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Cardio Exam 2 > Hypertension - Quiz 4 > Flashcards

Hypertension - Quiz 4 Flashcards

1
Q

what is the most common disease-related reason for visits for primary care providers

A
  • hypertension
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2
Q

what is the number one attribute risk for death worldwide

A
  • suboptimal BP
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3
Q

highest countries for DALYs by systolic blood pressure level

A
  • china

- india

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4
Q

normal BP

A

<120/<80

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5
Q

elevated BP

A
  • 120-129

- <80

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6
Q

stage 1 htn

A
  • 130-139

- 80-89

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7
Q

stage 2 htn

A
  • > 140

- >90

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8
Q

how many BP measurements should be used

A
  • at least 2
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9
Q

when making clinical decisions based on at-home BP measurements, how many days should be used

A
  • at least 3
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10
Q

systolic BP increases with

greater in which race

A
  • age

- African Americans

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11
Q

factors included in framingham heart study

A
  • systolic BP
  • cholesterol/HDL
  • diabetes
  • cigarettes
  • left ventricular hypertrophy
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12
Q

important systems in blood pressure regulation

A
  • kidneys
  • SNS
  • RAAS
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13
Q

hemodynamic progression of hypertension

A
  • early in life it’s cardiac output

- later in life its peripheral resistance

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14
Q

tubular model of the arterial system

A
  • vascular stiffness contributes to systolic hypertension in the elderly
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15
Q

essential (primary) hypertension cause of hypertension in what percent of patients

A
  • 90%
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16
Q

cardiovascular structures affected by HTN

A
  • heart
  • large and medium arteries
  • small arteries and arterioles (microvasculature)
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17
Q

organs most at risk due to hypertension

A
  • heart
  • arteries
  • brain
  • kidney
18
Q

pathogenesis of left ventricular hypertrophy

A
  • increased afterload
  • increased LV work
  • hypertrophy of LV myocytes
  • concentric LV hypertrophy with increased stiffness
19
Q

left ventricular hypertrophy on the EKG

A
  • taller R waves in leftward leads (I, AVL, V6)
  • deeper S waves in rightward leads (V1, V3)
  • downsloping ST depression
  • T wave inversions
20
Q

S wave in V1 and R wave in V5 (or V6) measurement in left ventricular hypertrophy

A
  • > 35 mm
21
Q

R wave in AVL measurement in left ventricular hypertrophy

A

> 11 mm

22
Q

R wave in lead I measurement in left ventricular hypertrophy

A

> 15 mm

23
Q

S wave in V3 and R in AVL measurement in left ventricular hypertrophy

A

> 20 mm (women)

> 28 mm (men)

24
Q

HTN effects on large-medium arteries

A
  • accelerated atherosclerosis
25
Q

complications of accelerated atherosclerosis

A
  • MI
  • stroke/brain infarct
  • aortic aneurysm
26
Q

Chronic HTN effects on microvasculature - pathology

A
  • thickened vessel wall

- stenotic lumen

27
Q

pathogenesis of chronic HTN in small arteries

A
  • adapt
  • wall thickens with increased elastin and increased collagen
  • benign arteriosclerosis
28
Q

pathogenesis of chronic HTN in arteriole

A
  • adapt +/- injury
  • wall thickened with increased collagen and plasma proteins
  • benign arteriolosclerosis
  • hyaline arteriolosclerosis
29
Q

complications of stenotic lumen

A
  • ischemia to tissues downstream
30
Q

organs affected by downstream ischemia

A
  • kidney (renal failure) -> benign nephrosclerosis

- retina

31
Q

pathology of severe, acute htn affects on microvasculature

A
  • thickened vessel wall

- stenotic lumen

32
Q

pathogenesis of severe, acute htn in small arteries and arterioles

A
  • adapt

- endothelial injury

33
Q

adaption of small arteries and arterioles in severe, acute htn

A
  • wall thickens with increased layers of smooth muscle cells

= onion skinning

34
Q

endothelial injury of small arteries and arterioles in severe, acute htn

A
  • necrotic wall thickened with fibrinoid necrosis
  • insudated plasma proteins
  • +/- thrombus
35
Q

SBP reduction of weight reduction

A
  • 10 mmHg
36
Q

SBP reduction of adoption of DASH diet

A
  • 11 mmHg
37
Q

most patients with hypertension should have BP measurements done where

A
  • also outside of the clinic
38
Q

there is a _____ between BP and cardiovascular risk

A
  • continuous, graded relationship
39
Q

what contributes to high BP

A
  • increased cardiac output
  • elevated peripheral resistance
  • vascular stiffness
40
Q

important end-organ manifestations of hypertension

A
  • heart failure
  • myocardial infarction
  • stroke
  • renal failure
41
Q

biggest ways in lowering BP

A
  • weight loss
  • adoption of DASH diet
  • dietary sodium restriction
  • physical activity
  • moderation of alcohol intake

Cardio Exam 2 (29 decks)

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