Hypertension and Stroke Flashcards

1
Q

What is hypertension?

A

Elevated BP

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2
Q

Describe korotkow sounds?

A

Systolic pressure = when sounds appear(upper number)

Diastolic pressure = when sounds disappear = bottom number

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3
Q

Generally what level is high BP?

A

140/90

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4
Q

What is taken into account when diagnosing hyperteniosn?

A

BP, cardiovascular risk e.g. weight, smoking, exercise

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5
Q

Describe the position of patient when measuring BP?

A

Sitting

At rest

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6
Q

How many readings should you take when measuring BP?

A

2

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7
Q

List 6 pathophysiological effects of hypertension?

A
Bursting effects e.g. cerebral haemorrhage
Coronary heart disease
Stroke
Renal Failure
Arteriosclerosis
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8
Q

What type of hypertension is responsible for the majority of hypertension cases?

A

Essential hypertension

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9
Q

Aetiology of essential hypertension?

A

Poly-causal

Genetic and environmental (obesity, salt, lack of exercise)

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10
Q

Generally how is essential hypertension diagnosed?

A

Diagnosis of exclusion

Look at all potential causes of hypertension, if they all come back negative then essential hypertension is diagnosed

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11
Q

Name another type of hypertension - existing in 10% of hypertensive cases?

A

Secondary hypertension

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12
Q

List 4 indicators of secondary hypertension?

A

Very high BP, poorly controlled, in the young, medication not controlling it

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13
Q

What are the first 3 things to look at in a patient if you suspect secondary hypertension?

A

Renal function, electrolytes and patient symptoms

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14
Q

Most common causes of secondary hypertension? (2)

A

Renal artery stenosis

Endocrine causes e.g. Conn’s or Cushing’s syndrome

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15
Q

What is Cushing’s syndrome?

A

Excess circulating steroids

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16
Q

What is Cushing’s disease?

A

primary pituitary disease causing excess circulating steroid

17
Q

What would an electrolyte test showing low K suggest?

A

Conn’s syndrome

18
Q

What is an effect of Cushing’s syndrome?

A

Obesity with striae (stretch marks)

19
Q

What part of the body does Conn’s syndrome effect?

A

Adrenal gland - tumour

20
Q

Effect of elevated BP?

A
Heart - increased risk of coronary heart disease, (left ventricular hypertrophy = increased muscle = less space in ventricle), arrhythmia
Aortic aneurysm 
Peripheral vascular disease
Cerebral circualtion - stroke
Hypertensive encephalopathy
Eye changes
21
Q

Complications of hypertension?

A

MI, stroke or peripheral vascular disease

22
Q

How is hypertension treated?

A

Weight reduction
Exercise
Decrease salt intake
Alcohol reduction

23
Q

List 3 measures that will reduce cardiovascular risk but not BP

A

Smoking cessation
Reduce saturated fat
Increase intake of oily fish

24
Q

What is a stroke?

A

Neurological deficit of a presumed vascular cause

25
What is transient Ischaemic attack (TIA)?
Neurological deficit of presumed vascular cause, last around 24 hours, patient makes full recovery
26
What suggest a stroke a) rapid onset of symptoms b) same symptoms over weeks/months
a
27
What 2 things can cause stroke?
Ischaemia to brain | Haemorrhage in brain
28
What type of stroke will thrombosis cause?
Ischaemic stroke
29
Symptoms of stroke (6)
Paralysis (opposite side of body to brain) Loss of sensation Double vision Unsteadiness Loss of speech Loss of ability to use/understand language
30
What determines which part of the brain is affected by stroke?
Arterial territory effected
31
Biggest risk factor for stroke?
Hypertension
32
List 5 other risk factors for stroke, other than hypertension?
``` Vascular disease Smoking Diabetes TIA Atrial fibrillation ```
33
Why is diagnosing and treating high BP important?
Reduce risk of stroke
34
How is stroke prevented?
``` Lower BP Surgery - for patient with narrowed carotid artery Aspirin and other anti-platelet drugs Lower cholesterol Warfarin ```