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Module 4 > systemic hypertension > Flashcards

systemic hypertension Flashcards

1
Q

what is stage 1 hypertension

A

> 130/80

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2
Q

How is MAP derived

A

TRP x CO

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3
Q

how is CO derived

A

HR x SV

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4
Q

how is SV derived

A

diastolic - systolic

Volume of blood ejected from each ventricle per beat

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5
Q

what are the structural causes that induce sustained elevation of BP in essential hypertension

A 
endothelial dysfunction (NO, endothelial)
vdmc constriction (calcium)
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6
Q

what are the functional causes that induce sustained elevation of BP in essential hypertension

A

increased wall mass (hypertrophy and hyperplasia)

wall remodeling with no increase in mass

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7
Q

describe functional and structural rarefaction

A

Rarefaction Decrease of number of vessels in parallel with increase resistance
In functional rarefaction the vessels are there but not being perfused  this can then turn into structural rarefaction where then the vessels degrade

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8
Q

what does a decrease in the number of
vessels in parallel do to the network
vascular resistance

A

increases the resistance

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9
Q

what happens to the chamber size in hypertension

A

decreases since the wall thickens

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10
Q

what happens to the diastolic filling in hypertension

A

decreases due to decreased ventricular compliance (stiffness)

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11
Q

define after load

A

Resistance that the left ventricle has to overcome to eject blood

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12
Q

what impact does insulin resistance have on the pathophysiology of hypertension

A

VSMC hypertrophy and increased resistance

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13
Q

what impact does obesity have on the development of hypertension

A

increases angiotensinogen, increased blood viscosity, augments blood volume

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14
Q

when do you assess for secondary hypertension

A
  • Age ( before 20 or after 50)
  • Severity – dramatic
  • Onset- acute
  • Associated symptoms – ie renal artery bruit
  • Family history – not common
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15
Q

is Reduced nephron number a risk factor for hypertension

A

yes

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16
Q

how does an Abdominal aortic aneurysm occur in hypertension

A

Usually below the renal artery so high perfusion leads to Prominent dialation then weakened by the high flow and atherosclerosis

17
Q

how does an aortic dissection occur in hypertension

A

weakened intima media is then collapsed by high pressures

18
Q

what are two pathologies of the kidney that develop with hypertension

A

renal failure
Hyaline arteriolosclerosis
Fibrinoid necrosis (SM hypertrophy and necrosis of cap walls)

19
Q

what does ischemia in the optic nerve result in

A

blurred vision

20
Q

what is a sign of acute hypertension

A

hemorrages, exudates

21
Q

what is a sign of very high BP with high ICP

A

Pailledema

22
Q

what is a sign of chronic hypertension

A

Increased light reflection- arterial sclerosis

23
Q

ID some things that can lead to increased BP

A 
estrogens can lead to increased angiotensinogen
glucocorticoids
epo
cyclosporine
sympathetic activity
NSAids 
Ang II
24
Q

how does renal parenchymal disease lead to hypertension without impacting GFR

A

excessive renin elaboration

often causes fibromuscular lesions in the media of the vessel

25
Q

how can you ID renovascular hypertension

A

renal artery bruit or unexplained hypokalemia

26
Q

can you treat renovascular hypertension with ACEi

A

yes IF its not bilateral and they don’t have an already reduced GFR

27
Q

what are some symptoms of pheochromocytoma

A

NE secreting tumor resulting in

headaches, sweating, palpitations and tachycardia

28
Q

what is cushings syndrome

A 
excessive glucocorticoid secretion 
central obesity
round face
proximal muscle weakness
hirsutism
29
Q

what are Cotton Wool Spots on retina exam

A

Accumulations of debris within bundles of unmyelinated ganglion cell axons due to focal ischemia

30
Q

what are some ways that Hyperinsulinemia / Insulin resistance can cause hypertension

A

Increased sympathetic activity, volume expansion from increased renal sodium reabsorption,
upregulation of angiotensin II receptors, and decreased cardiac natriuretic peptide (protein released by heart to reduce arterial pressure)

Module 4 (28 decks)

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