Hypertension SEM 2

Question 1

What is blood pressure?

Answer 1

The force of blood pushing against the blood vessels of the body.

Question 2

What is blood pressure measured in?

Answer 2

millimeters mercury

Question 3

Define hypertension.

Answer 3

A medical condition in which constricted arterial blood vessels increase the resistance to blood flow, causing an increase in blood pressure against the vessel walls.

Question 4

Solution to a disorder of lifestyle.

Answer 4

Lifestyle modifications.

Question 5

What consequences are African patients with hypertension more likely to suffer from?

Answer 5

Cerebral haemorrhage, renal disease, left ventricular hypertrophy.

Question 6

From what cardiovascular disease do African patients with hypertension suffer less from or are less likely to suffer from?

Answer 6

Coronary artery disease (CAD).

Question 7

In which group of patients with hypertension is CAD more common?

Answer 7

White and Indian.

Question 8

True or false: Studies show that the duration of urbanization is an independent risk factor in the development of hypertension.

Answer 8

True.

Question 9

What is the reading of high normal hypertension?

Answer 9

> 130-139/85-89 mmHg

Question 10

Readings of Grade 1 hypertension?

Answer 10

140-159/90-99 mmHg

Question 11

Readings of Grade 2 hypertension?

Answer 11

160-179/100-109 mmHg

Question 12

Readings of Grade 3 hypertension?

Answer 12

> 180/110 mmHg

Question 13

Define hypertensive urgency.

Answer 13

Symptomatic hypertension that is not life threatening.

Question 14

Define hypertensive emergency.

Answer 14

Life threatening hypertension.

Question 15

According to which characteristic is hypertension classified?

Answer 15

The extent of organ damage.

Question 16

Characteristics of Hypertensive Urgency.

Answer 16

Severe hypertension; No signs of organ damage; Asymptomatic;

Question 17

Characteristics of a Hypertensive Emergency.

Answer 17

Clinical condition of severe hypertension with symptoms of acute or progressive organ failure.

Question 18

Hypertensive Emergency-What dysfunctions can encephalopathy cause?

Answer 18

Confusion, vision disturbances, decreased level of consciousness.

Question 19

Hypertensive Emergency- What are the consequences of hypertension on the heart and heart system?

Answer 19

Pulmonary oedema: shortness of breath, swelling of legs, paroxysmal nocturcal dyspnoea.

Question 20

Hypertensive Emergency: What are the consequences of hypertension on the kidneys?

Answer 20

Acute renal failure- Anuria, acidotic, fluid overload.

Question 21

How does a hypertensive emergency arise?

Answer 21

Mechanisms are poorly understood. Failure of normal autoregulation and an abrupt rise in systemic vascular resistance. Endothelial injury with fibrinoid necrosis of arterioles. Deposition of platelets and fibrin. Breakdown of the normal autoregulatory function. Results in ischemia. Prompts further release of vasoactive substances.

Question 22

What is the management for a hypertensive emergency?

Answer 22

Admission to ICU/HCU. Aim to lower mean arterial pressure by no more than 25% within the first 24 hours.

Question 23

Describe malignant hypertension.

Answer 23

Severely elevated blood pressure, referred to a hypertensive urgency. Equal or greater than 180/110. Evidence of direct damage to one or more organs as a result of severely elevated blood pressure greater than 180/120. Mostly CNS, CVS and renal systems.

Question 24

What are the causes of malignant hypertension?

Answer 24

Missing doses of medications.
Kidney disease.
Spinal cord injuries. 
Tumours of the adrenal glands. 
Use of certain drugs, e.g. contraception and recreational drugs.

Question 25

Describe gestational hypertension.

Answer 25

The development of new hypertension in a pregnant women after 20 weeks gestation without the presence of protein in the urine or any other signs of preeclampsia.

Question 26

Does gestational hypertension go away after pregnancy?

Answer 26

Yes.

Question 27

What defines gestational hypertension?

Answer 27

BP of >140/90 mmHg

Question 28

What are the risk factors for gestational hypertension?

Answer 28

First time pregnancy
Family history
Having twins.
Younger than 20 and older than 40
Prior kidney disease.

Question 29

What is the recommended treatment for gestational hypertension?

Answer 29

Rest/lifestyle changes/modifications

May need to deliver the baby.

Question 30

What is the cause of primary hypertension?

Answer 30

Cause is unknown.

Question 31

What are some of the causes of secondary hypertension?

Answer 31

Coarctation of aorta.
Renal disease.
Endocrine disorders.
Sleep apnoea, oral contraceptives, cerebral haemorrhage.

Question 32

What are some of the conditions related to renal disease and secondary hypertension?

Answer 32

Diabetes, interstital tubular disease, glomerular disease, polycustic kidney disease, analgesic nephropathy, renal artery stenosis.

Question 33

What are some of the triggers for hypertension?

Answer 33

Gestational hypertension, drugs, foetal (low birth weight), endocrine disease, renal disease, vascular disease.

Question 34

Explain the genetic susceptibility for hypertension.

Answer 34

Increased sodium transport in kidney with impaired excretion.

Question 35

Which other factors may lead to hypertension?

Answer 35

Smoking, obesity, dietary sodium intake, alcohol, stress, aging, excess calories, diabetes and insulin resistance.

Question 36

What are some of the risk factors associated with hypertension?

Answer 36

Increasing age, gender, family history, ethnicity, diabetes mellitus, elevated cholesterol and triglycerides, sedentary lifestyle.

Question 37

Signs and symptoms of hypertension?

Answer 37

Mostly asymptomatic, fatigue, reduced activity tolerance, dizziness, blurred vision, palpitations, angina, difficulty breathing.