S2 - Hypertension and Stroke

Question 1

What is primary (essential) hypertension?

For what percentage of HTN cases does it account?

Answer 1

An idiopathic form of HTN (cause unknown)

90%

Question 2

What is secondary HTN (responsible for 10% of cases)?

Answer 2

HTN due to some underlying disease

Question 3

What is systolic blood pressure? What is diastolic blood pressure?

Answer 3

Systolic BP = BP while the ventricles are contracting - Top number (e.g. 120 / 80)

Diastolic BP = BP while the ventricles are relaxing - Bottom number (e.g. 120​ / 80)

Question 4

What is the normal blood pressure classification?

Answer 4

< 120 / 80 mmHg

Question 5

What is the proper classification for an individual with a BP ranging from 120 - 129 / 80 mmHg?

Answer 5

Elevated BP

(No longer known as pre-HTN)

Question 6

What is the stage 1 HTN pressure reading?

Answer 6

130 to 139 / 80 to 89 mmHg

Question 7

What is the stage 2 HTN pressure reading?

Answer 7

≥ 140 / ≥ 90 mmHg

Question 8

At what BP reading is an individual considered to be in a hypertensive crisis (at immediate risk for organ damage)?

Answer 8

≥ 180 / ≥ 120 mmHg

Question 9

What are some common complications of HTN?

Answer 9

Stroke

Atherosclerosis

Thrombosis

Aneurysm formation

Organ damage

(Not a comprehensive list)

Question 10

What is the DASH diet?

Answer 10

An antihypertensive diet focusing on the reduction of salt and lipid intake

Question 11

What lifestyle modifications can be utilized to lower BP?

Answer 11

Weight loss

Salt intake reduction

Physical activity increase

Meditation

Question 12

What is the REGARDS study?

Answer 12

the REasons for Geographic And Racial Differences in Stroke

Question 13

Define ischemia

Answer 13

Lack of oxygen delivery to tissues

Question 14

Define infarct.

Answer 14

Cell damage and death due to loss of blood flow

Question 15

What is the definition of a transient ischemic attack?

Answer 15

A ‘mini-stroke’ that results in signs and symptoms that have completely resolved 24 hours after the insult

Question 16

Just as heart attack refers to an acute myocardial infarction, what is the term that can also refer to a cerebral infarction (stroke)?

Answer 16

Cerebrovascular attack (CVA)

Question 17

What are the two main types of stroke?

Which is more common?

Which is more deadly?

Answer 17

Ischemic (thrombotic; loss of blood supply) and hemorrhagic (rupture leads to blood entering cranial space)

Ischemic is more common (85-90% of cases)

Hemorrhagic is more deadly

Question 18

What is the core zone of a stroke? What is the ischemic penumbra?

Answer 18

The core zone refers to the infarcted tissues following complete loss of blood supply

The penumbra refers to the affected area of tissue that is often still viable tissue but will die if perfusion is not reestablished; there is usually some collateral circulation supplying the tissues with some blood flow

Question 19

Define aneurysm.

Answer 19

A weakening or outpouching in the blood vessel wall (a ballooning that is more likely to rupture than surrounding tissue)

Question 20

What are some of the risk factors for stroke?

Answer 20

Hypertension (Most important factor)

Metabolic syndrome

Atherosclerosis

Atrial fibrillation

Aneurysms

Race (African-Americans more at risk)

Medical history of thrombotic events

Question 21

What are some of the common signs and symptoms of stroke?

Answer 21

Headache, weakness, paralysis, dizziness, vision changes, balance changes, drooping facial features, slurred speech, disorganized speech or thoughts

(Physical signs often unilateral)

Question 22

On which side of the body will a right-sided stroke manifest?

What is the term for this manifestation?

Answer 22

The left side (and vice-versa for a left-sided stroke)

Contralateral

Question 23

How can stroke be diagnosed?

Answer 23

Clinical presentation, MRI, CT scans, angiography

Question 24

What medication can be given to prevent thrombotic stroke?

What medication can be given to dissolve the clot that is causing thrombotic stroke?

Answer 24

Aspirin and/or heparin

TPA (tissue plasminogen activator)

Question 25

Where does stroke fall in the U.S. leading causes of death?

Answer 25

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