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CVS PATHOLOGY > CVS 1- HYPERTENSION > Flashcards

CVS 1- HYPERTENSION Flashcards

1
Q

What are the two principal mechanisms of vascular disease?

A

Narrowing or complete obstruction of vessel lumen and Weakening of vessel walls

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2
Q

What results from narrowing or obstruction of the vessel lumen?

A

Acute or progressive blockage

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3
Q

What happens due to the weakening of vessel walls?

A

Dilation and rupture

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4
Q

What are the main components of the vessel wall?

A

Endothelial Cells (ECs)

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5
Q

What does the extracellular matrix (ECM) include?

A

Elastin

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6
Q

What are the three layers of the vessel wall?

A

Intima

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7
Q

What influences the variation in vessel wall layers?

A

Tissue requirements and hemodynamic forces

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8
Q

What is blood pressure a function of?

A

Cardiac output and peripheral vascular resistance

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9
Q

What influences blood pressure?

A

Multiple genetic and environmental factors

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10
Q

What does cardiac output depend on?

A

Stroke volume and heart rate

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11
Q

What influences stroke volume?

A

Sodium concentration and myocardial contractility

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12
Q

What controls heart rate?

A

Alpha- and beta-adrenergic systems

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13
Q

What factors affect peripheral vascular resistance?

A

Arterioles’ neural and humoral inputs

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14
Q

What maintains normal vascular tone?

A

Balance between vasoconstrictors and vasodilators

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15
Q

What is autoregulation in blood pressure?

A

Increase in blood flow followed by vasoconstriction

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16
Q

What fine-tunes vascular resistance?

A

Tissue pH and hypoxia

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17
Q

What organs are involved in blood pressure regulation?

A

Kidneys, adrenals, and myocardium

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18
Q

What system plays a key role in blood pressure regulation?

A

Renin-angiotensin system

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19
Q

What triggers the release of renin?

A

Low blood pressure in afferent arterioles, high levels of circulating catecholamines, and low sodium levels in distal convoluted tubules

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20
Q

What are examples of vasodilators?

A

Prostaglandins, nitric oxide (NO)

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21
Q

What hormone is released by the adrenal glands?

A

Aldosterone

22
Q

What peptide is released by the myocardium?

A

Natriuretic peptide

23
Q

What is hypertension (HYPERTENSIVE VASCULAR DISEASE)?

A

Increased blood pressure with sustained diastolic pressure > 90 mm Hg or sustained systolic pressure > 140 mm Hg

24
Q

What percentage of the general population is hypertensive?

A

About 25%

25
Q

What are the pathological effects of hypertension?

A

Stroke, coronary heart disease, cardiac hypertrophy, heart failure, aortic dissection, multi-infarct dementia, and renal failure

26
Q

What is hypertension (HYPERTENSIVE VASCULAR DISEASE)?

A

Increased blood pressure with sustained diastolic pressure > 90 mm Hg or sustained systolic pressure > 140 mm Hg

27
Q

What percentage of the general population is hypertensive?

A

About 25%

28
Q

What are the pathological effects of hypertension?

A

Stroke, coronary heart disease, cardiac hypertrophy, heart failure, aortic dissection, multi-infarct dementia, and renal failure

29
Q

What is malignant hypertension?

A

Rapidly rising blood pressure that if untreated leads to death within 1-2 years

30
Q

What are the characteristics of severe hypertension?

A

Systolic pressure > 180 mm Hg, diastolic pressure > 120 mm Hg, renal failure, retinal hemorrhages, and exudates

31
Q

What is malignant hypertension usually superimposed on?

A

Preexisting benign hypertension

32
Q

What genetic factors are linked to hypertension?

A

Angiotensinogen polymorphisms, angiotensin II receptor variants

33
Q

What gene defects cause rare severe forms of hypertension?

A

Gene defects affecting aldosterone metabolism (aldosterone synthase, 11β-hydroxylase, 17α-hydroxylase)

34
Q

What do mutations affecting sodium resorption cause?

A

Increased distal tubular resorption of sodium

35
Q

What are the environmental factors contributing to hypertension?

A

Stress, obesity, smoking, lack of exercise, heavy salt consumption

36
Q

What effect does hypertensive vascular morphology have on atherogenesis?

A

Accelerates atherogenesis

37
Q

What changes occur in the walls of large and medium-sized arteries due to hypertensive vascular morphology?

A

Degenerative changes including aortic dissection and cerebrovascular hemorrhage

38
Q

What are the two forms of small blood vessel disease associated with hypertensive vascular morphology?

A

1) Hyaline arteriolosclerosis 2) Hyperplastic arteriolosclerosis

39
Q

What condition is hyaline arteriolosclerosis associated with?

A

Benign hypertension

40
Q

What is a key characteristic of hyaline arteriolosclerosis?

A

Thickening of arteriolar walls

41
Q

What type of material is found in hyaline arteriolosclerosis?

A

Homogeneous pink hyaline material

42
Q

What happens to the underlying structural details in hyaline arteriolosclerosis?

A

Loss of underlying structural details

43
Q

What happens to the arteriolar lumen in hyaline arteriolosclerosis?

A

Narrowed arteriolar lumen

44
Q

What causes the leakage of plasma proteins in hyaline arteriolosclerosis?

A

Leakage of plasma proteins across the endothelium

45
Q

What happens to extracellular matrix (ECM) synthesis in hyaline arteriolosclerosis?

A

Excessive ECM synthesis

46
Q

Who is more likely to develop hyaline arteriolosclerosis?

A

Elderly & Diabetics

47
Q

What condition is hyperplastic arteriolosclerosis characteristic of?

A

Severe “malignant” hypertension

48
Q

What is a key feature of hyperplastic arteriolosclerosis?

A

Onion skin - concentric and laminated wall thickening

49
Q

What effect does hyperplastic arteriolosclerosis have on the arteriolar lumen?

A

Arteriolar luminal narrowing

50
Q

What do the laminations in hyperplastic arteriolosclerosis indicate?

A

SMC with thickened basement membrane

51
Q

What severe condition is associated with malignant hypertension in hyperplastic arteriolosclerosis?

A

Necrotizing arteriolitis (fibrinoid necrosis)

CVS PATHOLOGY (2 decks)

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