?
-Arteriosclerosis
What is the lipid deposits/plaques called atheromas in the arteries known as?
-Atherosclerosis
What will a pt with an atherosclerotic coronary artery feel like when exerting themselves?
-Angina
What does an abrupt stenosis cause?
-Thrombus/embolus
What does a slow stenosis cause?
-Stable Angina
What are the most common sites of atherosclerosis?
- Aorta
- Coronary arteries
- Legs
- Carotids/circle of Willis
- Kidney
- pulmonary
What causes an MI?
-A thrombus in the coronary artery
What are risk factors for atherosclerosis?
- Smoking
- Hypertension
- Diabetes
- Nephrosclerosis
- Post menopause
What does smoking, hypertension, diabetes, and inflammation do in the sequence of developing atherosclerosis?
-Endothelial dysfunction
Once you have endothelial dysfunction what is the next step in the sequence of developing atherosclerosis?
-Lipids deposit in vessel wall intima
Have lipids deposit in the vessel wall intima what is the next step in the sequence of developing atherosclerosis?
-Inflammation
What can inflammation do in developing atherosclerosis?
-Cause fibrosis in the smooth muscle or a plaque rupture
Stenosis impedes blood flow at what percent of blockage?
75%
What is the most dangerous type of stenosis?
-Abrupt stenosis
What causes most infarcts?
Ruptures that lead to a throbmus or embolism
What is the most common site for atherosclerosis?
-Aorta
What can atherosclerosis in the iliac, femoral or popliteal arteries cause?
-Claudications leading to necrosis/gangreneWhat
What can atherosclerosis in the kidney cause?
-Hypertension and maybe renal failure
What can damage to the media in the aorta cause?
-Aneurysm (enlargement of the artery/weakened)
What is the most common cause of strokes?
- Cerebral infarct (most common)
- Hemorrhagic
What does smoking do in the risk for atherosclerosis?
- Endothelial injury
- Increase coagulation
- Free radicals
What does dyslipidemia do in the cause atherosclerosis?
-Promotes lipid deposition in vessels
What does hypertension do in the cause atherosclerosis?
-Endothelial damage
What age increases your risk for atherosclerosis?
- > 45 males
- >55 females
What lifestyle factors increase your risk for atherosclerosis?
- Obesity
- Inactivity
- Poor diet
Where do you see numbness/paralysis from a stroke?
-Contralateral side
What are the causes of ischemic heart disease?
- Coronary artery stenosis
- Atheroma types
What is Angina pectoris?
-Paroxysmal attacks of chest pain in the substernal or precordial areas
What causes Angina pectoris?
-Myocardial ischemia
What causes Stable angina?
-Exertion
When does variant Angina occur?
-Typically at rest
What is unstable angina?
-New or worsening angina with prolonged pain or pain at rest
What type of angina has an ST elevation?
-Variant Angina
What are myocardial infarct symptoms?
- Retrosternal chest pain
- Dyspnea
- Diaphoresis
- nausea/vomiting
- palpitations
- anxiety
