Hypertension

Question 1

distinguish between primary and secondary hypertension

Answer 1

Primary where cause is unknown

Secondary where cause is identifiable

Question 2

Name three causes of secondary hypertension

Answer 2

Renovascular disease
Renal Parenchymal disease
Adrenal causes

Question 3

Describe renovascular disease

Answer 3

Renal arteries occluded (renal artery stenosis)–>Decreased renal perfusion pressure
Renin released in response from juxtaglomerular granular cells–>Vasoconstriction, aldosterone release, increased Na+ reabsorption in kidneys etc..

Question 4

Describe renal parenchymal disease

Answer 4

Kidney doesn’t filter as well as it normally would

Sodium simply not taken out of body–> hypervolaemia

Question 5

What are the three adrenal causes for hypertension? Describe each of them

Answer 5

Conn’s SYndrome: Aldosterone secreting adenoma. Increased Na+ reabsorption in the kidneys

Cushing’s Syndrome:Excess secretion of cortisol. Acts on aldosterone receptors

Tumour of the adrenal medulla: Secretes adrenaline and noradrenaline–>Increased heart rate, vasoconstriction

Question 6

Name two consequences of hypertension and what these can cause

Answer 6

Increased afterload–> Left ventricular hypertrophy–>MI

Increased arterial damage–>Atherosclerosis adn arterial wall weakening–>Aneursym

Question 7

Name 5 ways to reduce hypertension

Answer 7

ACE inhibitor- Decreased conversion of angiotensin 1–>angiotensin 2
Angiotensin 2 receptor antagonist- Preventing the effects of angiotensin 2
L-type Ca2+ blockers- Decreased Ca2+ into smooth muscle cells in blood vessels–>Releaxation of smooth muscle cells
Diuretics- Reduce circulating volume by inhibit reabsorption of Na+ in the distal tubule
Βeta blockers- Block β 1 receptors–> decreased heart rate and inotropy and decreased renin release