hypertension (flex week)

Question 1

blood pressure equation

Answer 1

ABP = COxTPR (total peripheral resistance)

Question 2

sepsis and blood pressure?

Answer 2

sepsis can lead to systemic vasodilation leading to drop in total peripheral resistance leading to low blood pressure

Question 3

how does the body manage blood pressure (2 ways)

Answer 3

carotid baroreceptors
renin angiotensin system

Question 4

renin angiotensin system explanation?

Answer 4

drop in blood pressure -> renin production from kidney -> angiotensin 1 to angiotensin 2 -> vasoconstriction and retention of salt & water -> increased blood pressure

Question 5

what does kidney failure cause

Answer 5

high blood pressure

Question 6

why is high blood pressure required in the kidneys

Answer 6

allows glomerular filtration

Question 7

causes of high blood pressure? (6)

Answer 7

increased cardiac output
sensors confused
kidneys cant excrete salt/water
sympathetics activated
RAAS activated
increase in TPR

Question 8

causes of high blood pressure - cardiac output increase - examples

Answer 8

exercise
hyperthyroidism

Question 9

causes of high blood pressure - sensors confused - examples

Answer 9

renal artery stenosis
baroreceptor dysfunction

Question 10

causes of high blood pressure - kidneys can’t excrete salt/water - examples

Answer 10

advanced CKD
NSAIDs

Question 11

causes of high blood pressure - sympathetics activated - examples

Answer 11

stress
phaeochromocytoma
sleep apnoea
cocaine

Question 12

causes of high blood pressure - RAAS - examples

Answer 12

hyperaldosteronism
Cushing syndrome
iatrogenic glucocorticoids

Question 13

causes of high blood pressure - increase in TPR - examples

Answer 13

coarctation

Question 14

hypertension definition

Answer 14

blood pressure high enough to cause disease: >140/90

Question 15

consequences of hypertension

Answer 15

stroke
MI
heart failure
atrial fibrillation
kidney failure
retinopathy
encephalopathy

Question 16

hypertension more common in men or women?

Answer 16

men! (L)

Question 17

biological causes of hypertension

Answer 17

genes:
-salt excretion
-drug metabolism
-target organ damage

Question 18

social causes of hypertension

Answer 18

diet
economic status
education
engagement with healthcare

Question 19

psychological causes of hypertension

Answer 19

stress
depression

Question 20

hypertension treatment - lifestyle

Answer 20

low sodium chloride intake
high potassium intake (fresh fruit & veg)
drink less alcohol
physical activity
weight loss

Question 21

hypertension treatment - procedures

Answer 21

NOT STANDARD PRACTICE:
sympathetic denervation
carotid baroreceptor stimulation
AV fistula formation

Question 22

hypertension treatment - drugs

Answer 22

calcium channel blockers
ACEi/ARBs
thiazide diuretics
alpha and beta blockers for second line treatment

Question 23

anti-hypertensive therapies adverse effects

Answer 23

all cause dizziness, falls
vasodilators can cause ankle oedema
diuretics cause gout, hyponatraemia, hypokalaemia

Question 24

what factors affect what type of hypertension treatment to give

Answer 24

CCB to those aged over 55 and black African/African Caribbean (can’t have ACEi/ARB)

ACEi/ARB to those with diabetes mellitus (can’t have CCB)