CSIM1.65 CDVS D/z 4 Flashcards
Difference between benign and malignant hypertension?
Malignant Hptn is defined by the diastolic pressure
>130 is severe malignant
I.e. Hypertension is usually defined as >140/90, but it can be benign because diastolic is still in the normal range
But if diastolic then increases, then it becomes malignant.
What are some factors affecting cardiac output and peripheral resistance?
CO : blood volume (electrolyte balance), HR, contractility
PR : vasoconstrictors/dilators and neural adrenergic constrictors/dilators
Possible causes of essential benign hypertension?
Abnormal RAAS cascade
Abnormal sodium homeostasis
Abnormal sensitivity to catecholamines
Some causes of secondary hypertension?
Renal diseases Endocrine diseases (tumors) Coarctation of the aorta Drugs Sleep apnea
How does benign hypertension increase cardiac risk?
Increase resistance means that heart has to pump harder whcih can result in LVH. If progresses, heart can give up and fail.
Consequences of malignant hypertension
Cardiac failure, blurred vision (papiloedema), retinal haemorrhages, kidney failure, brain damage/hamorhage
Difference between true and false aneurysm
A false aneurysm results from blood leaking out of a vessel and forming an extravascular mass. There is not change in size of the actual vessel
What is a berry aneurysm?
Aneurysms usually at the circle of willis.
Associated wit polycystic kidney disease
Can rupture to cause SAH
How does a dissecting aneurysm occur?
If a tear occurs between the intima and media, blood can tract into the space, tearing it apart further. This can cause it to bulge, occluding the main lumen and causing ischaemia.
Clinical features of a dissecting aneurysm?
Severe pain and shock
What are some causes of a dissecting aneurysm?
Degeneration of aortic media associated with single DNA mutation
E.g. Marfan’s sd, Edler’s Danlos SD
How does an atherosclerotic aneurysm happen?
Usually an AAA
Caused by atheroma in the aorta, weakening the wall of the artery, due to high pressure of the aorta, the weakened wall starts to bulge and form an aneurysm
Can burst -> fatal, die.
Enlargement of aneurysm compressing spine
What is a mycotic aneurysm?
Aneurysm caused by infection/septicaemia.
Pathogens line the vasa vasorum, causing inflammation and weakness
Effects of left sided heart failure?
Pulmonary edema/hypertension
Cor pulmonale
SOB
Effects of right sided heart failure?
Blood pooling in body, peripheral/ankle edema or portan hypertension, raised JVP.
