Hypertension

Question 1

What are the parameters for prehypertension?

Answer 1

120-139 systolic

or

80-89 diastolic

Question 2

What are the parameters for stage I hypertension?

Answer 2

140-159 systolic

or

90-99 diastolic

*** 150 or greater for people >= 60 years old

Question 3

What are the parameters for stage II hypertension?

Answer 3

>= 160 systolic

or

>= 100 diastolic

Question 4

What physiological properties does blood pressure measure?

Answer 4

cardiac output, intravascular volume, peripheral vascular resistance

Question 5

effects of the renin-angiotension system

Answer 5

hypertension/hypovolemia -> decreased blood flow -> decreased afferent arteriole stretch -> renin release

decreased delivery of renal blood flow to macula densa

sympathetic stimulation

Question 6

anatomy of the juxtaglomerular apparatus

Answer 6

cells in the wall of the afferent arteriole secrete reinin into the lumen of the arteriole as well as the renal lymph in response to its stretch receptors

Question 7

effects of angiotensin II

Answer 7

sympathetic activation

smooth muscle vasoconstriction

decreased bradykinin

Na/H2O reduction via aldosterone

Question 8

aldosterone

Answer 8

produced by the zona glomerulosa of the adrenal cortex

acts in the distal nephrone to cause Na+ absorption and K+ and H+ excretion

Question 9

renal sympathetic nerve activity

Answer 9

increases renal vascular resistance

increases sodium reabsorption

promotes renin release (JGA)

Question 10

ADH

Answer 10

antidiuretic hormone - arginine vasopressin

stimulates mainly water, some sodium resorption

current antagonists have minimal anti-hypertensive effect (used to treat hyponatrimia)

Question 11

ANP

Answer 11

atrial natriuretic peptide

promotes sodium excretion, increases GFR and blod flow to the kidney, decreases renin release

ANP analogues have not been effective for hypertension treatment

Question 12

renal effects of increased sympathetic tone

Answer 12

increased renin secretion

increased angiotensin II

increased aldosterone

increased sodium reabsorption

increased EABV/ECV

incresaed cardiac output

Question 13

alpha1 receptor effects

Answer 13

vasoconstriction

Question 14

alpha2 receptor effects

Answer 14

inhibits cAMP

decreases norepi release

Question 15

primary hypertension

Answer 15

high blood pressure due to genetic and environmental factors

also called essential hypertension

caused by genetic and environmental factors that have not been completely elucidated

accounts for 95% of chronic hypertension

Question 16

secondary hypertension

Answer 16

hypertension caused by a specific pathophysiologic process

accoutns for less than 5% of all hypertension

Question 17

primary causes of secondary hypertension

Answer 17

renal artery stenosis

hyper aldosteronism

hyperthyroidism

pheochromocytoma

medications that can riase blood pressure

Question 18

masked hypertension

Answer 18

an individual has normal blood pressure in the clinic but an elevate blood pressure at home

Question 19

main mechanisms by which blood pressure is maintained

Answer 19

volume regulation

vascular tone

cardiac output

Question 20

signs of hyperaldosteronism

Answer 20

low renin

high aldosteron

Question 21

11-beta-HSD-type 2

Answer 21

converts cortisol to cortisone

inhibited by licorisce (glycryyhetinic acid)

Question 22

Liddle’s Syndrome

Answer 22

rare dises - causes low renin and low aldosterone