Long term control of BP Flashcards

1
Q

What are the 2 main factors which lead to total peripheral resistance?

A
  • Arteriolar radius

- Blood viscosity (haematocrit)

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2
Q

What factors lead to increased ECF volume?

A
  • Fall in GFR
  • RAAS
  • Salt reabsorption
  • Sympathetic activation
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3
Q

What factors lead to vasoconstriction?

A
  • Sympathetic activation
  • Endothelin
  • Renal prostaglandins (+ other vasodilators) decrease
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4
Q

What factors lead to Renin release?

A
  • Sympathetic nerve activation (mediated by baroreceptor feedback)
  • Renal artery hypotension (independant of baroreceptor feedback)
  • Decreased Na+ in kidney distal tubules
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5
Q

Why do people with kidney disease get high blood pressure?

A
  • Activation of RAAS

- Retention of salt and water with reduced excretory function

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6
Q

What percentage of the UK adult population have hypertension?

A

25%

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7
Q

What percentage of people over 60 have hypertension?

A

50%

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8
Q

What is the effect of hypertension on K+ intake?

A

Decreased

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9
Q

What drugs can increase BP?

A
  • Oral contraceptive pill
  • Steroids
  • NSAIDs
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10
Q

What is usually the primary problem which causes hypertension?

A

Reabsorption of too much sodium

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11
Q

What are the causes of secondary hypertension?

A
- Renal disease
Renal artery stenosis 
Polycystic kidney disease 
Glomerulonephritis
- Coarcation of aorta
- Endocrine disorder 
Cushing's
Conn's
Pheochromocytoma
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12
Q

What is cushing’s syndrome due to?

A

Excess cortisol

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13
Q

Where is cortisol produced?

A

zona fasciculata of adrenal cortex

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14
Q

Where is aldosterone produced?

A

zona glomerulosa

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15
Q

What does the zona reticularis produce?

A

Androgens

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16
Q

What are the three zones of the adrenal cortex from outer to innermost?

A
  • Zona glomerulosa
  • Zona fasciculata
  • Zona reticularis
17
Q

WHat can the effects of hypertension be on the eyes?

A
  • Retinal blood vessels become damaged by high pressure
  • Arteries become narrowed and tortous
  • Subsequently veins occluded and oedema and haemorrhage occurs
18
Q

What are the effects of hypertension on the kidneys?

A

Autoregulation tries to protect the glomerulus
Albuminuria
Continued high pressure
- Arterial walls thicken and narrow
- Kidney function declines irreversibly (sclerosis due to fibroblast activity)
Urine formation falls
- Volume overload
- Decreased clearence of creatinine, urea and waste products