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Integrative Nutrition and Pathophysiology > CVD 3 > Flashcards

CVD 3 Flashcards

1
Q

normal SBP and DBP

A

SBP: < 120
DBP: < 80

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2
Q

elevated SBP and DBP

A

SBP: 120-129
DBP: < 80

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3
Q

stage 1 HTN SBP and DBP

A

SBP: 130-139
DBP: 80-89

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4
Q

stage 2 HTN SBP and DBP

A

SBP: > = 140
DBP: > = 90

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5
Q

HTN causes
increased cardiovascular __ and __
increased __
increased chronic __ disease and end stage __ disease

A

HTN causes
increased cardiovascular morbidity and mortality
increased cardiovasvular accidents (CVA, stroke)
increased chronic kidney disease and end stage kidney disease

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6
Q

blood pressure =

A

vascular resistance * cardiac output

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7
Q

vasoconstriction is caused by

A

catecholamines
angiotensin II
vasopressin

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8
Q

vasodilation is caused by

A

nitric oxide
ANP

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9
Q

RAAS system steps

A
  1. kidney senses low BP, secretes renin
  2. liver secretes angiotensignogen which becomes angiotensin
  3. acts on adrenal gland to increase aldosterone secretion –> increased sodium and water retention –> increased BP
  4. also decreased GFR and urine output via vasoconstriction
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10
Q

RAAS: when kidney senses low BP, it secretes

A

RAAS: when kidney senses low BP, it secretes renin

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11
Q

RAAS: renin causes liver to secrete __ which becomes __

A

RAAS: renin causes liver to secrete angiotensinogen which becomes angiotensin

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12
Q

RAAS: angiotensin acts on __ to increase __ secretion –> increases __ and __ retention –> increases __

A

RAAS: angiotensin acts on adrenal gland to increase aldosterone secretion –> increases sodium and water retention –> increases BP

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13
Q

RAAS: angiotensin also decreases __ and __ ouput via __

A

RAAS: angiotensin also decreases GFR and urine ouput via vasoconstriction

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14
Q

SNS system

A
    1. Cardiac Output via heart
    1. Catecholamines via Adrenal Medulla
    1. Kidney releases Renin
    1. Blood vessel and increased Vascular resistance
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15
Q

3 mechanisms of hypertension

A

BP
RAAS
SNS

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16
Q

risk factors for hypertension

A
  • age
  • obesity
  • family Hx
  • reduced nephron number
  • excessive alcohol
  • physical inactivity
  • high SODIUM diet
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17
Q

primary = __ HTN
secondary = __ HTN

A

primary = essential HTN
secondary = identifiable HTN

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18
Q

primary HTN is __% of cases

A

primary HTN is 95% of cases

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19
Q

primary HTN has __ and __ causes

A

primary HTN has genetic and environmental causes

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20
Q

primary HTN has NO __

A

primary HTN has NO discrete causative entity

21
Q

secondary HTN underlying etiological conditions

A
  1. hyperthyroidism
  2. Cushing’s
  3. renovascular disease
  4. obstructive sleep apnea
  5. hyperaldosteronism
  6. meds (NSAIDs, MAO-I, steroids, OCPs)
22
Q

secondary HTN is considered in patients with

A
  1. severe HTN
  2. resistant HTN
  3. HTN before puberty
  4. presentation before age 30 in non-obese patient with no family Hx
  5. signs/symptoms suggesting etiological entity
23
Q

severe HTN

A

SBP: > 170 mm Hg
DBP: > 110 mm Hg

24
Q

resistant HTN

A

on 3 drugs, one of which is a diuretic

25
Q

for each 1 gram increment in potassium excretion,

A

0.75 mm Hg decrease in SBP and 0.06 mm Hg decrease in DBP

26
Q

how do we excrete more potassium and lower BP

A

consume more potassium

27
Q

for each 1 gram increment in sodium excretion,

A

2.11 SBP increase, 0.78 DBP increase

28
Q

more sodium =

A

high BP

29
Q

best way to measure BP

A
  1. sitting back supported
  2. no talking
  3. correct cuff size
  4. arm bare and resting
  5. feet flat on floor
  6. quiet room
  7. no smoking, caffeine, exercise 30 mins before
  8. empty bladder
  9. relax for 5 min
30
Q

gold standard of measuring BP

A

24 hour ambulatory pressure monitoring (24 H ABPM)

31
Q

benefits of 24 H ABPM

A

shows BP patterns
shows nocturnal dipping

32
Q

office BP is generally

A

higher than ABPM or at home

33
Q

essential function of kidney

A
  1. excretion
  2. regulate EC volume by filtrating and reabsorbing sodium
  3. regulate plasma osmolarity
  4. regulate pH
  5. produce hormons for RBC production
  6. maintain bone health via vit D activation and phosphate excretion
  7. immune function
  8. drug metabolism
34
Q

kidney regulates extracellular volume by __ and __ __

A

kidney regulates extracellular volume by filtrating and reabsorbing sodium

35
Q

kidney produces hormones for

A

RBC production

36
Q

kidneys regulate plasma __ through __

A

kidneys regulate plasma osmolarity through water handling

37
Q

kidneys help maintain bone health through activation of __ and __ excretion

A

kidneys help maintain bone health through activation of vit D and phosphate excretion

38
Q

creatinine is a byproduct of __ and is released into __ at a __ rate

A

creatinine is a byproduct of muscle breakdown and is released into blood at a steady rate

39
Q

__ intake impacts creatinine levels

A

dietary meat intake impacts creatinine levels

40
Q

creatinine if mostly filtered by

A

creatinine if mostly filtered by kidney

41
Q

when kidney function declines, GFR __, and creatinine __

A

when kidney function declines, GFR declines, and creatinine increases in blood

42
Q

limit of using creatinine to estimate GFR

A

blood creatinine is influenced by muscle mass and protein intake

43
Q

AKI =
CKD =

A

AKI = acute kidney injury
CKD = chronic kidney disease

44
Q

AKI
time course
compensation
GFR
natural history

A

AKI
time course: days-weeks
compensation: inable to regulate volume and solutes
GFR: 0
natural history: potentially reversible

45
Q

CKD
time course
compensation
GFR
natural history

A

CKD
time course: 6 months-years
compensation: gradual adaptation allows for normal excretion until end stage
GFR: lowered, but okay
natural history: irreversible

46
Q

proteinuria

A

high levels of protein in urine

47
Q

proteinuria is independent of

A

estimated GFR

48
Q

proteinuria associated with increased __, __, __, and __

A

proteinuria associated with increased all cause mortality, CV events and mortality, CKD progression, and end stage renal disease (ESRD)

Integrative Nutrition and Pathophysiology (22 decks)

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