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Medical Pharmacology Exam 3 > Hypertension > Flashcards

Hypertension Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the BP cut off for hypertension?

A

140 / 90

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2
Q

What are the 4 stages of blood pressure culminating with hypertension? What are the cut offs?

A

Normal - less than 120
Prehypertension - 120 -139
Stage 1 - 140 - 159
Stage 2 - 160 and up

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3
Q

What are the 2 types of hypertension? How are they different? Which is more prevalent?

A

Essential hypertension - unknown etiology - 90-95% cases

Secondary hypertension - known cause - 5 - 10 % cases

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4
Q

Tumors in the renal system can cause hypertension. What are 2 ways a tumor in the adrenal cortex can cause hypertension? 2 ways a tumor in the adrenal medulla can cause hypertension?

A

Cortex - hyperaldosteroidism, increased blood volume

Medulla - Pheochromocytoma, increased epinephrine

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5
Q

How can renal artery stenosis cause hypertension?

A

Increased renin release, increased Ang II

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6
Q

What is iatrogenic hypertension?

A

Hypertension caused by medical interventions

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7
Q

Neural control of the blood pressure is also know as the _. This is a [short/long] term mechanism. Sympathetic stimulation goes to _ (3). Parasympathetic stimulation goes to _ (1)

A

Baroreflex
Short term
Heart, vessels, kidney
Heart

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8
Q

What are the 3 contributors to the brain that coordinate the baroreflex?

A

Arterial baroreceptors
Arterial chemoreceptors
Muscle metaboreceptors

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9
Q

What are the 2 brainstem (medulla) regions that mediate the baroreflex?

A

NTS - Nucleus tractus solitarius

RVLM - Rostral ventrolateral medulla

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10
Q

What is the effect of the baroreflex on sympathetic NS activity? on HR, vascular tone and BP?

A

Decreased all of the options

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11
Q

How is the baroreflex thought to be altered in hypertension? (2)

A

Baroreceptor resetting

Labile arterial pressure

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12
Q

Where in the body is angiotensinogen made? Where is pro-renin and renin made? What is the source of ACE? what is another name of ACE?

A

Liver
Kidney
Lungs
Kininase

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13
Q

What enzyme converts kininogen to bradykinin? What enzyme inactivates bradykinin?

A

Kallikrein

Kininase II

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14
Q

What are 2 widely accepted endothelial derived vasodialators? What are their second messenger systems?

A

PGI2 - Adenylyl cyclase and cAMP

Nitric oxide - guanylyl cyclase and cGMP

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15
Q

What is the precursor and the enzyme that form nitric oxide? What about PGI2 (prostacyclin)?

A

L-arginine and nitric oxide synthase

Arachidonic acid and (cyclooxygenase and PGI2 synthase)

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16
Q

What are 3 widely accepted endothelial derived vasoconstrictors? What is their common second messenger?

A

Endothelin1, TXA2 (thromboxane) and Ang II

Calcium

17
Q

What are the 2 receptors for endothelin? What does each mediate?

A

ETa- Constriction

ETb - Dilation

18
Q

What is the precursor for thromboxane?

A

Arachidonic acid

19
Q

What are the 2 factors that determine the contractile function of smooth muscle?

A

Intracellular calcium concentration

Calcium sensitivity of contractile proteins

20
Q

What occurs when the myosin light chain is phosphorylated? When it is dephosphorylated? What enzyme pair mediates this “switch”?

A

Phosphorylated - Contraction
Dephosphorylated - Relaxation
Myosin light chain kinase and phosphotase

21
Q

What is the role of the myosin light chain phosphotase? What enzyme inhibits it? What disease state is this enzyme upregulated in?

A

Phosphatase dephos. myosin light chain, lead to relaxation
Rho-kinase
cardiovascular disease

22
Q

What is the relationship between obesity and hypertension? What is the proposed mechanism (2)?

A

Obese more likely to be hypertensive

  • Insulin mediated sodium retention
  • increased centrally mediated vasoconstriction
23
Q

What are 2 way restricted sodium intake can improve hypertension?

A

Decreases MAP

Increases effectiveness of antihypertensive drugs

Medical Pharmacology Exam 3 (13 decks)

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