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Lecture 14
Hypertension Heart and Kidneys
| Question | Answer |
|---|---|
| What is a normal Blood Pressure | <120/<80 |
| what is Pre-Hypertension | 120-139/80-89 |
| What is Stage I hypertension | 140-149/90-99 |
| What is Stage II hypertension | >160/>99 |
| Can you diagnose hypertension during a patient's first visit? | no you must take an average of 2 or more readings taken at each of 2 or more visits |
| how do you define hypertension for children and adolescents | blood pressure that is >95th percentile or greater for adjusted age, height, and gender with repeated measurement |
| In persons >50 what is more important systolic or diastolic blood pressure elevation | Systolic (more of a cardiovascular risk factor) |
| What should you do when you have a patient with pre-hypertension | promote health promoting lifestyle modification |
| what percent of hypertension is due to a secondary cause? | <5% |
| what are some renal causes of hypertension | Renal artery stensis, fibromuscular dysplasia, parenchymal disease, PCKD, Urinary tract obstruction, Renin producing tumor |
| what are some endocrine causes of hypertension | Conn's syndrome, Cushings, Acromegaly, Congenital adrenal hyperplasia, hyperparathyroidism, oral contraceptives |
| what are some neurological causes of hypertension | increased intracranial pressure, sleep apnea, bulbar polimyelitis, psychogenic |
| what are some drugs and toxins that can cause hypertension | alcohol, cocaine, cyclosporine, erythropoietin, adrenergic medications |
| what is malignant hypertension | severe hypertension with rapid progression to renal failure and retinal hemorrhages and papilledema |
| Blood pressure = ? | cardiac output x peripheral resistance |
| What is GRA | glucocorticoid remediable aldosterone it causes ectopic production of aldosterone under the control of ACTH |
| what is AME | Apparent mineralocorticoid excess results in an increased level of cortisol which stimulated mineralcorticoid receptor |
| what is Liddle Syndrome | autosomal dominant syndrome associated with gain of function activity of the sodium channel independent of mineralcorticoids |
| what chromosome is involved in GRA | chromosome 8q |
| what chromosome is involved in AME | chromosome 16q |
| what chromosome is involved in Liddle Syndrome | 16p |
| Is GRA autosomal dominant or recessive | Dominant |
| is AME autosomal dominant or recessive | Recessive |
| is Liddle Syndrome autosomal dominant or recessive | Dominant |
| who is more at risk for developing cardiovascular disease men or women | men (post menopausal women approach the risk of men) |
| what is a pheochromocytoma | a tumor of the adrenal gland that secretes catecholamines |
| what is Conn Syndrome | primary hyperaldosteronism |
| what is the most common renal complication due to hypertension | nephrosclerosis |
| what are the two proposed mechanisms for nephrosclerosis with hypertension | glomerular hyperfiltration and ischemia |
| what effect does hypertension have on the eyes | hypertension may cause arterial changes with retinal exudates and hemorrhage |
| what are the three histologic changes seen in the kidney with malignant nephrosclerosis | fibrinoid necrosis or the arterioles, onion-skin arteriosclerosis, hypercellular glomeruli |
| what is hypertensive encephalopathy | cerebral edema results in increse intracranial pressure, headaches, vomiting confusion and coma |
| what opthalmoscopic exam findings may be correlated with malignant hypertension | cotton wool spots adn flame hemorrhages |
Created by:
UVAPATH3
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