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PBL SEM 2 > PBL 6 > Flashcards

PBL 6 Flashcards

1
Q

how does excessive BP affect the arteries?

A

causes hardening of the arteries = arteriosclerosis

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2
Q

how does hypertension affect the IEL?

A

thickens it

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3
Q

what is retinopathy?

A

damage to blood vessels in retina

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4
Q

what is the microalbumin test and when is it used?

A
  • tests for very small levels of proteins in the urine
  • kidney failure — leak proteins and gradually fail
  • this tests detects this
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5
Q

describe ANP

A

= counter-regulatory system for the RAAS

  • released by cells in the atria
  • responds to atrial stretch, sympathetic stimulation, angiotensin 2 (high levels)
  • acts on kidney to increase glomerular filtration rate, natruiresis and diuresis — increase urinary output
  • decrease renin and aldosterone release
  • these all decrease blood volume, CO and BP
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6
Q

what is the rate limiting enzyme in RAAS?

A

renin

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7
Q

where is renin made?

A

kidneys

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8
Q

where is ACE made?

A

lungs

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9
Q

what is the receptor for covid-19?

A

ACE 2

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10
Q

why are muscular arteries the main vasoconstrictors and vasodilators?

A

have the most smooth muscle

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11
Q

what type of artery has the largest tunica media?

A

elastic arteries

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12
Q

what type of artery lacks EEL?

A

arterioles

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13
Q

how does high BP affect the kidneys?

A
  • HBP can constrict and narrow the blood vessels throughout the body, including in the kidneys
  • this narrowing reduces blood flow
  • if the kidney’s blood vessels are damaged, kidneys are not able to remove all wastes and extra fluid from your body
  • extra fluid in the blood vessels can raise your BP even more
  • causes more damage leading to kidney failure
  • kidneys become granular and shrunken, leak proteins and gradually fail
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14
Q

what is a good drug choice for hypertensive obese people?

A

obesity activates RAAS — therefore increases renal tubular Na+ reabsorption — diuretics good choice

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15
Q

how can alcohol lead to hypertension?

A

leads to increased renin and decreases baroreceptor activity

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16
Q

what is indapamide?

A

= thiazide-like drug

  • diuretic (water pill)
  • acts at distal tubule at NaCl channel — inhibits it
  • causes increased loss of salt and water
  • lowers BP
  • not 1st line treatment — add on
17
Q

why is it essential to monitor serum electrolyte and creatine levels during diuretic treatment?

A

all diuretics can disturb the plasma-electrolyte balance, especially with K+. diuretics can also cause a loss of renal function as a consequence of hypovolaemia

18
Q

what is amlodipine?

A
  • blockade of Ca++ channels
  • antagonists for L-type Ca++ channels
  • decreases arterial smooth muscle contractility and vasoconstriction by inhibiting the influx of Ca++ through the channels
  • causes swollen ankles
19
Q

name an ACE inhibitor

A

ramipril

20
Q

what is given instead of ACE inhibitor to remove dry persistant cough?

A

angiotensin receptor blocker eg. candesartan

21
Q

what is/describe eGFR?

A

eGFR = estimated glomerular filtration rate

  • should be >90
  • measure of kidney function
  • based on age, sex, creatinine

high creatinine = low eGFR

22
Q

why does oedema occur with amlodipine?

A
  • antagonist for L-type Ca channels — decreases arterial smooth muscle contractility and vasocontriction by inhibiting the influx of calcium ions through the channels
  • triggers dilation of blood vessels — lowered BP and improves blood flow
  • improved flow can increase intra-capillary pressure — forces fluid into surrounding tissues
  • mostly in ankles due to gravity

pre-capillary arterioles dilate more than post-capillary venules, causing hydrostatic pressure that pushes fluid out of the capillaries

23
Q

what are normal levels of K+?

A

3.3 - 5.5 mmol/L

24
Q

what are normal levels of Na+?

A

135-145 mmol/L

25
Q

why is exercise recommended?

A
  • increased resistance to fatigue

- decreased TPR

26
Q

what is an inherited form of high BP?

A

liddle’s syndrome

27
Q

describe liddle’s syndrome

A
  • monogenic — Mendelian Hypertenison
  • autosomal dominant
  • mutations in the SCNNIB or SCNNIA gene
  • Na+ is continuously reabsorbed, along with H2O
  • kidneys excrete K+ but retain Na+ and H2O —> HYPERTENSION
  • hypokalaemia
28
Q

what is biochemical screening for nonadherance?

A

uses mass spec to measure levels of prescribed drugs in urine

29
Q

what % of people discontinue treatment of antihypertensive drugs within 1st year?

A

50%

30
Q

are blood vessels innervated?

A

yes, by sympathetic fibres only

31
Q

what is the normal range for LDL:HDL cholesterol ratio in males?

A

<100mg/dl LDL but > 40mg/dl HDL

32
Q

what part of the kidney tubule does a thiazide diuretic act upon?

A

distal convoluted tubule

33
Q

what is the mechanism of Losaratn?

A

angiotensin II receptor (type AT1) antagonist

34
Q

in what stage of the Stages of Change Model do people begin weighing up the pros and cons?

A

contemplation

35
Q

which ion does bendroflumethiazide inhibit the reabsoprtion of?

A

Cl-

36
Q

approximately what % of women aged over 75 have hypertension?

A

65%

37
Q

what is the main social predictor of smoking initiation?

A

having parents that smoke

PBL SEM 2 (44 decks)

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