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Pathophysiology > patho part 3 > Flashcards

patho part 3 Flashcards

1
Q

HTN?

A

consistent elevation of systemic arterial bp

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2
Q

if your bp is over 130/80 on 3 separate occasions you have…

A

htn

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3
Q

hypertensive emergency?

A

SBP over 180 mmHg AND OR DBP over 120 mmHG
Rapidly evolving end organ damage
Admit pt and give IV meds
Goal: reduce bp within hours bc changing it too quickly can cause cerebral ischemia

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4
Q

hypertensive urgency

A

SBP over 180 mmHg AND OR DBP over 120 mmHG
No evolving end organ damage
Out pt with oral meds
Goal: reduce bp over days

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5
Q

why may bp be elevated

A

pump, pipes, fluid, control system

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6
Q

what do they kidsneys do

A

uses a filtering process to remove contaminants by using a pressure gradient

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7
Q

renal artery stenosis is in ____% of hypertensive pts

A

1-2

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8
Q

2 types of renal artery stenosis

A

fibromuscular dysplasia and atherosclerosis

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9
Q

fibromuscular dysplasia? who does it mainly occur in

A

in young women; muscle wall in renal artery has changed

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10
Q

what type of renal artery stenosis is more common

A

atherosclerosis

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11
Q

who is renal artery stenosis from atherosclerosis more common in

A

older ppl

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12
Q

what happens in Endocrine mediated HTN by the ANS

A

catecholamines like epi, norepi, and dopamine increase EF

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13
Q

what impact does high serum Na have on blood volume

A

high serum sodium leads to increased blood volume which can increase bp

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14
Q

excessive RAAS leads to…

A

inc htn

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15
Q

Hyperaldosteronism (mineralcorticoid) causes the body to…

A

retains Na (inc fluid retention) and loses K

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16
Q

hypercortisolism in in what syndrome

A

cushings syndrome

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17
Q

what is cushings causes by

A

Caused by pituitary adenoma and chronic glucocorticoid use

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18
Q

what effect does too much cortisol have on the body

A

Too much cortisol leads to inc contractility, fluid retention, and inc effect of catecholamines of vasoconstriction

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19
Q

what does hyperparathyroidism cause

A

Hypercalcemia from renal insufficiency that causes calcium mediated vasoconstriction

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20
Q

what is hyperthyroidism

A

Isolated systolic HTN while diastolic is the same which causes inc CO

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21
Q

pheochromocytoma?

A

Benign adrenal tumor that secretes catecholamines causing headaches, palpitations, diaphoresis (sweating), and severe htn

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22
Q

when does pheochromocytoma occur

A

Occurs a lot between ages 20-50, but really can develop at any age

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23
Q

Testing: plasma free metanephrines or urinary fractionated metanephrines is for what disease

A

pheochromocytoma

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24
Q

trmt for pheochromocytoma

A

antihypertensives til surgery

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25
Q

coarctation of the aorta?

A

congenital defect causing different blood pressures in different parts of the body; any pressure below the coarctation is lower

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26
Q

+ family hx, age, male, black, high Na intake, DM, smoking, obesity, alcohol, low dietary intake of K+, Ca++, and Mg++

A combination of genes AND environment

are risk factors for….

A

primary htn

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27
Q

Increased SNS activity can result from…

A

Increased production of catecholamines

Increased catecholamine receptor reactivity (either more receptors or more numerous ones)

Receptors are not just in the heart and arteries

Over expressed beta adrenergic receptors on juxtaglomerular cells that causes increased renin secretion

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28
Q

Increased SNS activity can cause…

A

Inc hr and pvr, inc insulin resistance, vascular remodeling, procoagulant effects, endothelial dysfunction, narrowing of vessels and vasospasms

29
Q

wha Can cause endothelial damage and tissue ischemia

A

inflammation

30
Q

excessive inflammation Can cause endothelial damage and tissue ischemia by:

A

Vascular remodeling and inc PVR

Decreased production of vasodilators like NO

Increased production of vasoconstrictors like endothelin

31
Q

what are some other causes of HTN

A

Sleep apnea, obesity, preeclampsia (high bp during pregnancy and renal changes), iatrogenic from meds, alcohol, drugs, supplements

32
Q

preeclampsia?

A

high bp during pregnancy and renal changes

33
Q

requirements for hypotension

A

SBP less than 90 mmHg AND symptomatic

MAP less than 60 mmHg

34
Q

how do we decide when to treat hypotension

A

Treat based on degree of urgency and underlying cause

35
Q

New onset syncope should/should not be ignored

A

should NOT

36
Q

what are the 3 big causes of hypotension

A

cardiogenic shock, distributive shock, or hypovolemic shock

37
Q

how does cardiogenic shock cause hypotension

A

poor contractility, less preload, regurgitation, arrhythmogenic, obstructive

38
Q

3rd spacing?

A

fluid mvmt from intravascular space into interstitial/nonfunctional areas between cells

39
Q

how can hypovolemic shock lead to hypotension

A

hemorrhage, volume depletion

40
Q

Septic shock, hepatic failure, pancreatitis, anaphylactic shock, adrenal insufficiency, neurogenic shock, iatrogenic from meds we prescribed, alcohol, illicit drug, inactivity, gravity is a type of what shock from hypotension

A

distributive

41
Q

syncope?

A

transient, self limited loss of consciousness due to impairment of cerebral flow

42
Q

what is syncope caused by

A

orthostatic/postural hypotension (position changes) or neurogenic syncope

43
Q

orthostatic/postural hypotension?

A

when bp does not compensate for changes in gravity

44
Q

2 types of orthostatic/postural hypotension?

A

acute orthostatic hypotension aka fainting or chronic orthostatic hypotension

45
Q

how do we know if someone has orthostatic/postural hypotension

A

when a person stands…
SBP decreased by 20 mmHg or more

DBP decreased by 10 mmHg or more

Increase in HR by 20 bpm or more

46
Q

what can orthostatic/postural hypotension be a sign of

A

hypovolemia (MC) or neurogenic syncope

47
Q

neurogenic syncope?

A

Increased vagal tone /parasympathetic reflex from a cough, micturition, defecation, diving, sneezing, swallowing, carotid sinus massage (like during shaving)

48
Q

lipids?

A

heterogeneous group of compounds related by their physical properties rather than their chemical such as fats, oils, steroids, and waxes

49
Q

lipids are Insoluble in ____and soluble in _____

A

water, nonpolar solvents

50
Q

how are lipids transported in the body

A

carrier protein

51
Q

function of lipids

A

Have high nrg value, store energy, regulate heat, myelinate nerves, high concentration in brain ( so you don’t want statins during pregnancy bc they lower cholesterol)

52
Q

Key difference between plant and animal cells

A

lipids in membrane

53
Q

cholesterol?

A

steroid like compound that is a precursor of all other steroids (corticosteroids, sex hormones, bile acids, and vitamin D)

54
Q

It’s amphipathic- has a hydrophobic and hydrophilic side

A

cholesterol

55
Q

how do we get cholesterol in the body

A

Can be ingested in foods of animal origin like egg yolk, meat, liver, and brain or made in tissues from acetyl CoA

56
Q

triglyceride

A

ester that allows transport of fat and glucose from liver via chylomicrons

57
Q

where is cholesterol

A

Free floating, Lipoprotein for transport, Stored as cholesteryl ester

58
Q

lipoproteins?

A

large macromolecular structures with proteins that transport lipids throughout the body to and from tissues

59
Q

types of lipoproteins

A

chylomicrons, VLDL, IDL, LDL, HDL

60
Q

to many carriers of lipoproteins to tissues can cause this

A

hyperlipidemia

61
Q

Chylomicrons and VLDL- carry ______

A

triglycerides

62
Q

IDL- carry _______

A

triglycerides and cholesterol

63
Q

LDL and HDL- carry

A

cholesterol

64
Q

apolipoproteins are made here

A

liver and intestine

65
Q

too much of this can cause gallstones and atherosclerosis

CAD

A

cholesterol

66
Q

atherosclerosis

A

inflammatory response due to accumulation of lipids in arterial wall

67
Q

atheromas or plaques?

A

accumulation and swelling in artery walls made of macrophage cells, lipids, fibrous CT and calcium

68
Q

foam cells?

A

Macrophages filled with oxidized LDL in walls of arteries of most ppl

69
Q

what do statins do?

A

stabilize paques and dec LDL

Pathophysiology (17 decks)

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