Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is blood pressure like in the population?

A
  • Vary widely

- Show normal distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hypertension?

A

Risk of complications increasing progressively with higher values
Cut off = arbitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is isolated systolic hypertension?

A

Isolated elevation in systolic pressure alone with normal diastolic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What value is isolated systolic hypertension equal to and above?

A

140mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What population is isolated systolic hypertension common in?

A

Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is isolated systolic hypertension a problem with? (3)

A
  • Increased stiffness
  • Reduced compliance
  • In large elastic blood vessels e.g aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is white coat hypertension?

A

Rise in blood pressure while examined by physician e.g flight/fight response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the types of hypertension? (4)

A
  • Primary essential hypertension
  • Secondary hypertension
  • Isolated systolic hypertension
  • White coat hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is primary essential hypertension? (3)

A
  • No known cause identified
  • Most common
  • Causes organ damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the threshold for primary essential hypertension?

A

More than or equal to 140/90 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is secondary hypertension? (2)

A
  • Uncommon

- Pathology: defined underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is hypertension normally discovered? (2)

A

Majority asymptomatic : discovered in

  • Routine physical examination
  • Complication e.g MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the “classic” symptoms of hypertension? When do they normally occur? (3)

A
  • Headache
  • Nosebleeds
    = severe hypertension
  • Normally only sign is high recorded BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the damages that occur to the heart that occur as a result of primary hypertension? (2)

A
  • Left ventricular hypertrophy: congestive cardiac failure (CCF)
  • Accelerated coronary ahterosclerosis : ischaemia + infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What occurs in myocytes cause hypertrophy? (2)

A
  • Enlarged myocytes

- NOT more myocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the organs damaged as a result of primary hypertension? (4)

A
  • Heart
  • Brain
  • Aorta/peripheral vasculature
  • Kidney
  • Retina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the damages that happen to the brain due to primary hypertension? (3)

A
  • Microaneurysms rupturing to cause haemorrhagic strokes (CVE/CVA)
  • Cerebral infarct: atherosclerotic plaques in internal carotid arteries
  • Lacunae (cavaties) occulusion of small penetrating branches = multiple tiny infarcts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment for an ischaemic stroke? (4)

A
  • Specialised scanning cenre
  • Drug administred to dissolve clot (thrombolysis)
  • Catheter in and suck out blood clot
  • 12 hour window
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 3 ways the peripheral vasculature and aorta is damaged by primary hypertension? (3)

A
  • Peripheral vascular disease
  • AAA (+6cm diameter: rupture and death risk)
  • Aortic dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is the kidney damaged by primary hypertension? And what should be assessed to check this? (4)

A
  • Nephrosclerosis (scarring)
  • Can progress to proteinuria - leaking protein into urine
  • Chronic renal failure
  • Urine test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How should damage due to primary hypertension be checked in the retina?

A

Visualed with an ophalmoscope through pupil to back of eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do changes in the retina caused by primary hypertension depend on? (2)

A
  • Hypertension severity

- Hypertension duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What area of the retina is used for fine detail examination?

A

Maccular

24
Q

What are the signs of hypertension in the retina? (5)

A
  • Flame haemorrage
  • Papilloedema
  • Hard exudates: small white/yellow deposits in outer layers of retina deep to vessels
  • Cotton wool spot
  • Optic disc disappears (=SEVERE)
25
Q

What should be done on seeing signs of hypertension in the retina? (2)

A
  • Measure BP

- Refer to hospital for high BP

26
Q

What are the signs of secondary hypertension? (6)

A
  • Young age onset (less than 20)
  • Abrupt not progressive
  • Accelerated hypertension
  • Underlying pathology
  • Sporadic (no history in 1st degree relatives)
  • Refractory to drug treatment
27
Q

What value is acclerated hypertension?

A

> 180/110 mmHg

28
Q

What are the categories of causes for secondary hypertension? (5)

A
  • Renal
  • Mechanical
  • Endorcrine
  • Drugs
  • Pre-eclamptic toxaemia
29
Q

What are the renal causes of secondary hypertension? (2)

A
  • Chronic renal failure

- Renal artery stenosis

30
Q

What is a mechanical cause of secondary hypertension? (2)

A

Coarctation of the aorta - congenital aorta narrowing

31
Q

List endocrine causes of secondary hypertension (5)

A
  • Conn’s syndrome (primary hyperaldoesteronism)
  • Cushing’s syndrome
  • Phaechromocytoma
  • Acromegaly
  • Thyrotoxicosis
32
Q

What common type of drug used causes secondary hypertension?

A

Oral contraceptives

33
Q

How does renal artery stenosis cause secondary hypertension? (4)

A
  • Stenosis in one renal artery: not enough blood flow
  • Activation of renin-angiotensin-aldosterone system (pumps out renin)
  • Angiotensin: fluid retention: increased TPR: increased BP
  • Aldosterone: potassium excretion by kidney
34
Q

When should renal artery stenosis be suspected as a cause of hypertension patients? (2)

A

Abrupt onset hypertension plus

  • Hypokalaemia
  • Abdominal bruit (whooshing through stenoised artery)
35
Q

What is coarctation of the aorta as a cause of secondary hypertension? (2)

A
  • Congenital narrowing of aorta

- Distal to left subclavian artery origin

36
Q

What are the signs of coarctation of aorta as a cause of secondary hypertension? (3)

A
  • BP more in arms than leg
  • Weak/absent femoral pulses
  • Notched rib appearance of upper ribs on chest x ray
37
Q

Why does coarctation of aorta as a cause of secondary hypertension cause a notched appearance of upper ribs?

A

Shunting of bood through enlarged internal mammary arteries (rather than aorta)

38
Q

What is Conn’s syndrome as a cause of secondary hypertension? (3)

A
  • Adrenal tumour (adenoma) secretes excess aldosterone
  • Fluid retention
  • Hypokalemia
39
Q

What is Cushing’s syndrome as a cause of secondary hypertension? And what are the main symptoms? (4)

A

Excess glucocorticoid secretion

  • Moon face
  • Central obesity
  • Hirsutism
  • Promixal muscle wasting
40
Q

What is phaechromocytoma? (3)

A
  • Rare catecholamine secreting tumour of adrenal medulla
  • Sudden bursts of (nora)adrenaline
  • Stimulates cardiac b1 adrenoreceptors
41
Q

What are the symptoms of phaechromocytoma? (6)

A
  • Anxiety
  • Sweating
  • Palpitations
  • Hypertension
  • Headache
  • Swelling
42
Q

What is pre-clamptic toxaemia of pregnancy as a cause of secondary hypertension? (3)

A
  • Placental ischaemia = release of agents causing:
  • Endothelial dysunction
  • Vasoconstriction
43
Q

What are the symptoms of pre-clamptic toxaemia of pregnancy? (2)

A
  • Eclampsia (high BP fits)

- Maternal death

44
Q

What should be monitored throughout pregnancy and why?

A

Blood pressure - check for pre-eclamptic toxaemia of pregnancy

45
Q

What does hyperthyroidism e.g Grave’s disease cause of secondary hypertension?

A
  • Excess production of thyroid hormones
  • Calcium release
  • Increase in blood volume and cardiac output
46
Q

What is the pathophysiology of hypertension? (5)

A
  • Imbalance between CO and TPR
  • Early: Increased CO and normal TPR
  • Disease progression: LVH
  • Compromises diastolic filling and reduces CO
  • Long term: blood vessel changes=increased TPR
47
Q

What causes long term elevated TPR in hypertension to do with blood vessels? (4)

A
  • Prolonged vasoconstriction and high BP
  • Resistance
  • Tunica media hypertrophy to withstand
  • Narrowing of artery lumen
48
Q

What are the other causes for elevated TPR in hypertension other than blood vessels? (2)

A
  • Rarefraction: vessel number/unit volume reduction

- Baroreceptor reflex reset at higher set point

49
Q

What is accelerated (malignant) hypertension?

A

Emergency BP requiring admission to hospital

50
Q

What are the signs of acclerated (malignant) hypertension? (2)

A
  • More than 180/110 mmHg

- + papilloedema/retinal haemorrhage

51
Q

When do patients die if aaccelerated (malignant) hypertension is left untreated?

A

6-12 months

52
Q

What is the pathological cause of acclerated (malignant) hypertension?

A

Fibrinoid necrosis of arterioles

53
Q

What are the long term effects of acclerated (malignant) hypertension on the brain?

A

Impaired function of brain: hypertensive encephalopathy

54
Q

What is the treatment of acclerated (malignant) hypertension? (2)

A
  • IV medication

- Reduce TPR/CO

55
Q

What blood/urine tests should be done to check for secondary causes of hypertension? And for what conditions? (8)

A
  • Plasma creatinine + GFR
    + protein urinalysis : renal disease
  • Plasma potassium (hypokalaemia) + plasma renin:aldosterone ratio: Conn’s (primary aldosteronism)
  • Urinary catecholamines: phaechromocytoma
  • Hyperglycaemia + 24hr urinary cortisol secretion + dexamethasone supression test: Cushing’s
56
Q

What imaging tests should be done to check for secondary causes of hypertension? And for what conditions? (3)

A
  • Renal USS: renal disease
  • Renal duplex ultrasonography: renal artery stenosis
  • CT/MRI abdo pelvis: phaeochromocytoma

Cardiology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions