Hypertension Flashcards
What constitutes hypertension in terms of blood pressure readings?
A sustained diastolic pressure greater than 90 mm Hg or a sustained systolic pressure in excess of 140 mm Hg constitutes hypertension.
Which is more important in determining cardiovascular risk: systolic or diastolic blood pressure?
Systolic blood pressure is more important than diastolic blood pressure in determining cardiovascular risk.
List some guidelines in ensuring accurate blood pressure measurement.
🩺 The equipment should be regularly inspected and validated.
🩺 The operator should be trained and regularly retrained.
🩺 The patient must be properly prepared and positioned and seated quietly for at least 5 minutes in a chair.
🩺 The auscultatory method should be used.
🩺 Caffeine, exercise, and smoking should be avoided for at least 30 minutes before BP measurement.
🩺 An appropriately sized cuff should be used.
____(a)____ of individuals in the general population are hypertensive.
The prevalence and vulnerability to complications increase with ____(b)____.
(a) 25%
(b) age
Blood pressure is a complex trait involving the interaction of multiple genetic and environmental factors that influence two hemodynamic variables: ________.
(1) cardiac output
(2) peripheral vascular resistance
“Cardiac output is affected by blood volume which is strongly dependent on ____(a)____ concentrations.”
“Peripheral resistance is regulated predominantly at the level of the ____(b)____ and is influenced by neural and hormonal inputs.”
(a) sodium
(b) arterioles
site of production and action of atrial natriuretic peptide
Atrial natriuretic peptide (ANP) is a hormone produced by the heart’s atrial myocytes.
It promotes excretion of sodium (natriuresis) and water (diuresis) by the kidneys, reducing blood volume and pressure.
Briefly discuss the pathogenesis of hypertension.
🩺 Approximately 90% to 95% of hypertension cases are classified as essential hypertension, also known as idiopathic hypertension.
🩺 The remaining 5% to 10% of hypertension cases are classified as secondary hypertension. Secondary hypertension results from an identifiable underlying condition, such as kidney disease, endocrine disorders, or the use of certain medications.
About 1 - 5% of hypertensive persons show a rapidly rising blood pressure that if untreated leads to death within 1 or 2 years. This is termed ________ hypertension.
accelerated/malignant
Briefly outline clinical presentations of malignant hypertension.
◾ very high blood pressure with diastolic pressure over 120mmHg
◾ hypertensive retinopathy: bilateral retinal hemorrhages and/or exudates, with our without papilledema [swelling of the optic disk due to increased intracranial prssure]
◾ cardiac symptoms: chest pain, dyspnea, and signs of left ventricular hypertrophy or dilated cardiomyopathy
renal failure
◾ neurological symptoms: occipital headache, visual disturbacnes, cerebral infarction or hemorrhage, hypertensive encephalophathy
list renal causes of secondary hypertension
◾ Acute glomerulonephritis
◾ Chronic renal disease
◾ Polycystic disease
◾ Renal artery stenosis
◾ Renal vasculitis
◾ Renin-producing tumors
list endocrine causes of hypertension
◾ Adrenocortical hyperfunction/tumour (Cushing, Conn)
◾ Exogenous glucocorticoids
◾ Pheochromocytoma
◾ Acromegaly
◾ Hyperthyroidism
◾ Pregnancy-induced
list cardiovascular causes of hypertension
◾ Coarctation of aorta
◾ Polyarteritis nodosa
◾ lncreased intravascular volume
◾ lncreased cardiac output
◾ Rigidity of the aorta
list neurologic causes of hypertension
◾ Psychogenic causes
◾ lncreased intracranial pressure
◾ Sleep apnea
◾ Acute stress, including surgery
State the parameters that define Grade I hypertension.
Systolic BP: 140 - 159 mm Hg
Diastolic BP: 90 - 99 mm Hg
State the parameters that define Grade II hypertension.
Systolic BP: 160 - 179 mm Hg
Diastolic BP: 100 - 109 mm Hg
State the parameters that define Grade II hypertension.
Systolic BP: ≥ 180 mm Hg
Diastolic BP: ≥ 110 mm Hg
What is the primary defect in essential hypertension?
(a) hyperthyroidism
(b) acute stress
(c) increased production of catecholamines
(d) renal retention of excess sodium
(e) renal failure
(d) renal retention of excess sodium
Which of the following is a feature of malignant hypertension in arterioles?
(a) Atherosclerosis
(b) Aneurysm
(c) Arteriolosclerosis
(d) Fibrinoid necrosis
(e) Dissection
(d) Fibrinoid necrosis
The following are features of malignant hypertension except ________.
(a) severe hypertension
(b) cerebrovascular accident
(c) renal failure
(d) papilledema
(e) retinal hemorrhages
(b) cerebrovascular accident
Which of the following is an endocrine cause of secondary hypertension?
(a) Polyarteritis nodosa
(b) Renal artery stenosis
(c) Acute stress
(d) Congenital adrenal hyperplasia
(e) Coarctation of the aorta
(d) Congenital adrenal hyperplasia
Which of the following is not a cause of secondary hypertension?:
(a) Polyarteritis nodosa
(b) Coarctation of the aorta
(c) Rigidity of the aorta
(d) Congenital adrenal hyperplasia
(e) High salt intake
(e) High salt intake
Hypertension is a risk factor for all of the following except ________.
(a) heart failure
(b) aortic dissection
(c) cerebrovascular accidents
(d) coronary artery disease
(e) extradural hematoma
(e) extradural hematoma
What is the primary defect in essential hypertension?
(a) Hyperthroidism
(b) Renal retention of excess sodium
(c) Increased production of catecholamines
(d) Renal failure
(e) Acute stress
(b) Renal retention of excess sodium
Feature of benign hypertension
(a) Papilledema
(b) Diastolic blood pressure above 120 mm Hg
(c) Fibrinoid necrosis
(d) Atherosclerosis
(e) Retinal haemorrhages
(d) Atherosclerosis
Endocrine cause of secondary hypertension
(a) Rigidity of the aorta
(b) Acromegaly
(c) Coarctation of the aorta
(d) High salt intake
(e) Polyarteritis nodosa
(b) Acromegaly
Feature of malignant hypertension in the arterioles
(a) Dissection
(b) Atherosclerosis
(c) Aneurysm
(d) Hyperplastic arteriolosclerosis
(e) Arteriolosclerosis
(d) Hyperplastic arteriolosclerosis
Which of the following is a risk factor for the development of primary hypertension?
(a) Acute stress
(b) High salt diet
(c) Coarctation of the aorta
(d) Polyarteritis nodosa
(e) Congenital adrenal hyperplasia
(b) High salt diet
Hypertension is a risk factor for
(a) Extradural hematoma
(b) Intracerebral hemorrhage
(c) Dilated cardiomyopathy
(d) Acute subdural hematoma
(e) Thrombophlebitis
(b) Intracerebral hemorrhage
Which of the following is a vascular change occurring as a result of malignant hypertension?
(a) fibrinoid necrosis
(b) hyaline arteriosclerosis
(c) vascular dilatation
(d) angiogenesis
(e) fibroblastic proliferation
(a) fibrinoid necrosis
Use of thiazide diuretics in the treatment of hypertension may lead to the following except ________.
(a) hyperuricaemia
(b) hypercalcemia
(c) hyponatremia
(d) hyperkalemia
(e) hyperglycemia
(d) hyperkalemia
Which of the following is true regarding malignant hypertension?
(a) 75% recover with no loss of renal function
(b) is associated with abnormal renin levels
(c) is more common compared to benign hypertension
(d) affects 1 - 5% of hypertensive patients
(e) has an insidious onset
(d) affects 1 - 5% of hypertensive patients
Which of the following is not associated with essential hypertension?
(a) smoking
(b) stress
(c) obesity
(d) heavy salt consumption
(e) being resident in Africa
(e) being resident in Africa
Which of the following is a cause of Surgically Treatable Hypertension?
(a) Diabetes Mellitus
(b) IgA Nephritis
(c) Fibromuscular dysplasia of renal artery
(d) SLE Nephritis
(e) Goodpasture Syndrome
(c) Fibromuscular dysplasia of renal artery
Which of the following is (are) a feature of Malignant Hypertension?
(a) Hyperplastic Arteriosclerosis
(b) Crescent Formation
(c) Fibrinoid Necrosis
(d) A & B
(e) A & C
(e) A & C
