02.05 Hypertensive Vascular Disease

Question 1

Most important risk factor for coronary artery disease and stroke

Answer 1

Hypertension

Question 2

Extent and velocity of shortening or force of contraction

Answer 2

Contractility

Question 3

Prime determinant of arterial pressure over the long term

Answer 3

Intravascular volume (TPR)

Question 4

Maintains pressure homeostasis via pressure, volume and chemoreceptor signals

Answer 4

Autonomic nervous system

Question 5

Most potent vasoconstrictor

Answer 5

Angiotensin II

Question 6

Most common cause of secondary hypertension

Answer 6

Renal disease

Question 7

Due to obstruction of renal artery
Mechanism through activation of RAAS
Deterioration of renal function associated with an ACE-I/ARB/DRB

Answer 7

Renovascular hypertension

Question 8

Surgery is the only definitive treatment

Answer 8

Primary aldosteronism

Question 9

Most common congenital cardiovascular cause of hypertension

Answer 9

Coarctation of the aorta

Question 10

First-line agent

Answer 10

Diuretics

Question 11

Inhibit NaCl pump in the distal convoluted tubule (inc. na secretion, diuresis, dec. sv, dec. CO)

Answer 11

Hydrochlorothiazide

Question 12

Very strong diuretic, usually reserved for renal insufficiency

Answer 12

Furosemide

Question 13

Centrally acting sympathetic agonist

Useful for patients with autonomic neuropathy

Answer 13

Sympatholytic agents (clonidine, methyldopa)

Question 14

Side effects include orthostatic HPN, somnolence, dry mouth, rebound HPN on withdrawal, secual dysfunction, myocarditis, thrombocytopenia, bradycardia, weakness

Answer 14

Sympatholytic agents

Question 15

Blocks alpha-adrenergic receptors
Used for phreochromocytoma
Not been shown or proven to reduce CV events

Answer 15

Alpha-blockers (Terasozin)

Question 16

Blocks beta-adrenergic receptors
Good for tachycardic patients, palpitations, anxiety
Proven to reduce CV events in post-MI, CAD, CHF

Answer 16

Beta-blockers (metraprolol, atenolol, bisoprolol, carvediol)

Question 17

Side effects include bronchospasm, weakness, easy fatigue, bradycardia, AV block

Answer 17

Beta-blockers

Question 18

Directly dilates peripheral vessels

Usually in combination with diuretic or beta-blockers

Answer 18

Direct vasodilator (hydralazine)

Question 19

Decreases peripheral resistance by reducing intracellular calcium
Proven to reduce morbidity and mortality

Answer 19

Calcium channel blockers

Question 20

3 types of CCB

Answer 20

Phenylalkylamine (verapamil)
Benzothiazepine (Diltiazem)
Dihydropyridine (Nifedipine, amiodipine)

Question 21

Side effects include flushing, palpitations, headache, pedal edema, AV block

Answer 21

CCB

Question 22

Aldosterone antagonist

Answer 22

Spironolactone

Question 23

Very effective in primary hyperaldosteronism

Answer 23

RAAS blocker

Question 24

Side effects include gynecomastia, impotence, hyperkalemia

Answer 24

RAAS blocker

Question 25

Blocks conversion of angiotensin I to angiotensin II

Answer 25

ACE-I (catopril, enalapril)

Question 26

Side effects include cough and hyperkalemia

Answer 26

ACE-I

Question 27

Selective blocker of angiotensin I receptors

Answer 27

ARB (losartan, irbesartan, teimisartan)

Question 28

Selective blocker of renin

Answer 28

Direct renin inhibitor (aliskerin)