functional vascular disorders

Question 1

what is raynauds phenomena?

Answer 1

intermittent ischemia of the fingers and toes, nose and ears

Question 2

in raynauds, finger and toes and nose and ears will have what color change?

Answer 2

white, blue, red

Question 3

what is the difference between raynaud’s phenomena and disease?

Answer 3

phenomena =

• happens in young women
• idiopathic
• exaggerated response to emotion or cold by vasoconstriction

disease =

• secondary to: scleroderma, CREST, SLE, buerguer’s disease, cryoglobulinemia, ergot poisoning
• triggered by cold/stress

Question 4

what is normal BP?

pre-hypertension?

hypertension 1?

hypertension 2?

Answer 4

120/80 or less

120-139/80-89

140-159/90-99

160/100 or more

Question 5

how many times do you need to take the BP to diagnose hypertension?

Hypertension will predispose for what 5 conditions?

Answer 5

3 times

1. stroke
2. renal failure
3. aortic dissection
4. coronary heart disease (MI)
5. cardiac hypertrophy (heart Failure)

Question 6

how do you measure BP?

how does angiotensin 2 increse BP?

Answer 6

BP = CO x TPR

retains Na+ which leads to retention of water

causes vasoconstriction

Question 7

what are the roles of Sodium in Hypertension?

Answer 7

1) Na retention increases plasma volume so it increases systolic volume = increase in CO which increases systolic BP

2) excess Na enters smooth muscle cells or arterioles causing Ca2+ channels to open and leading to contraction = increase in TPR

Question 8

what are the 2 types of Hypertension?

Answer 8

Essential and Secondary HTN

Question 9

what causes lead to secondar hypertension?

Answer 9

1. renovascular hypertension by renal artery stenosis
2. glomerulonephritis
3. Conn’s disease or Cushings, pheochromocytoma
4. grave’s disease
5. coarctation of the aorta

Question 10

what causes renovascular disease in elderly?

what causes renovascular disease in young women?

Answer 10

atherosclerosis

fibromuscular hyperplasia of renal artery

Question 11

what are the clinical findings of renovascular hypertension?

Answer 11

uncontrollable hypertension

involved kidney is smaller in size

involved kidney has increased renin in renal vein

Question 12

what are the complications of both types of hypertension?

Answer 12

1. concentric left ventricular hypertrophy
2. stroke
3. nephrosclerosis due to hyaline arteriolosclerosis
4. HTensive retinopathy (papilledema)

Question 13

What BP reading is considered malignant hypertension?

what complications does it bring?

Answer 13

240/100

renal failure, retinal hemorrhage, papilledema