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Renal > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What does a high BP (particularly systolic/pulse pressure) put you at risk of?

A

cardiovascular disease

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2
Q

What other CVD risk factors are often associated with hypertension?

A

diabetes, smoking, abnormal lipids, obesity

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3
Q

What are the cardiovascular diseases that are more likely with hypertension?

A

ischaemic heart disease, atherosclerosis, cerebrovascular disease, aortic dissection, renal vascular disease, small vessel disease of kidney, brain, and retina, heart failure

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4
Q

What is the definition of hypertension?

A

140/90

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5
Q

What is primary/essential hypertension?

A

hypertension with no specific identifiable cause

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6
Q

What percentage of hypertension is primary?

A

90-95%

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7
Q

What is secondary hypertension?

A

hypertension with a specific underlying cause

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8
Q

What is benign hypertension?

A

hypertension that rises slowly

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9
Q

What is malignant hypertension?

A

hypertension that is quickly developing and can get very high - may occur in someone who already has benign hypertension

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10
Q

What 2 forces result in blood pressure?

A

cardiac output (stroke volume and heart rate) and resistance in arterioles

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11
Q

What are age related arterial changes potentiated by?

A

high blood pressure

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12
Q

What happens to the aorta with age?

A

loss of elasticity and hardening, fragmented elastin in media and increased collagen in media and intima - aorta often dilates - stiffening leads to loss of compliance which increases BP

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13
Q

What happens to small and medium arteries with age?

A

fragmentation of elastin in media and increased collagen in media and intima causing intimal thickening

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14
Q

What happens to arterioles with age?

A

hyaline arteriolosclerosis - thickened wall with narrowed lumen - may cause increased BP with age

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15
Q

What genes contribute to the pathogenesis of hypertension?

A

sympathetic responses, transport of ions across cell membranes, arteriolar responses to local regulatory factors, activity components of RAAS

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16
Q

What lifestyle factors contribute to the pathogenesis of hypertension?

A

salt in diet, alcohol, physical activity, abdominal obesity and metabolic syndrome

17
Q

What causes hypertension with wide pulse pressure?

A

decreased compliance of the aorta

18
Q

What is the biggest cause of secondary hypertension?

A

renal disease

19
Q

When does atherosclerosis cause hypertension?

A

ONLY in renal artery arteriosclerosis via activation of RAAS

20
Q

What causes an aortic aneurysm?

A

atherosclerosis prevents blood from getting to the media which causes weakening which results in a focal dilation

21
Q

Where is the blood in an aortic dissection?

A

in the media

22
Q

What are the complications of an aortic dissection?

A

haemopericardium and cardaic tampenade, haemothorax, compression of common carotid causing stroke, compression of coronary arteries causing MI

23
Q

What is the main cause of LV concentric hypertrophy?

A

hypertension

24
Q

How does concentric hypertrophy cause diastolic failure?

A

impaired filling due to stiff wall

25
Q

How does concentric hypertrophy cause systolic failure?

A

impaired contraction because of stiff wall

26
Q

How does concentric hypertrophy cause risk of an MI?

A

increased oxygen demand and reduction in perfusion gradient due to increased pressure in wall

27
Q

What do most patients with complications from hypertension die from?

A

cardiac complications

28
Q

Why is hypertension a risk factor for end stage renal disease?

A

elevated pressure damages the glomerulus and hyaline arteriolosclerosis causes ischaemia

29
Q

What is a marker of chronic kidney disease and a predictor of its progression?

A

proteinuria

30
Q

What does a kidney in end stage renal disease look like macroscopically?

A

granular with cortical atrophy

31
Q

What does a kidney in end stage renal disease look like microscopically?

A

lymphocytes, atrophied tubules, sclerosed glomeruli, collagen in bowman’s space

32
Q

What type of blockage is the usual cause of an infarction in the kidney?

A

atheroembolism

33
Q

What are lacunar infarcts?

A

small infarcts in the brain caused by hyaline arteriolosclerosis

34
Q

What is a berry aneurysm?

A

an aneurysm in the circle of willis leading to a subarachnoid haemorrhage if it ruptures

35
Q

What is the result of hyaline arteriolosclerosis in the retina?

A

AV nipping, exudates, ischaemia, haemorrhage - can cause visual deterioration

36
Q

What are the complications of malignant hypertension?

A

retinopathy, acute renal failure, haemolytic anemia, encephalopathy

Renal (12 decks)

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