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Pathophysiology Loyola > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the mechanism by which oral contraceptives increase blood pressure

A

Na retention, increase angiotensinogen, catecholamine facilitation

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2
Q

How does alcohol increase blood pressure?

A

Activates the sympathetic branch, increases cortisol, Ca++

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3
Q

How do amphetamines increase blood pressure

A

By increasing TPR

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4
Q

How do NSAIDs increase blood pressure?

A

Na+ retention, renal vasoconstriction, interferes with Beta-blockers, diuretics, ACE blockers, Ag receptor blockers

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5
Q

How do corticosteroids increase blood pressure?

A

Iatrogenic Cushing’s syndrome

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6
Q

How does cocaine increase blood pressure?

A

Systemic vasoconstriction, increase TPR

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7
Q

How does marijuana increase blood pressure?

A

By increasing systolic blood pressure

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8
Q

All forms of HTN are treated with what?

A

Beta-adrenergic blockers, ACE inhibitors, Ca++ channel blockers, and diuretics

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9
Q

How does clonidine reduce blood pressure?

A

Clonidine is an alpha 2 agonist and it thus decreases sympathetic tone

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10
Q

How does ANP affect blood pressure?

A

Lowers it (causes sodium loss)

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11
Q

How is the Na-H exchanger affected in primary HTN?

A

In 50% of people with primary HTN, the exchanger’s activity is enhanced

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12
Q

Define metabolic syndrome

A

The combination of insulin resistance, hyperlipidemia, obesity, and hyper-insulinemia

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13
Q

How does reduced renal function affect mineralocorticoid secretion?

A

Increases, resulting in more Na+ and water retention, thus causing hypertension

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14
Q

Which populations show more salt sensitivity?

A

Hypertensive black people show more salt sensitivity (73%) than hypertensive white people (55%) and less salt resistance (27% VS 45%)

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15
Q

What happens in malignant hypertension?

A

widespread fibrinous necrosis of the media and intimal fibrosis in arterioles, causing narrowing, leading to progressive retinopathy , HF, and renal failure

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16
Q

What happens in hypertensive encephalopathy

A

Confusion, disordered consciousness, seizures - due to arteriolar spasms and cerebral edema

17
Q

Why do elderly patients with essential hypertension see a rise in blood pressure upon standing?

A

Due to a hyper-reactive sympathetic response

18
Q

How do systolic and diastolic pressure change with age?

A

Systolic generally increases with age. Diastolic increases with age until 50-60 years of age and then falls, so pulse pressure increases.

19
Q

Why would overly aggressive treatment of diastolic HTN in older patients with CAD or CHF result in MI?

A

Because adequate perfusion of the coronaries is dependent upon diastolic pressure

20
Q

What tests are ordered to identify cardiovascular risk factors?

A

Cholesterol (total, HDL), triglycerides, fasting blood glucose

21
Q

What tests are ordered to identify target organ injury?

A

Chest x-ray, ECG, UA, serum creatinine or BUN, uric acid, urine microalbumin

22
Q

What tests are ordered to screen for secondary HTN?

A

serum creatinine, potassium, calcium, UA

23
Q

What is part of the basic testing for primary hypertension?

A

Fasting blood glucose, complete blood count, lipid profile, serum creatinine with eGFR, serum sodium, potassium, and calcium, TSH, UA, ECG

24
Q

What is part of the optional testing for primary HTN

A

Echocardiogram, uric acid, urinary albumin to creatinine ratio

25
Q

What blood pressure is a classic feature of essential HTN?

A

<180/<110 mm Hg

26
Q

What is considered normal blood pressure?

A

<120/<80

27
Q

Define stage 1 HTN

A

130-139/80-89

28
Q

Define stage 2 hypertension

A

> 140/>90 in at least 3 consecutive clinic visits

29
Q

When there is a drop in BP, baroreceptor reflex causes decreased parasympathetic stimulation to which receptor in the heart?

A

Muscarinic 2

30
Q

When there is a drop in BP, baroreceptor reflex causes increased sympathetic stimulation to which receptor in the heart?

A

beta-1

31
Q

When there is a drop in BP, baroreceptor reflex causes increased sympathetic stimulation to which receptor to increase stroke volume?

A

Beta 1

32
Q

When there is a drop in BP, baroreceptor reflex causes increased sympathetic stimulation to which receptor to decrease vessel diameter

A

Alpha 1

Pathophysiology Loyola (7 decks)

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