Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Fundamentals Exam 3 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

what is Normal BP range?

A

Systolic under 120 Diastolic under 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what range is considered elevated BP?

A

Systolic 120-129 Diastolic <80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what range is considered Stage 1 Hypertension?

A

Systolic 130-139 Diastolic 80-89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what range is considered Stage 2 Hypertension?

A

Systolic 140 and over Diastolic 90 and over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what range is considered a hypertensive crisis?

A

Systolic over 180 and diastolic over 120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is primary/essential hypertension?

A

Hypertension that we do not know the specific cause of, however it is usually correlated to lifestyle factors and genetics. 90-95% of all adults diagnosed with HTN have primary hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is secondary hypertension?

A

Hypertension where we can pinpoint the cause. Some causes are chronic kidney disease, polycystic kidney disease , renal artery stenosis. There are also endocrine causes such as Cushing’s disease, hyperaldosteronism, hyperparathyroidism, and pheochromocytoma. 5-10% of adults diagnoses with HTN fall within this category.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does NSAIDs increase BP?

A

By retaining salt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why does NSAIDs constrict the efferent arterioles?

A

Because they break down prostaglandin which is a vasodilator. The vasoconstriction will activate the RAAS which will increase BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what part of the body produces nitric oxide?

A

The endothelium cells which is the inner lining of the blood vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is nitric oxide?

A

A vasodilator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to the blood vessels when a person is sufferings from HTN?

A

The inner lining gets damaged over time and plague or cholesterol builds up which makes the vessel narrow. Also damaged endothelium will no longer produce nitric oxide which is a vasodilator and the vessels will vasoconstrict.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does Cushing’s disease increase BP?

A

increases cortisol, glucocorticoids and mineralocorticoids (stress). Constant alarm stage which becomes chronic stress and BP will increase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does Hyperparathyroidism increase BP?

A

Calcium – takes calcium from bone and increases levels of calcium in blood. Calcium affects the muscles by contracting them. Which will increase BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does Hypoparathyroidism increase BP?

A

Patients with Hypoparathyroidism often struggle with lethargy, and are not using the sugar and fats through diet for energy, there will be increase in cholesterol which will increase BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does Prostate disease cuase increased BP?

A

Due to urinary retention and therefore increase in BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What other diseases/conditions may prolonged hypertension lead to?

A

Inflammation in the endothelium which causes atherosclerotic disease which may contribute to an MI, Cerebrovascular accident and kidney disease due to narrowing of vessels.
Damaged endothelium walls makes it easier for cholesterol to attach to the walls which makes the blood vessels more narrow. This may cause chest pain, angina, MI, cerebrovascular accident (stroke), blindness may happen due to damaged blood vessels in the eyes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

For older adults what is the target blood pressure?

A

Less than 130 over 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why do we want to start low and go slow when it comes to giving older adult antihypertensive medications?

A

Because they are at greater risk of orthostatic hypotension whihc may increase the risk of falls. It is harder for older adults to adapt to a change in BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In terms of blood vessels what increases BP?

A

BP rises due to increased vascular resistance (blood vessel constriction) and elevated cardiac output (blood volume pumped).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How come increase in sympathetic nervous system activity increases BP?

A

Because epinephrine released by the SNS increases BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does insulin resistance increase BP?

A

Insulin resistance raises BP as glucose remains in the bloodstream, leading to vessel inflammation and damage.
This damage encourages cholesterol buildup and platelet aggregation, narrowing the vessel lumen and restricting oxygenated blood flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does immune system activation increase BP?

A

Inflammatory processes activate the immune system, placing the body under constant stress, which in turn increases BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is advancing age a risk factor for HTN?

A

Decreased elasticity of the vessels. Heart has to pump harder. there are also co-morbidities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is Isolated Systolic Hypertension?
Arterial stiffness raises systolic BP, potentially leading to endothelial damage and atherosclerosis, which in turn increases the risk of aortic aneurysm. High systolic BP also increases the heart’s workload, potentially causing left ventricular hypertrophy (heart muscle enlargement with reduced ventricular space). Decreased cardiac output may reduce oxygen supply to the kidneys, leading to renal insufficiency and triggering the RAAS (renin-angiotensin-aldosterone system
26
What are some Special Considerations for Those Over 60 Who's Already Suffered From A Heart Attack?
For individuals over 60 who have had a stroke, the target systolic BP is less than 140 mmHg to reduce the risk of a recurrent stroke. Older adults commonly have multiple comorbidities, such as heart or kidney disease, and a lower life expectancy.
27
Why may ethnicity be a risk factor for HTN?
African Americas are genetically predisposed to to a gene (sometimes referred to as the "thrifty gene" or "starvation gene") which may lead to a greater tendency to retain salt, increasing hypertension risk compared to other ethnic groups, such as Caucasians
28
Why may kidney disease cause HTN?
With kidney problems the body struggles to regulate BP effectively due to impaired RAAS (renin-angiotensin-aldosterone system) function.
29
Why may alcohol increase the risk of HTN?
Drinking more than two drinks per day for men and one for women increases inflammation and the risk of hypertension.
30
What are genetic risk factors for HTN?
Genetic factors, gender, and age play a role in hypertension risk, with men over 64 and post-menopausal women (65+) at equal risk.
31
How is obesity a risk factor for HTN?
Obesity, often linked to metabolic syndrome, increases the risk of hypertension, hyperlipidemia, diabetes, and hypercholesterolemia.
32
How is hypercholesterolemia a risk factor for HTN?
High cholesterol levels can damage blood vessels, contributing to hypertension.
33
In what ways does a poor diet increase the risk of HTN?
High salt intake, processed foods, and low fruit and vegetable consumption can raise BP. Potassium (from vegetables) dilates blood vessels, while sodium constricts them. Insoluble Fiber (from fruits and vegetables) supports bowel health and gut microbiome balance, promoting beneficial short-chain fatty acids. Soluble Fiber helps reduce bad cholesterol.
34
How does an sedentary lifestyle increase the risk of HTN?
Lack of exercise lowers nitric oxide levels, reducing blood vessel dilation.
35
How does smoking increase the risk of HTN?
Smoking leads to vasoconstriction and inflammation, increasing BP.
36
How does stress increase the risk of HTN?
Raises cortisol and activates sympathetic nervous responses, which can elevate BP.
37
What does potassium do to the blood vessels?
Relaxes them.
38
What does sodium do to the blood vessels?
Contract them.
39
what is the first thing we do to treat HTN?
Lifestyle changes.
40
How do we confirm if someone is suffering from HTN?
Accurate BP measurement is essential for HTN diagnosis, requiring two separate visits to confirm. If BP is elevated, at Stage 1 or Stage 2 HTN, lifestyle changes should be initiated before reassessment. If BP remains elevated on the second visit, medication is prescribed alongside continued lifestyle changes. However, if BP is more than 160 systolic or over 100 diastolic, then immediate medication may be necessary without waiting for a follow-up visit.
41
What is the most accurate way to measure BP?
Ambulatory BP Monitoring is more accurate than office measurements, as BP tends to be lower at rest
42
How do we assess if HTN is primary or secondary?
by examining the cardiovascular system
43
What does a bruit in the carotid artery suggest?
Presence of a bruit suggests narrowed vessels, increasing stroke risk.
44
What does Jugular vein distension suggest?
Distended veins may indicate heart remodeling and poor cardiac output, potentially leading to heart failure and fluid retention. the reason for the distended vein will be the fluid retention.
45
Why should we auscultate the apical pulse when attempting to diagnose HTN?
Bounding impulse with an S4 sound may indicate left ventricular hypertrophy and diastolic dysfunction, progressing to systolic dysfunction.
46
What may protein in the urine indicate?
Protein in urine, particularly macroalbuminuria, should not be present. Protein may indicate kidney damage due to HTN.
47
What is the CO2 in the Basic Metabolic Panel ?
Bicarb. In the case with an Arterial Blood Gas the CO2 is carbon dioxide.
48
What are 3 diagnostic tests that we use to determine the causes of HTN?
Urinalysis Basic Metabolic Panel Heart Failure and MI Markers
49
By assessing the apical pulse, how can this tell us if there is hypertrophy of the heat?
The apical pulse should eb auscultated at the 5th intercostal, however if the apical pulse is in the 6th intercostal then that is a sign of an enlarged heart.
50
What should the BUN to Creatinine ratio be ideally?
10-20 to 1
51
What does a A high BUN/creatinine ratio suggests ?
Dehydration. This would eb a pre renal issue. The kidneys have not been damaged yet and we should administer fluid to the patient and hold any diuretics to prevent kidney damage.
52
What would a low BUN/creatinine ratio suggests ?
a low ratio may indicate intrinsic kidney damage (intra-renal issue).
53
What would high troponin levels indicate?
That the patient has had a myocardial infarction as troponin is released by the cardiac cells during a myocardial infarction.
54
What does BNP indicate?
It is the lab specific for heart failure.
55
What does a high QRS complex indicate?
ventricular hypertrophy, which indicates increased heart workload and ventricular contraction.
56
What does low creatinine in the urine indicate?
Problems with the kidneys. Creatinine is a wase product and should be excreted, if it is low in the urine it means that it is not bein excreted properly. If we did a blood test, the creatinine would be high since its not excreted it is being reabsorbed into the blood.
57
What level do we want the lipid profile ration to be at?
4.5. If it is higher it may indicate increase risk for CV disease.
58
What is the daily recommendation for sodium?
No more than 2000mg per day /1 tsp
59
Describe hypertensive crisis : urgency
Urgency: Elevated BP without evidence of target organ damage. Symptoms may include double vision or transient ischemic attacks (TIA), but no immediate organ injury. Treatment: Rapid-acting oral antihypertensives are administered. Assessment: Verify medication compliance and history.
60
Describe hypertensive crisis : emergency
Elevated BP with evidence of target organ damage, such as kidney impairment or stroke. Treatment: IV antihypertensives to lower BP safely. Monitoring: BP should not be reduced more than 25% within the first hour. After 6 hours, the target BP is 160/100 mmHg, with further gradual reduction over 1-2 days. Caution: Reducing BP too quickly can compromise blood flow to organs that have adapted to higher BP levels, potentially causing organ injury due to sudden low perfusion.

Fundamentals Exam 3 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions