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PATHO I > HTN and Arteriosclerosis > Flashcards

HTN and Arteriosclerosis Flashcards

1
Q

Normal BP is considered:

A
  • Systolic < 120 mmHg
  • Diastolic < 80 mmHg
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2
Q

USPSTF recommends all individuals be screen for HTN at what age?

A

≥18 yo

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3
Q

Malignant HTN (> 200/120 mmHg) will lead to death within how long?

A

1-2 years

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4
Q

How many people with uncontrolled HTN will die due to stroke?

A

1/3

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5
Q

How many with uncontrolled HTN will die due to IHD or CHD?

A

50%

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6
Q

Angiotensin II is a powerful BLANK

A

vasoconstrictor

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7
Q

Angiotensin II is a powerful vasoconstrictor that stimulates the release of BLANK

A

Aldosterone –> increased blood volume and blood pressure

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8
Q

The pulmonary and renal endothelium release ACE which functions to do what?

A

Converts angiotensin I to angiotensin II

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9
Q

What does the liver secrete to facilitate RAAS?

A

Angiotensinogen

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10
Q

What results in the transformation of angiotensinogen to angiotensin I?

A

Renin

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11
Q

What are the important effects of angiotensin II resulting in an increase in BP?

A
  • SANS activity
  • Tubular NaCl reabsorption & H2O retention
  • Adrenal gland stimulation to secrete aldosterone (leads to the above)
  • Arteriolar vasoconstriction
  • Pituitary gland stimulation leading to ADH secretion increasing H2O retention
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12
Q

H2O and Na retention stimulate which cells for negative feedback on the RAAS?

A

Juxtaglomerular cells

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13
Q

Primary HTN occurs in what percentage of cases?

A

95%

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14
Q

What characteristic of arteries is changed during aging that enhances risk for HTN development?

A

Increased stiffness and less compliance due to a decrease in elasticity

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15
Q

What are the disorders (categories) of secondary HTN?

A

ABCDEF
* Aldosterone
* Bad kidneys
* Catecholamines, coarctation of aorta, Cushing’s syndrome
* Drugs: methamphetamines, cocaine, NSAIDs, corticosteroids, oral contraceptives (high doses of estrogens)
* Erythropoietin & Endocrine disorders (hypothyroidism, hyperthyroidism, hyperparathyroidism)
* Food

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16
Q

What is the function of aldosterone? How can it increase the risk of secondary HTN?

A
  • Na reabsorption from tubular urine back into bloodstream
  • Increased blood volume increases BP
  • K secretion into tubule

Idiopathic hyperaldosteronism or adenoma

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17
Q

What can cause HTN with hypokalemia?

A

Hyperaldosteronism

18
Q

What is renovascular HTN?

A

HTN resulting from compromised arterial supply to the kidneys
* Decrease in stretch of juxtaglomerular apparatus leading to release of renin

19
Q

Fibromuscular dysplasia (FMD) occurs most commonly in which gender?

A

females (90%)

20
Q

Fibromuscular dysplasia (FMD) has multiple areas displaying what?

A

Stenosis then dilation (string of beads)

21
Q

T/F: Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic process that most commonly involves the renal arteries

A

True, renal arteries (75-80%) of time

22
Q

How often are extracranial cerebrovascular arteries involved in fibromuscular dysplasia (FMD)?

A

75% of time

23
Q

Hyperplasia of what structures leads to lumenal stenosis in fibromuscular dysplasia (FMD)?

A
  • Tunica media
  • Tunica intima
24
Q

What are the (4) Ps of HTN-associated arteriosclerosis?

A
  • Pink (hyaline deposition)
  • Plasma proteins
  • Pressure (HTN) & DM
  • Pinpoint lumen or Packed lumen
25
Q

What is the pathogenesis of HTN-associated arteriosclerosis?

A
  • Leakage of plasma components across injured endothelial cells into vessel wall
  • Increased ECM due to smooth muscle stimulation
  • lumenal narrowing
26
Q

An onion skin appearance of vessels is noted in what type of arteriosclerosis?

A

Hyperplastic ateriosclerosis (HTN associated)

27
Q

Malignant HTN is associated with what type of necrosis?

A

Fibrinoid necrosis

28
Q

What is hyaline arteriosclerosis?

A

A form of arterial thickening and hardening as a result of hypertension

29
Q

What happens to the LV due to HTN?

A

Concentric LV hypertrophy

30
Q

How does HTN lead to nephrosclerosis?

A
  • Benign: hyaline deposition leading to media and intima thickening and narrowed lumen
  • Results in ischemia and atrophy
  • Renal function maintained
  • Malignant: Fibrinoid necrosis and hyperplastic arteriosclerosis
  • Renal function is not maintained
31
Q

Papilledema is a sign of which type of HTN retinopathy?

A

Severe

32
Q

Cotton-wool spots is a sign of what type of HTN retinopathy?

A

Moderate

33
Q

Arteriovenous nicking is a sign of what type of HTN retinopathy?

A

Mild

34
Q

Aortic dissection occurs when?

A

Blood separates the tunica media

35
Q

What are some predisposing factors to aortic dissection?

A
  • HTN, M, 40-60 yo (90%)
  • Marfan syndrome or Ehlers Danlos
  • Trauma
  • Vasculitis
  • Use of cocaine
  • intima tear
36
Q

Where does a Type A aortic dissection take place?

A

Affects ascending aorta

37
Q

Where does a type B aortic dissection take place?

A

Begins beyond the subclavian artery

38
Q

Pain from aortic dissection can radiate to?

A

Back

39
Q

How do calcium salts appear on H&E?

A

Dark blue

40
Q

T/F: In Monckeberg medial calcific sclerosis the lumen is significantly narrowed

A

False

PATHO I (8 decks)

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