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Pathology 2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is athlerosclerosis?

A

The formation of a lipid rich plaque in the wall of a blood vessel

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2
Q

What is peripheral vascular disease?

A

Flurrying up of arteries supplying arms and legs

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3
Q

What are aneurysms?

A

Abnormal ballooning out of blood vessels

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4
Q

What can high blood pressure cause?

A

Atherosclerosis
Heart failure
Chronic Kidney Disease

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5
Q

What are the main symptoms of high Bp?

A

Typically no symptoms except in accelerated hypertension (very rare)

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6
Q

What is systolic BP?

A

Maximum pressure in the vessels after cardiac contraction

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7
Q

What is diastolic BP?

A

Minimum pressure in vessels during cardiac contraction

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8
Q

Which artery is normally used to measure BP?

A

Brachial artery

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9
Q

What constitutes as normal BP?

A

90/60 - 120/80 mmHg (no definite answer)

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10
Q

What is the clinical BP stage 1 hypertension?

A

Systolic - 140-159

Diastolic - 90-99

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11
Q

What is the clinical BP stage 2 hypertension?

A

Systolic - 160-179

Diastolic - 100-119

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12
Q

What is the clinical BP of stage 3 hypertension?

A

Systolic - over 180

Diastolic - over 120

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13
Q

What are the 3 steps in investigating a patient with hypertension?

A
  1. Establish if hypertension is present
  2. Look for evidence of target organ damage
  3. Look for evidence of secondary cause
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14
Q

What does an ambulatory monitoring do?

A

A cuff inflates throughout the day taking BP at different times throughout a 24 hour period

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15
Q

What is primary hyperaldosteronism?

A

An excessive production of aldosterone (secondary cause of high blood pressure)

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16
Q

What is Cushing’s syndrome?

A

An excess of corticosteroid production

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17
Q

List secondary causes of hypertension

A 
Primary hyperaldosteronism 
Cushing’s syndrome 
Phaeochromocytoma 
Renal artery stenosis 
Intrinsic renal disease 
Coarctation of the aorta 
Obstructive sleep apnoea
18
Q

What is renal artery stenosis?

A

Narrowing of the main artery supplying the kidney causing an increase in BP

19
Q

What does a high Bp in a pregnant woman indicate?

A

A high bp in the future

20
Q

What do non steroidal anti-inflammatory drugs do?

A

They are taken to relieve inflammation and pain and they cause salt and water retention which can increase bp

21
Q

If a patient complained of sweating and palpitations, what secondary condition would come to mind?

A

phaeochromocytoma - when the body decides to pump out more adrenaline and it may be because you have a tumour in your adrenal gland and the tumour makes too much adrenaline (RARE)

22
Q

If a patient complained of flank pain, what secondary condition would come to mind?

A

Kidney disease

23
Q

If a patient had daytime somnolence, snoring and erratic sleep, what secondary condition would come to mind?

A

Obstructive sleep apnea - body fires or adrenaline every now and then

24
Q

What is oedema?

A

Swelling

25
Q

What is postural hypertension?

A

When a patient’s bp falls when standing up

26
Q

What does a bad ophthalmology examination tell us? ( in relation to blood pressure )

A

High blood pressure for a long period of time

27
Q

List 4 target organs of high bp?

A

Heart
Kidney
Eye
Artery walls

28
Q

What happens the heart in high bp?

A

The heart can thicken - (Left ventricular hypertrophy)

29
Q

What on an ECG indicates left ventricular hypertrophy ?

A

Pronounced P and S waves

30
Q

What can high bp do to the kidney ?

A

It can cause kidney disease

31
Q

How can kidney disease be detected?

A
  1. Look at the urine - a healthy kidney won’t let protein out into the urine
  2. Look at the blood - high creatinine levels can indicate kidney dysfunction and problem with the filtration of the kidney
32
Q

How do you investigate Cushing’s syndrome?

A

Measure the amount of steroids in the urine (cortisol)

33
Q

How to test for phaeochromocytoma ?

A

Measure the amount of adrenaline in the blood or urine

34
Q

How to detect renal artery stenosis?

A
  1. Wishing noise when listening to patients abdomen

2. Scan of kidney

35
Q

What website do we use to calculate a patients risk factor if having an MI or stroke ?

A

QRISK-3

36
Q 
Which of the following is least important in terms of cardiovascular risk?
Smoking 
Diabetes 
Osteoarthritis 
Migraine
Depression
A

Osteoarthritis - inflammatory conditions that increase the risk not osteoarthritis

Note - not asked in QRISK questioning

37
Q

List lifestyle interventions to reduce cardiovascular risk?

A
  1. Stop smoking
  2. Achieve a healthy body weight
  3. Eat a healthy diet (DASH Diet)
  4. Restrict diet intake
  5. Moderate alcohol intake
  6. Take adequate exercise
  7. Discourage excessive caffeine intake
38
Q

Who should you give drug treatment to for hypertension ?

A

^ persistent stage 2 hypertension

^ stage 1 hypertension of patients who are over 80

39
Q

Who do you give ACE inhibitors or Angiotension Receptor Blockers to as a first stage ?

A

~ patients with hypertension and type 2 diabetes

~ patients with hypertension, who are under 55 and are not from black African or African-Caribbean family origin

40
Q

Who do you give calcium channel blockers to as a first stage?

A

~ patients age 55 or over

~ patients of black African or African-Caribbean family origin (any age)

Pathology 2 (6 decks)

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