Patho HCVD Duval Flashcards
Malignant BP
- Rapidly rising BP
- Death within 1-2 years
Syndrome of malignant HTN
- Severe HTN (systolic 120+ mmHg)
- Renal failure
- Retinal hemorrhages
- Pre-existing benign HTN
BP formula
BP = CO x TPR
Cardiac output depends on ____ which depends on ____
- Blood volume
- Serum sodium
Peripheral vascular resistance depends on ___ under the control of _____
- Arteriolar luminal diameter
- Vasoconstrictors and dilators
Name some common vasoconstrictors:
- AT II
- Catecholamines
- Thromboxane
- Leukotrienes
- Endothelin
Name some common vasodilators:
- Kinins
- Prostaglandins
- NO
- Lactic acid
- Hydrogen ions
- Adenosine
What factors cause essential HTN?
- Genetic
- Environmental
What is Liddle syndrome?
- Mutations in epithelial Na channel protein
- Causes increased response to aldosterone
What is the hypothesized primary defect in essential HTN?
Defect in renal Na homeostasis
What are the two types of arteriosclerosis pathology-wise?
- Hyaline
- Hyperplastic
What populations does hyaline arteriosclerosis affect?
- Elderly
- Benign nephrosclerosis
- Diabetic microangiopathy
What is the morphology of hyaline arteriosclerosis?
Homogenous pink hyaline thickening
What populations does hyperplastic arteriosclerosis affect?
Malignant HTN
What is the morphology of hyperplastic arteriosclerosis?
- Onion skinning
- Smooth muscle hypertrophy/plasia
- Fibrinoid deposition/acute necrosis
- Kidney, periadrenal fat, gallbladder, intestinal, peripancreatic
Definition of hypertensive heart disease (pathology)
- LVH in someone w/HTN
- No other reason for LVH
Pathogenesis of HHD
- Sustained pressure load acts as stimulus causing changes in gene expression of myosin, actin, etc.
- Increased metabolic requirements w/reduced supply
Gross morphology of HHD
- Increased heart weight
- LVH usually concentric
- Dilation if longstanding with RVH
- CAD
Micro morphology of HHD
- Enlarged, hyperchromatic “box car” nuclei
- Interstitial fibrosis/infarcts
Definition of cor pulmonale (pathology)
- Disease of R heart due to pulm HTN
* NOT due to L heart or congenital disease
Morphology of acute cor pulmonale
Acute RVF = dilated, normal chamber size
Morphology of chronic cor pulmonale
Chronic RVF = increased weight, pulm artery AS
