CVS Pathology Flashcards

1
Q

What is the cause of primary hypertension?

A

cause is unknown

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2
Q

What are the non-modifiable risk factors of Primary (essential) hypertension?

A

Positive family history
Ethnicity
Advanced age

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3
Q

What are the modifiable risk factors of Primary (essential) hypertension?

A
Obesity
Diabetes 
Smoking
Excessive alcohol or caffeine intake 
Diet high in sodium 
Physical inactivity 
Psychological stress
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4
Q

What is the cause secondary hypertension?

A
caused by underlying problem LESS common such as:
kidney disease
Certain arterial conditions
Some drugs
Occasionally pregnancy
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5
Q

What are the risk factors for Secondary hypertension?

A

RECENT:
R = Renal (e.g., renal artery stenosis, glomerulonephritis),.

E = Endocrine (e.g., Cushing syndrome, hyperthyroidism, Conn syndrome).

C = Coarctation of aorta.

E = Estrogen (oral contraceptives).

N = Neurologic (raised intracranial pressure, psychostimulants use).

T = Treatment (e.g., glucocorticoids, NSAIDs).

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6
Q

95% of patients diagnosed with hypertension have which type of hypertension?

A

Essential (Primary) Hypertension

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7
Q

When taking a patient’s BP they must be resting for at least?

A

5 minutes

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8
Q

Essential (Primary) Hypertension is best understood by?

A
  1. Over activation of the sympathetic nervous system.

2. Over activation of the angiotensin-aldosterone systems.

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9
Q

Renin secretion is triggered by?

A
  • Reduced renal perfusion pressure.
  • Diminished intravascular volume.
  • Circulating catecholamines.
  • Increased sympathetic nervous system activity.
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10
Q

What medication reduces the effect of antihypertensive drugs?

A

NSAIDs

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11
Q

Since hypertension is often asymptomatic, what is necessary to prevent end-organ damage?

A

Regular screening!

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12
Q

Non-pharmacological measures should be pursued in any patient with a systolic BP and diastolic BP of?

A

systolic BP > 120 mm Hg
or
diastolic BP > 80 mm Hg!

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13
Q

Hypertensive crises are generally defined as?

A

> 180/120 mm Hg. (a severe increase in blood pressure that can lead to a stroke.)

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14
Q

Examples of what a hypertensive crisis can cause (end-organ damage)?

A

Damage to the brain (e.g., encephalopathy, stroke).
Eyes (e.g., retinopathy).
Cardiovascular system (e.g., ACS, pulmonary edema, aortic dissection).
Kidneys (e.g., acute renal failure).

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15
Q

What does hypertensive crisis management consist of?

A

rapidly identifying end-organ damage with patient history, physical examination, and focused testing, and determining whether the rapid lowering of the blood pressure with IV antihypertensives is required.

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16
Q

In the absence of end-organ damage, hypertensive crises should be managed with?

A

rapid follow-up and oral antihypertensives

17
Q

Disclaimer: Reduce BP by max. ______ within the _____ hour to prevent _______________ and to ensure _____________.

A

25% - first hour - coronary insufficiency - adequate cerebral perfusion pressure.

18
Q

Mean arterial pressure should not be lowered by more than 25% within the first hour, except in special cases. Reducing blood pressure too rapidly can lead to?

A

hypoperfusion and ischemia in certain organs

(e.g., brain, kidney, heart). KBH. كبة.

19
Q

What are the eye complications of hypertensive crisis?

A
  1. A-V nicking
  2. Papilledema
  3. retinal hemorrhages
  4. Retinal exudates
  5. Copper/silver wires.
20
Q

What are the effects of Angiotensin II?

A
  1. Systemic vasoconstriction
  2. Sodium and water retention
  3. Stimulation of aldosterone synthase
21
Q

What are the clues of renovascular hypertension?

A
  1. new-onset HTN in very young or >50.
  2. Abdominal bruit on an exam.
  3. Proven Peripheral Artery Disease (PAD).
  4. Abrupt deterioration of renal function after initiation of ACE-I or ARB
22
Q

What is the most common cause of hyperaldosteronism?

A

Adrenal Adenoma (Conn’s syndrome)