HTN/Atherosclerosis

Question 1

Arteriosclerosis

Answer 1

thick, harder less elastic artery

Question 2

Arteriolosclerosis

Answer 2

Hardening/damage to the small arterioles - usually caused by HTN, DM, advancing age. microvascular disease

Question 3

Atherosclerosis

Answer 3

Hardening of arteries due to plaque deposits. macrovascular disease

Question 4

Risk factors of atherosclerosis

Answer 4

HTN, hyperglycemia, high cholesterol (LDL), smoking, advanced age, male, postmenopausal female, fam history, stress, diet

Question 5

Complications of atherosclerosis

Answer 5

leads to weakened vessel walls

• dissection: separation or tear of layers of the vessel
• aneurysms: ballooon-like bulge
• narrowed arteries lead to reduced bld flow, lead to kidney disease, and kidneys will compensate by activating raas b/c thinks BP is low
• plaque rupture: fibrous cap cracks and exposes foam to blood, leads to clot, risk of embolism

Question 6

Tx atherosclerosis

Answer 6

prevention

Question 7

Prevention atherosclerosis

Answer 7

treat co-morbidities (HT, Diabetes), lipid control, lifestyle changes

Question 8

Complications of vascular disease

Answer 8

chronic illness, acute limb ischemia

Question 9

Lipid panel

Answer 9

total cholesterol - estimate of all in bld <200
LDL - bad <150
HDL - protects against heart disease >40/50
triglycerides - another type of fat <100

Question 10

CAD - coronary artery disease

Answer 10

buildup of plaque in arteries that supply bld to the heart

Question 11

Hyaline vs hyperplastic ateriolosclerosis

Answer 11

hyaline - high pressure blood flow from HTN causes proteins to leak into vessel wall - buildup narrows opening

hyperplastic - thickening of bld vessel walls from HTN (add more layers of muscle to make them stronger –> narrowing)

Question 12

chronic peripheral arterial disease

Answer 12

I: asymptomatic (may have bruit, decreased pulses)
II: claudication (pain with exercise)
III: pain with rest (usually in toes, foot)
IV: necrosis/gangrene

Question 13

signs of peripheral arterial disease

Answer 13

weak/absent pulses, temp differences in lower extemities, slow cap refill, bruit, loss of hair on lower calf/ankle/foot, thick toenails, dry/pale/mottled skin, cyanosis

Question 14

angioplasty

Answer 14

open blocked artery with a balloon followed by placement of a stent

Question 15

six Ps of ischemia

Answer 15

pain
pallor
pulselessness
paresthesia
paralysis
poikilothermy (coolness)

Question 16

Primary HTN

Answer 16

developed over time - from lifestyle, genetics, stress, aging

Question 17

HTN categories

Answer 17

normal - <120/80
elevated - 120-129/<80
HTN 1 - 130-139 OR 80-89
HTN 2 - 140 or higher OR 90 or higher
hypertensive crisis - >180 and/or >120

Question 18

risks for HTN

Answer 18

Modifiable: diet, obesity, inactivity, smoking, hyperlipidemia, diabetes
Non-modifiable: genetic, family hx, african american, age, male

Question 19

HTN management (non pharm)

Answer 19

monitor BP, diet (DASH, low salt), exercise, weight loss, alcohol reduction (1-2drinks), stop smoking, reduce stress

Question 20

HTN management (pharm)

Answer 20

1st line - reduce fluid volume to decrease SV: diuretics

• Inhibit neural side of BP: alpha or beta blockers
• inhibit hormonal side: renin blocker, ACEi, ARB, aldosterone antagonists
• act on vessels directly to prevent vasoconstriction and decrease SVR: calcium channel blockers

Question 21

TX hypertensive crisis

Answer 21

lower BP slowly
arterial line gives continuous BP
IV antihypertensives

Question 22

HTN complications

Answer 22

arteriosclerosis, PVD, aneurysms, hypertensive retinopathy, stroke, CKD, CAD

Question 23

signs of HTN

Answer 23

headache, facial flushing, dizziness, fainting

Question 24

proper BP technique

Answer 24

take in both arms
2 or more readings each visit
appropriate cuff
stay still, avoid smoking,caffeine or exercise within 30 min before

Question 25

proper BP technique

Answer 25

take in both arms
2 or more readings each visit
appropriate cuff
stay still, avoid smoking, caffeine or exercise within 30 min before

Question 26

Signs of hypertensive crisis

Answer 26

headache, SOB, epistaxis, heart palpitations, anxiety, nausea, lightheadedness

Question 27

DASH diet

Answer 27

fruits and veg, low fat dairy, whole grains, low meat, low sweets