Hypertension, PVD, and Stroke

Question 1

Hypertension definition

Answer 1

systolic > 140; diastolic > 90

Question 2

Types of hypertension

Answer 2

benign: most common, stable course
malignant (5%): rapidly rising BP with accelerated renal failure; retinal hemorrhagic exudates +/- papilledema; diastolic >120

Question 3

Regulation of blood pressure is a function of

Answer 3

cardiac output and peripheral resistance - if either of those increase, BP also increases

Question 4

Hypertension is an altered relationship between

Answer 4

blood volume and total arteriolar resistance

Question 5

Vasoconstrictors

Answer 5

angiotensin II, catecholamines, thromboxane, leukotrienes, endothelin, lactic acid, hydrogen ions, adenosine, hypoxia

Question 6

Vasodilators

Answer 6

kinins, prostaglandins, nitric oxide

Question 7

Atriopeptin

Answer 7

secreted by heart atria in response to volume expansion; leads to decrease in Na resorption

Question 8

Renal vasodepressor substances

Answer 8

counterbalance vasopressor response of angiotensin

Question 9

Essential hypertension

Answer 9

increased cardiac output +/- increased peripheral resistance

Question 10

Possible causes of increase in cardiac output

Answer 10

genetic defect in renal sodium excretion; inherited heterogeneity in the renin-angiotensin system; decreased perfusion of kidneys which leads to volume expansion (as in CHF)

Question 11

Possible causes of increase in peripheral resistance

Answer 11

behavioral or neurogenic; increased release of vasoconstrictive agents (renin, catecholamine, endothelin); increased sensitivity of smooth muscle to vasoconstrictor effects

Question 12

Environmental factors in hypertension

Answer 12

stress, obesity, smoking, inactivity, heavy consumption of salt (augments HTN)

Question 13

Hyaline arteriolosclerosis

Answer 13

elderly patients, diabetes; leakage of plasma components, increased extracellular matrix in SM layers; homogeneous, pink, hyaline thickening of walls of arterioles with narrowing of lumon

Question 14

Benign nephrosclerosis

Answer 14

hyaline arteriolosclerosis in the kidney

Question 15

Hyperplastic arteriolosclerosis

Answer 15

more acute or severe elevations of blood pressure; characteristic of malignant hypertension with diastolic pressures >110; onionskin, concentric laminated thickening of the walls of the arterioles

Question 16

Hyperplastic arteriolosclerosis may be associated with

Answer 16

fibrinoid and acute necrosis - necrotizing arteriolitis

Question 17

onionskin, concentric laminated thickening of the walls of the arterioles; narrowing of the lumen; thickened basement membrane

Answer 17

Hyperplastic arteriolosclerosis

Question 18

Chronic ischemia of the coronary arteries causes

Answer 18

CHF; subendothelial infarcts

Question 19

Intermittent hypoperfusion of the coronary arteries causes

Answer 19

angina

Question 20

Infarction of the coronary arteries causes

Answer 20

transmural myocardial infarction

Question 21

chronic ischemia of the carotid arteries causes

Answer 21

cerebral atrophy; organic brain syndrome

Question 22

Intermittent hypoperfusion of the carotid arteries causes

Answer 22

transient ischemic attacks

Question 23

Intermittent hypoperfusion of the femoral artery causes

Answer 23

claudication

Question 24

Infarction of the femoral artery causes

Answer 24

gangrene

Question 25

chronic ischemia of the renal artery causes

Answer 25

renal atrophy; pre-renal azotemia (elevated nitrogen)

Question 26

Chronic ischemia of the mesenteric arteries causes

Answer 26

mucosal infarction

Question 27

intermittent hypoperfusion of the mesenteric arteries causes

Answer 27

ischemic colitis

Question 28

Infarction of the mesenteric arteries causes

Answer 28

mural infarction