Hypertension

Question 1

Classification of hypertension

Answer 1

Cause (aetiology) - Primary et secondary

Consequences (clinicopathological) _ Benign et malignant

Question 2

Secondary hypertension could be a sign of

Answer 2

Renal, Endocrine, Aortic diseases. Renal artery stenosis, Drug therapy (steroids)

Question 3

Renal diseases causing 2ndary hypertension

Answer 3

Renal artery stenosis
Acute or chronic glomerulonephritis
Cystic diseases
Chronic pyelonephritis (thyroidisation of the kidney)
Interstitial nephritis.

Due to reduced renal blood flow, renin release is affected and causes hypertension

Question 4

Endocrine causes of hypertension

Answer 4

Adrenal gland hyperfunction
Adrenal gland tumours:
Conn’s Syndrome - excess aldosterone
Cushing’s Syndrome - excess corticosteroid
Phaeochromocytoma - excess noradrenaline.

Question 5

Other causes of hypertension

Answer 5

~Coarctation of aorta (congenital) - abnormal narrowing of arteries (above or below ductus arteriosus?)
~ Intracranial tumour
~ Hyperparathyroidism
~ Obstructive sleep apnoea

Question 6

How does hypertension affect the heart?

Answer 6

LVH, AF

Question 7

Vascular diseases associated with increased CVD risk

Answer 7

Ischaemic Heart Disease
Cerebro Vascular Disease
Peripheral Vascular Disease

Diabetes

Question 8

Grades of hypertensive retinopathy

Answer 8

I - modest narrowing of retinal arterioles
II - modest to severe narrowing, arteriovenous nicking
III - Bilateral soft exudates/ flame shaped haemorrhages
IV - Bilateral optic nerve oedema (papilloedema), cotton wool, hard exudates

Question 9

What could be an uncommon cause of hypertension in women?

Answer 9

Fibromuscular dysplasia

Question 10

β-blockers must nit be used in first line treatment unless ____________.

Answer 10

Fertile female. Then, use Ca2+ antagonist, diuretic, spironolactone