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Cardiopulmonary pathology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the minimum value of diastole & systole for hypertension?

A

Diastole pressure >= 90mmHg

Systole pressure >= 140 mmHg

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2
Q

Value of diastole & systole for stage II hypertension

A

Diastole Pressure >= 100 mmHg

Systole Pressure >= 160 mmHg

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3
Q

T/F: hypertension is caused by one factor

A

False

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4
Q

Equation to calculate blood pressure?

A

Cardiac output x Total peripheral resistance

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5
Q

What are factors that influence the BP?

A

cardiac output

blood vessel tone - determine TPR

kidney

hormone

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6
Q

What are the factors influence stroke volume, which affect cardiac output?

A

preload - the amount of blood returned to heart

afterload- the resistance force that left ventricle has to overcome to eject blood

the cardiac contractility

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7
Q

What are circulating regulators that increase the TPR?

A

hormone: catecholamine family (epinephrine) & angiotensin II

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8
Q

What systems does the catecholamine (epinephrine) stimulate?

A

HR, SV, venous tone, TPR

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9
Q

How does the kidney regulate BP when BP is high?

T/F: kidney can bring BP down even though TPR/CO is very high

A

by increase Na+ & water excretion

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10
Q

What effects the chronic hypertension have on the kidney function?

A

damage the renal tubules & renin-angiotensin- aldosterone (RAA) system -> reduce the kidney’s ability to excrete sodium

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11
Q

What are the local regulators that inhibit/decrease TPR?

A

NO

endothelin

[H+]

adenosine

oxygen

prostaglandins

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12
Q

What are drugs that increase/decrease TPR?

A

alpha-1 : increase

beta-2: decrease

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13
Q

What are the factors influence the venous return?

A

blood volume & venous tone

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14
Q

What are the factors that increase the blood volume?

A

thirst

Na+ & water renal retention

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15
Q

What are the factors that stimulate sodium & water renal retention?

What are the factors that inhibit sodium & water renal retention?

A

aldosterone, ADH & sympathetic system

natriuretic peptides

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16
Q

Drugs that block the formation of angiotensin II or block aldosterone receptors, _____ blood volume

A

reduce

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17
Q

where is the location of baroreceptors?

What system does baroreceptor activate (parasympathetic/ sympathetic)?

A

aortic & carotid sinuses

Both. stimulate parasympathetic system & inhibit sympathetic system

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18
Q

What happen to baroreceptors for chronic hypertension?

A

desensitized baroreceptor

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19
Q

T/F: baroreceptors respond to the long-term increase in BP

A

False

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20
Q

What

A
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21
Q

Describe the activation pathway of angiotensin II

A

Angiotesinogen increases -> angiotensin I activation & react with ACE in the lung -> angiotensin II ->

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22
Q

What chemical in female that help reducing hypertension?

A

estrogen

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23
Q

What is the other name for ADH?

A

vasopressin or arginine vasopressin

24
Q

Where is the ADH released?

A

hypothalamus (pituitary gland)

25
Q

What are the effects of angiotensin II?

What do all these effects have in common?

A

1) stimulate adrenal cortex -> aldosterone
2) stimulate pituiatary gland -> ADH & thirst
3) vasoconstriction of arterioles
4) stimulate sympathetic nervous system (release of norepinephrine)
5) stimulate kidney
6) stimulate heart contractility & ventricular hypertrophy
- > increase Na+ & water retention -> increase BP

26
Q

essential hypertension

A

the exhibition of BP with no specific physical findings

most common form of hypertension (95% of the case)

27
Q

Aldosterone________Na+ & water retention, ______ water loss in urine, ________ blood volume

A

increase

reduce

increase

28
Q

T/F: Essential hypertension is high concordance in identical twins

T/F: ____________ is higher in African american than other races

A

True

True

29
Q

how does insulin resistance cause hypertension?

A

type 2 diabetes have high blood sugar due to excessive insulin not being taken -> increase SNS tone & increase vascular resistance

30
Q

T/F: Stress can cause abnormal response in BP increase

A

True

31
Q

Why does obesity cause hypertension?

A

increase blood viscosity due to the adipocyte secretion of protein as profibrinogen

increase release of angiotensinogen from adipose tissue

increase blood volume to body mass

high incidence of metabolic syndrome - high triglyceride, low LDL, glucose intolerance

32
Q

What are the primary abnormalities in blood vessel system causing essential hypertension?

A

reduce nitric oxide secretion

increase endothelin production

Ion channels defects

hyperresponsiveness to catecholamine

32
Q

What are the primary abnormalities in kidney system causing essential hypertension?

A

RAA system dysfunction

ion channels defects (Na+/K+/Cl-)

33
Q

T/F: Less than 60% of American over 60 will have essential hypertension

A

False

34
Q

What is the characteristic of essential hypertension in age-systole/diastole relation?

A

Systolic rise with age while diastolic pressure rise and tend to fall slightly after 50

35
Q

In younger hypertensive patients, high BP is driven by _______ CO & _____ TPR.

With increasing age, the effect of CO _______ & TPR_________

A

high & normal

declines & increases

36
Q

What is the cause of renovascular hypertension?

What are the consequences of this disease?

A

stenosis of one or both renal arteries

obstruct the blood flow to kidney -> reduce excretion of Na+ & water and increase renin production

37
Q

How can you detect renovascular hypertension?

A

detecting murmur by stethoscope on spleen, renal arteries or abdominal aorta

38
Q

abdominal bruit

A

the murmur sound heard at renal arteries, spleen or abdominal aorta due to the turbulence as blood squirt through narrowing renal artery

39
Q

coarctation of aorta

what is the consequence of this disease?

A

the narrowing of part of aorta

1) the BP in head, arm & aortic arch is higher than the descending aorta & distal branches
2) the lower flow to kidneys stimulate renin production -> increase Na+ & water reabsorption
3) the baroreceptors in carotid & aortic arch desensitize to high BP

40
Q

pheochromocytoma

Symptoms??

A

tumor of adrenal medulla

increase release of catecholamine (epinephrine) -> intermittent vasoconstriction, tachycardia,

41
Q

what is the cause of Cushing’s syndrome?

T/F: This disease doesn’t cause hypertension

A

glucocorticoid excess

False

42
Q

What are the consequences of hypertension?

A

left ventricular hypertrophy

aneurysm

organ damages (kidney, retina, cerebrovascular, aorta & peripheral vascular)

43
Q

what type of ventricular hypertrophy it is in hypertension?

A
44
Q

aneurysm

What does it can cause?

A

ballon-like swelling in an artery

stroke (in brain or abdominal aorta) when weakened wall burst

45
Q

What are the non-pharmacologic treaments for hypertension?

A

diet (high veggies & low fat + sodium) + potassium supplements

exercise

reduce/quit smoking & alcohol

reduction of stress

46
Q

What are the pharmacological treaments for hypertension?

A

diuretics

beta 2-blocker drug

ACE inhibitors & Angiotensin II receptors blockers

Ca2+ channel blocker

alpha-adrenergic receptors inhibitors

47
Q

What is the effect of diuretics on alleviating hypertension?

A

reduce blood volume -> decrease BP

48
Q

Tumor in adrenal cortex can cause excess _________

A

aldosterone

49
Q

T/F: Thyroid hormone abnormalities can cause hypertension

Renin is always in the blood stream

A

True

True

50
Q

Renin

A

the enzyme that circulating in blood to convert angiotesinogen to angiotensin I

51
Q
A
52
Q
A
53
Q
A
54
Q
A
55
Q
A
56
Q
A

Cardiopulmonary pathology (12 decks)

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