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CVPR: Renal (Exam 4) > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the arbitrary definition of prehypertension?

A
  • SBP 120-139
  • DBP 80-89
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2
Q

What does fibromuscular dysplasia cause in young, female pts?

A

renal artery stenosis

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3
Q

Name 7 environmental factors that contribute to essential HTN.

A
  • high dietary Na intake
  • excess caloric intake
  • EtOH
  • stress
  • sedentary lifestyle
  • smoking
  • low K+ or Ca++ intake
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4
Q

What is the prognosis for untreated malignant HTN?

A

renal failure in less than 1 year

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5
Q

What is the major determinant of ECF volume?

A

total Na content

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6
Q

What is renovascular HTN?

A

abnormal signal to release renin

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7
Q

What is non-malignant HTN?

A

HTN in the absence of hypertensive neuroretinopathy

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7
Q

What are the fundoscopic findings that indicate HTN-induced arteriolitis?

A
  • flame shaped (striate) hemorrhages
  • cotton wool spots (soft exudates)
  • papilledema
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8
Q

What is the long term physiologic effect of a diuretic?

A

decreased peripheral vascular resistance (PVR)

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8
Q

What is secondary hyperaldosteronism?

A

increased renin secretion

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9
Q

What is naturesis?

A

renal Na excretion

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10
Q

What causes renal artery stenosis in older pts, esp male smokers?

A

atherosclerosis

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10
Q

Maligant HTN is characterized by necrotizing arteriolitis in the _____, _____, _____, and _____.

A

kidneys, retinas, heart, and CNS

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11
Q

What lifestyle modifications can reduce BP?

A
  • weight reduction
  • DASH diet
  • dietary Na+ reduction
  • physical activity
  • moderation of EtOH
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12
Q

What is the arbitrary definition of HTN?

A
  • SBP>140
  • DBP>90
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12
Q

What is pheochromocytoma?

A

a benign tumor of the adrenal medulla causing excess catecholamines

14
Q

Name some various factors contributing to secondary HTN.

A
  • Cushings/Chronic steroid therapy
  • pheochromocytoma
  • 1a hyperaldosteronism
  • coarctation of the aorta
  • sleep apnea
  • drug induced
  • thyroid/parathyroid disease
15
Q

What is the tx for renal artery stenosis in those with fibromuscular dysplasia?

A

percutaneous balloon dilatation

15
Q

What are the ABCDs of HTN treatment?

A
  • A = ACEis and ARBs
  • B = beta blockers
  • C = Ca++ channel blockers
  • D = diuretics
17
Q

How is renin stimulated to be released?

A
  • activation of beta-sympathetic nerves
  • stimulation of renal baroreceptors
  • activation of the macula densa chemoreceptor
19
Q

What is the renal Na excretion called?

A

naturesis

20
Q

What is primary/essential HTN?

A

an unknown, single reversible cause of HTN

22
Q

Increased TPR primarily occurs at the level of the _____.

A

precapillary arterioles

23
Q

Name 2 signs of primary hyperaldosteronism.

A
  • hypokalemic metabolic acidosis
  • resistant HTN
  • ****NO edema
24
Q

What is the BP goal for diabetics or pts with CKD?

A
  • less than 130 SBP
  • less than 80 DBP
25
Q

What usually causes renal artery stenosis in female pts younger than 30yo?

A

fibromuscular dysplasia

26
Q

What is the acute physiologic effect of a diuretic?

A

decreased ECF and plasma volume with reduced CO

27
Q

What is primary hyperaldsteronism?

A

defect of the adrenal cortex (adenoma, hyperplasia)- secretion independent of extra-adrenal stimuli

28
Q

What is a hypertensive crisis?

A

when asymptomatic HTN pts take a turn into symptomatic, acutely elevated BP

28
Q

This is HTN in the absence of hypertensive neuroretinopathy .

A

non-malignant HTN

29
Q

What is the first line treatment for essential HTN?

A

thiazide diuretics

31
Q

Physiologically, HTN can only result from _____ and/or _____.

A

increase in CO; increase in total peripheral resistance

32
Q

The Frank-Starling mechanism suggest that an increase in ECF volume due to renal Na and water retention should result in increased ____, ____, and _____.

A

blood volume, venous return, and stroke volume

33
Q

What does TPR stand for?

A

total peripheral resistance

35
Q

Secondary HTN is rare. When would you check for it?

A
  • in very young pts (>30yo)
  • in pts with restistant HTN that are already on at least 4 drugs
36
Q
  • What do the following fundoscopic findings indicate? flame shaped (striate) hemorrhages
  • cotton wool spots (soft exudates)
  • papilledema
A

HTN-induced arteriolitis of malignant HTN

37
Q

What is malignant HTN?

A
  • marked elevation of BP
  • hypertensive vasculopathy
  • hypertensive neuroretinopathy
38
Q

People who are normotensive at age 50 have a ____% lifetime risk of developing HTN.

A

90

CVPR: Renal (Exam 4) (29 decks)

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