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Pathology
Dz of Blood vessels
Question | Answer |
---|---|
How is systemic hypertension (HTN) or aka. High blood pressure defined as? | Systolic above 140, OR Diastolic above 90 |
Is hypertension multifactorial inheritance? | Yes! BP is a complex trait determined by interaction of multiple genetic & environmental factors |
BP is product of what? | cardiac output & peripheral resistance |
what determines cardiac output & peripheral resistance? | cardiac output - stroke volume & heart rate peripheral resistance - arterioles thru opposing vasoconstrictor & vasodilator |
Kidney plays an impt. role in BP, mainly thru what? | renin-angiotensin axis |
what is the epidemiology of HTN? | Very common, 25% of general population. 50% die w/ ischemic heart dz or congestive heart failure. 33 % die w/ stroke. 5 % w/ malignant hypertension(rapidly rising BP), die of renal failure. |
HTN is an impt. risk factor for what dzs? | 1. ischemic heart dz 2. cerebrovascular accident (stroke) 3. congestive heart failure 4. renal failure |
Etiologic types of HTN: describe them. | 1. Essential HTN (90-95%) = considered idiopathic & primary 2. Secondary HTN (5-10%) = happens secondary to other dz, esp to renal dz/narrowing of renal artery. |
Describe: Benign HTN vs. Malignant HTN | Benign HTN = fairly stable over yrs - decades, lives long life. Malignant HTN (accelerated HTN) = BP rises rapidly, death w/in 1-2 yrs, diastolic >120, renal failure, retinal hemorrhages. |
what are some mechanisms for Essential HTN? (they are no single mechanism that are responsible) | 1. Reduced renal sodium excretion 2. Increased Vascular resistance 3. Genetic factors 4. Environmental influences |
Define: 1. Hyaline arteriolosclerosis 2. Hyperplastic arteriolosclerosis | |
What is Arteriosclerosis? | general term of 3 types of vascular dz which cause thickening & inelasticity of arteries. |
what are types of arteriosclerosis? | 1. arteriolosclorosis 2. Monkeberg medial calcific sclerosis 3. atherosclerosis |
what is Arteriolosclerosis? | Dz. of small arteries & arterioles. occurs often w/ hypertension & diabetes mellitus. |
what is Monkeberg medial calcific sclerosis? | calcifications in media of medium sized muscular arteries. typically age >50yrs. vessels may be hard to palpate & interesting radiograph. trivial dz & not ass. w/ clinical dz. |
what is atherosclerosis? | Formation of atheromas(fibrofatty plaques at intima) |
Athromas produce...? | 1. vascular narrowing - b/c protrude into lumen 2. degenerative changes - b/c weakens the vessel wall |
Most serious consequences of artherosclerosis is seen at...? | 1. coronary artereis 2. cerebral vessels 3. aorta |
what's the epidemiology of atherosclerosis? | 1. Major complication is death/ disability from heart attacks & stroke 2. cause 1/3 of death in US |
what are the constitutional risk factors for atherosclerosis? | 1. Genetics (mostly related to polygenic traits for hypertension & diabetes) 2. Age 3. Gender |
what are the modifiable major risk factors for atherosclerosis? (list in rank) | 1. hyperlipidemia/Hypercholesterolemia 2. Hypertension 3. cigarette smoking 4. Diabetes mellitus |
Describe the pathogenesis of ATH. | 7 steps- look notes |
sites of predilection for ATH. | 1. lower abdominal aorta 2. coronary arteries 3. popliteal arteries. 4. internal carotid arteries 5. circle of Willis |