Hypertension, Atheroma and Thrombosis Flashcards
What is Conn’s Syndrome an excess of?
excess Aldosterone
What is Cushing’s Syndrome an excess of?
excess excess corticosteroid
What is Phaeochromocytoma an excess of?
noradrenaline
What can left hypertrophy cause?
Increased LV Load Poor perfusion Interstitial fibrosis Micro infarcts Diastolic dysfunction
What does subarachnoid haemorrhage involve rupture of?
Berry aneurysm
In maligant hypertension, what is the diastolic blood pressure?
> 130-140
What is papilloedema?
Swelling of optic disc
Hypertension and proteinuria during pregnancy suggests what?
pre-eclampsia
What does this describe: Narrowing of arterial lumen, reduced elasticity, reduced flow in systole, tissue ischaemia?
Arterial stenosis
What happens if aterial stenosis occurs in peripheral arteries?
Claudication and food/leg ischaemia
What does plaque rupture often trigger?
thrombosis
What does this describe: Splitting within the media by flowing blood?
arterial dissection
Which syndrome is a risk for arterial dissection?
Marfan’s
What is ischaemia the result of?
impaired vascular perfusion depriving the affected tissue of nutrients
Can ischaemia be reversed?
yes (depending on many factors)
What is infarction?
ischaemic necrosis (death) of a tissue or organ secondary to occlusion/reduction of the arterial supply or venous drainage
What are the 3 aspects of Virschow’s triad?
- Change in blood flow (stasis or turbulence)
- Change in coagulability (hypercoagulability)
- Change in vessel wall (endothelial damage)
What produces the EC matrix?
endothelial cell
What is blood flow normally in vessels?
laminar
Do arterial thrombi show lines of Zahn?
Yes
What are phlebothromboses?
venous thrombi
What colour are venous thrombi?
reddish/blue
In what circumstance do venous emboli do cause infarcts in peripheral arterial circulation?
Atrial/Ventricular Septal Defect
‘Paradoxical Embolus’
Exceptionally rare
Arteriosclerosis is the generic term for which 3 disease patterns?
-Atherosclerosis (Intimal)
-Monckeberg Medial Calcific Sclerosis (Calcification of medium sized arteries in those >50yrs)
Arteriolosclerosis (Small arteries and arterioles, Hyaline and hyperplastic types)
What is arteriosclerosis associated with?
Associated with diabetes mellitus and hypertension
Does changing posture/position help pericarditis?
Yes
What are symptoms of a DVT?
pain,
swelling,
redness,
hot/inflamed
What imaging can be done for a DVT?
Duplex scanning
How long should TED compression stockings be given for a DVT?
6 weeks
What are symptoms of a PE?
SOB
Collapse
Pleuritic Chest Pain
Haemoptysis
What are signs of a PE?
Wheeze Tachycardia Fourth heart sound Accentuated pulmonic component of the second heart sound Pleural Rub Oligemia on CXR (segmental loss of pulmonary vasculature) Signs of Pleural effusion Consolidation on CXR
What drug treatment is associated with a lower rate of recurrent PE?
Induction period with heparin of 5 days
What does this describe: the patient is pain-free at rest, but after variable periods of exercise develops ischaemic pain in the affected limb, which is relieved by further rest.
Intermittent claudication
What are non invasive investigations in chronic lower leg ischaemia?
Measurement of ABPI (Ankle Brachial Pressure Index)
Duplex ultrasound scanning
What are invasive investigations in chronic lower leg ischaemia?
Magnetic resonance angiography
CT angiography
Catheter angiography
What are symptoms of critical leg ischaemia?
Pain at rest Requires strong analgesia Worse at night Helped by sitting and putting the leg in a dependent position Helped by getting up and walking about
Are males or females more likely to develop aortic aneurysms?
Males
What are investigations for aortic aneurysms?
Ultrasound Scan
CT Scan
Which leg veins are deep?
tibials, popliteal femoral
Which leg veins are superficial?
saphenous and perforators
What are varicose veins?
Dilated, tortuous superficial veins, due to transmission of deep vein pressure
Do you often get varicose veins after a DVT?
yes
Are varicose veins more prominent standing or sitting?
standing
What is chronic venous insufficiency?
irreversible skin damage as result of sustained ambulatory venous hypertension
When are compression stockings contraindicated?
low ABPI
