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Posterior Segment > Systemic Hypertension and the Eye > Flashcards

Systemic Hypertension and the Eye Flashcards

1
Q

Prehypertension is defined as what?

A

120/80 to 139/89

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2
Q

Stage 1 HTN is defined as ?

A

140/90 to 159/99

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3
Q

Stage 2 HTN is defined as ?

A

> 160/100

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4
Q

How many adults in the US have HTN? What percentage is this?

A

67 million people

30% of adults

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5
Q

How many adults are aware that they have hypertension?

A

53 million

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6
Q

How many adults are treated for HTN?

A

47 million

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7
Q

How many adults have controlled HTN?

A

31 million

Only 47% of ppl w/ HTN

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8
Q

What percentage of adults have pre-HTN?

A

30%

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9
Q

What ethnicity has the highest rate of HTN? What percentage per gender group?

A

African Americans

43% men, 45.7% women

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10
Q

What is the second race to have the highest rate of HTN?

A

Mexican Americans

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11
Q

What is the name of the specialized cell in the distal convoluted tubule that senses sodium concentration in the blood?

A

Macula Densa

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12
Q

If the macula densa cell senses low sodium, it will send what to the juxtaglomerular cell?

A

Prostaglandin – tells juxtaglomerular cells to release renin

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13
Q

The juxtaglomerular cell is found in what part of the kidney

A

Afferent arteriole (or juxtaglomerular apparatus)… secretes renin

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14
Q

What stimulates renin?

A

i. Prostaglandin released by Macula Densa Cells

ii. Sympathetic nervous system via Medulla signal via the baroreceptors:

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15
Q

Where are the baroreceptors found? Which CN is associated with each?

A

Aortic Arch - CN X (vagus nerve)

Carotid - CN IX (glossopharyngeal)

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16
Q

Renin will cause what?

A

Reacts w/ Angiotensinogen to become angiotensin I

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17
Q

Angiotensin I reacts with ACE to become what? What does this signal cause?

A

Angiotensin II - power vasoconstrictor to increase BP

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18
Q

Does A-II go to pituitary? What does it do?

A

Yes, it tells the pituitary to secrete an antidiuretic hormone

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19
Q

Does A-II go to the hypothalamus? What does it do?

A

Yes, stimulates the thirst center to make us drink water

20
Q

Where are the 4 locations that A-II goes?

A
  1. Pituitary
  2. Hypothalamus
  3. Tunica Media
  4. Adrenal Gland
21
Q

At what age does your risk for hypertension increase?

A

75 and older

22
Q

If you are 50 yo or less, what’s the sodium intake?

A

2300mg a day

23
Q

If you are 51 or older, what’s the sodium intake?

A

1500mg a day

24
Q

How much salt does the average american intake a day?

A

3400

25
Q

What organ secretes angiotensinogen?

A

Liver

26
Q

Where is ACE secreted from?

A

Vascular endothelial cells of lung, kidney, heart, brain and adrenal medulla

27
Q

A-II goes to the cortex of the adrenal gland to release? What does this hormone do?

A

Releases aldosterone

  • aldosterone goes to collecting duct to bring sodium in, which brings in water to increase BP
28
Q

A-II goes to the pituitary gland to release? What does this do?

A

Anti-diuretic hormone (ADH)

  • can’t pee excess water out of body
29
Q

A-II goes to the hypothalamus to stimulate what?

A

stimulates thirst center

  • makes us thirsty to drink water
30
Q

What retinal changes are found in Grade 3 HR? What’s the diastolic BP around this time?

A

CWS, Exudates, Flame Shaped Hemes

> 100-115 over the last 3 mo.

31
Q

What retinal changes are found in Grade 4 HR?

A

Grade 3 + ONH swelling

> 200/120+

32
Q

What are the 4 things you want to ask a grade 3 or grade 4 patient?

A
  1. Heart pain
  2. Blood in urine
  3. Pain in arm
  4. HA
33
Q

What are the grades for AS?

A
  1. broadened arteriole light reflex
  2. Increased broadening of arteriole
  3. Copper wiring
  4. silver wiring
34
Q

What are the 4 causes of malignant hypertension?

A
  1. Renal Artery Stenosis
  2. Pheochromocytoma
  3. Coarctation
  4. Blockage of carotid
35
Q

What is a pheochromocytoma?

A

Tumor of adrenal gland secreting too much epinephrine/norepinephrine

36
Q

HTN can damage what important structures in the brain?

A

internal capsule and basal ganglia

37
Q

What are the 2 types of strokes?

A

Ischemia and Hemorrhage

38
Q

What percentage of strokes are ischemic?

A

85%

39
Q

The diastolic number for malignant hypertension is what?

A

usually above 120 - 130

40
Q

What should be the blood pressure of a hypertensive patient with kidney disease?

A

125/80

41
Q

What secretes renin?

A

Kidney

42
Q

What are the complications of HTN?

A
  • most common cause of premature CV disease, MI
  • Hemorrhagic stroke
  • Embolic Stroke
  • Renal Failure
43
Q

90-95% of ppl don’t know what is causing their HTN. What type of HTN is this?

A

Primary (essential) HTN

44
Q

This is known a hyalanized, thickened and calcified arterioles

A

Arteriolosclerosis

45
Q

Where is arteriolosclerosis most severe?

A

Basal Ganglia (60%)
Thalamus (10%)
Pons (10%)
Cerebellum (10%)

46
Q

What % of all strokes occur after the age of 65?

A

75%

Posterior Segment (8 decks)

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