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Lecture 14

Hypertension Heart and Kidneys

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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