Hypertension Heart and Kidneys
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| What is a normal Blood Pressure | <120/<80
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| what is Pre-Hypertension | 120-139/80-89
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| What is Stage I hypertension | 140-149/90-99
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| What is Stage II hypertension | >160/>99
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| 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
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| 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
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| In persons >50 what is more important systolic or diastolic blood pressure elevation | Systolic (more of a cardiovascular risk factor)
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| What should you do when you have a patient with pre-hypertension | promote health promoting lifestyle modification
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| what percent of hypertension is due to a secondary cause? | <5%
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| what are some renal causes of hypertension | Renal artery stensis, fibromuscular dysplasia, parenchymal disease, PCKD, Urinary tract obstruction, Renin producing tumor
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| what are some endocrine causes of hypertension | Conn's syndrome, Cushings, Acromegaly, Congenital adrenal hyperplasia, hyperparathyroidism, oral contraceptives
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| what are some neurological causes of hypertension | increased intracranial pressure, sleep apnea, bulbar polimyelitis, psychogenic
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| what are some drugs and toxins that can cause hypertension | alcohol, cocaine, cyclosporine, erythropoietin, adrenergic medications
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| what is malignant hypertension | severe hypertension with rapid progression to renal failure and retinal hemorrhages and papilledema
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| Blood pressure = ? | cardiac output x peripheral resistance
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| What is GRA | glucocorticoid remediable aldosterone it causes ectopic production of aldosterone under the control of ACTH
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| what is AME | Apparent mineralocorticoid excess results in an increased level of cortisol which stimulated mineralcorticoid receptor
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| what is Liddle Syndrome | autosomal dominant syndrome associated with gain of function activity of the sodium channel independent of mineralcorticoids
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| what chromosome is involved in GRA | chromosome 8q
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| what chromosome is involved in AME | chromosome 16q
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| what chromosome is involved in Liddle Syndrome | 16p
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| Is GRA autosomal dominant or recessive | Dominant
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| is AME autosomal dominant or recessive | Recessive
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| is Liddle Syndrome autosomal dominant or recessive | Dominant
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| who is more at risk for developing cardiovascular disease men or women | men (post menopausal women approach the risk of men)
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| what is a pheochromocytoma | a tumor of the adrenal gland that secretes catecholamines
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| what is Conn Syndrome | primary hyperaldosteronism
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| what is the most common renal complication due to hypertension | nephrosclerosis
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| what are the two proposed mechanisms for nephrosclerosis with hypertension | glomerular hyperfiltration and ischemia
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| what effect does hypertension have on the eyes | hypertension may cause arterial changes with retinal exudates and hemorrhage
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| what are the three histologic changes seen in the kidney with malignant nephrosclerosis | fibrinoid necrosis or the arterioles, onion-skin arteriosclerosis, hypercellular glomeruli
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| what is hypertensive encephalopathy | cerebral edema results in increse intracranial pressure, headaches, vomiting confusion and coma
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| what opthalmoscopic exam findings may be correlated with malignant hypertension | cotton wool spots adn flame hemorrhages
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