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TAS Nephrology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is hypertension defined as in children?

A

A systolic and/or diastolic pressure greater than the 95th percentile for age, gender, and height on at least 3 occasions

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2
Q

What can hypertension be classified into?

A
  • Essential
  • Secondary
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3
Q

What is essential hypertension?

A

When no specific cause can be identified

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4
Q

What are the majority of cases of secondary hypertension caused by?

A
  • Renal parenchymal disease
  • Renovascular disease
  • Coarctation of aorta
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5
Q

What are the less common causes of secondary hypertension?

A
  • Raised ICP
  • Phaeochromocytoma
  • Congenital adrenal hyperplasia
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6
Q

What is the most common presentation of hypertension in children?

A

Incidental finding

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7
Q

What are the symptomatic presentations of hypertension?

A
  • Headache
  • Facial palsy
  • Acute emergency
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8
Q

What are the acute emergency presentations of hypertension?

A
  • Congestive cardiac failure
  • Cerebrovascular accident
  • Hypertensive encephalopathy
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9
Q

What are haemodynamics defined as?

A

Physical factors that govern blood flow

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10
Q

What is blood flow determined by?

A
  • The blood pressure gradient between arterial and venous blood
  • Resistance provided by blood vessel and viscosity of blood
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11
Q

Why is the blood inside arteries and smaller branches always under pressure?

A
  • Constant tension in the walls of the arteries
  • Peripheral resistance
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12
Q

What is meant by peripheral resistance in the context of haemodynamics?

A

The resistance offered to the passage of blood as it passes into smaller and smaller vessels

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13
Q

What provides the tension in the walls of arteries?

A

Muscle and elastic tissue

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14
Q

What happens to the pressure exerted on blood inside arteries when the left ventricle contracts?

A

There is a surge of pressure

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15
Q

What is the result of the surge of pressure produced by the contraction of the left ventricles?

A

It causes the larger arteries to distend and then recoil due to their own elasticity, causing a pulsation

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16
Q

What produces a greater change in arterial pressure during left ventricular contraction?

A

A greater stroke volume

17
Q

What is the aortic pulse pressure?

A

The maximal change in aortic pressure during systole

18
Q

How is the aortic pulse pressure calculated?

A

The systolic minus the diastolic pressure

19
Q

What factors determine the systolic and diastolic blood pressure?

A
  • Cardiac output
  • Total peripheral resistance
20
Q

What factors determine the rise in aortic pressure from diastolic to systolic?

A
  • The compliance of the aorta
  • The ventricular stroke volume
21
Q

Which vessel has the greatest compliance in the arterial system?

A

The aorta

22
Q

Why is the compliance in the aorta important?

A

It dampens down the pulsatile output of the left ventricle - if the aorta were rigid, the pulse pressure would be very high

23
Q

Why is the energy from ventricular contraction not instantly transferred around the circulation after each heartbeat?

A

Because the circulatory system is elastic, and has resistance and other impediments to flow

24
Q

What is the result of the energy from ventricular contraction not being instantly transferred around the circulation?

A

The energy of venous flow is several heartbeats behind that of ventricular ejection

25
Q

What factors is blood pressure determined by?

A
  • Cardiac output
  • Peripheral resistance
26
Q

What is the clinical relevance of BP being determined by cardiac output and peripheral resistance?

A

Clinical disorders that either raise cardiac output or peripheral vascular resistance can raise BP

27
Q

What is cardiac output determined by?

A
  • Stroke volume
  • Heart rate
28
Q

What is the most commonly affected factor leading to an increase in cardiac output?

A

An increase in stroke volume

29
Q

What can cause a rise in stroke volume?

A

Rise in intravascular volume

30
Q

What can cause a rise in intravascular volume?

A

Fluid retention

31
Q

What can cause excessive fluid retention?

A
  • Decreased fluid output
  • Salt retention
32
Q

What can cause decreased fluid output?

A

Oliguric renal failure

33
Q

What can cause salt retention?

A
  • Excessive salt intake
  • Activation of the renin-angiotensin-aldosterone system (RAAS)

TAS Nephrology (16 decks)

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