Arterial HTN

Question 1

This is the most common type of HTN, where the cause of the elevated BP is unknown, as it’s usually attributable to diverse etiologies.

Answer 1

Essential HTN

Question 2

This the type of HTN where the cause of the elevated BP is due to a definable cause

Answer 2

Secondary HTN

Question 3

What is the equation to calculate BP (2 values)?

Answer 3

BP = CO*TPR

Question 4

Does angiotensin II, catecholamines, a1 receptors, endothelin, oxygen, and hematocrit increase or decrease TPR?

Answer 4

Increase

Question 5

Does B2 receptors, NO, H, and prostaglandins increase or decrease TPR?

Answer 5

decrease

Question 6

This the phenomenon when an increase in BP leads to an increased urine volume and Na+ excretion, which then lowers the BP to normal.

Answer 6

Pressure natriuresis

Question 7

This is the stage of blood pressure when the systolic is <80

Answer 7

normal

Question 8

This is the stage of blood pressure when the systolic is 120-139 and the diastolic is 80-89

Answer 8

Prehypertension

Question 9

This is the stage of blood pressure when the systolic is 140-159 and the diastolic is 90-99

Answer 9

Stage 1 HTN

Question 10

This is the stage of blood pressure when the systolic is >160 and the diastolic is >100

Answer 10

Stage 2 HTN

Question 11

Which ANS pathway can cause essential HTN?

Answer 11

SANS

Question 12

Increased SANS, certain hormones, and ion channel defects can cause what with blood vessels to cause essential HTN?

Answer 12

Vasoconstriction

Question 13

What are the 2 problems with the kidney that can cause essential HTN?

Answer 13

1. ion channel defect
2. inappropriate hormone regulation

all to increase salt and water retnetion

Question 14

In young adults, is systolic or diastolic HTN more common?

Answer 14

diastolic

Question 15

What is high in young adults to cause HTN (mainly)?

Answer 15

Cardiac output

Question 16

In the elderly, is systolic or diastolic HTN more common?

Answer 16

Systolic

Question 17

Why is systolic HTN more common in the elderly? What causes this?

Answer 17

Increase in TPR –> LV hypertrophy

Question 18

This is the most common cause of HTN, age of onset is 20-50, family Hx of HTN, normal serum K+ and urinalysis.

Answer 18

Essential HTN

Question 19

Which factor is elevated in urinalysis with HTN from chronic renal disease?

Answer 19

Creatinine

Question 20

Primary aldosteronism will cause a decrease in which ion, which u can use as a marker, for HTN?

Answer 20

K+

Question 21

This is the cause of HTN where there are abdominal bruits, a sudden onset, and a decreased serum K+

Answer 21

Renovascular

Question 22

This is the cause of HTN where there is paroxysms of palpitations, diaphoresis, headache, weight loss, and episodic HTN.

Answer 22

Pheochromocytoma

Question 23

This is the cause of HTN when the BP in the arms is > legs or the R arm is > the left atm.

Answer 23

Coarctation of the aorta

Question 24

This is the cause of HTN associated with central obesity and hirsutism.

Answer 24

Cushing syndrome

Question 25

What does oral contraceptives, glucocorticoids, cyclosporine, and sympathomimertic drugs act on to cause secondary HTN?

Answer 25

Renin-angotensin system

Question 26

How does erythopoietin (EPO) cause secondary HTN?

Answer 26

increases blood viscosity

Question 27

What does NSAIDs do to the kidney to cause secondary HTN?

Answer 27

Na and water retention

Question 28

Which ANS pathway does ethanol and cocaine act on to cause secondary HTN?

Answer 28

SANS

Question 29

Why do damaged nephrons cause secondary HTN?

Answer 29

unable to secrete normal amts of Na and water

Question 30

Which 3 conditions cause secondary HTN by causing the kidney to release renin?

Answer 30

arteriosclerosis, fibromuscular dysplasia, and coarctation of the aorta

Question 31

This is the condition where there is an adrenal adenoma or bilateral hyperplasia of the adrenal gland to cause hyperaldosteronemia and low renin levels.

Answer 31

Primary aldosteronism

Question 32

This is the generic rearrangement in which the aldosterone synthesis abnormally comes under the regulatory control of the adrenocorticotropic hormone (ACTH)

Answer 32

Glucocorticoid-remediable aldosteronism (GRA)

Question 33

This is the condition where there is increased angiotensin II production from a rare renin-secreting tumor, women taking oral contraceptives, or impaired AGII degredation in liver diseases.

Answer 33

Secondary aldosteronism

Question 34

Glucocorticoids can stimulate which system to cause HTN?

Answer 34

renin angiotensin system

Question 35

Which thyroid abnormality (hyper or hypothyroidism) can cause disastolic HTN by increasing TPR by SANS and adrenal activation?

Answer 35

Hypothyroidism

Question 36

How can hyperthyroidism cause HTN?

Answer 36

cardiac hyperactivity with an increase in blood volume

Question 37

We keep talking about this renin-angiotensin-aldosterone system (RAAS), but we need to figure it out. Where is renin secreted from?

Answer 37

juxtaglomerular cells of the afferent arteriole of the Kidney

Question 38

Renin acts like an enzyme to cause angiotensinogen to be converted to what?

Answer 38

Angiotensin I

Question 39

Which enzyme converts angiotensin I to angiotensin II?

Answer 39

ACE

Question 40

What is the role of angiotensin II on the arterial smooth muscle?

Answer 40

vasoconstriction

Question 41

What is the role of angiotensin II on the adrenal gland?

Answer 41

increase aldosterone

Question 42

How does aldosterone cause HTN?

Answer 42

increases renal Na+ reabsoption

Question 43

What is the role of angiotensin II on the SANS?

Answer 43

facilitates release of NE

Question 44

What is the role of angiotensin II on the kidney?

Answer 44

increase renal tubular Na+ reabsorption

Question 45

What is the role of angiotensin II on the brain?

Answer 45

Stimulates thirst and vasopressin secretion

Question 46

What is the role of angiotensin II on the heart?

Answer 46

Enhances contractility and ventricular hypertrophy

Question 47

In what way does low BP cause renin release from the juxtaglomerular cells of the afferent arteriole?

Answer 47

decrease in renal perfusion Pressure

Question 48

Which ion is the main factor in maintaining fluid levels?

Answer 48

Na+

Question 49

This type of arteriolosclerosis shows homogenous, pink hyaline thickening with associated luminal narrowing.

Answer 49

Hyaline artiolosclerosis

Question 50

How does HTN cause hyaline arteriolosclerosis?

Answer 50

plasma protein leakage across injured endothelial cells

Question 51

This type of arteriolosclerosis shows onion skin lesions and fibrinoid necrosis

Answer 51

Hyperplastic arteriolosclerosis

Question 52

How much does HTN increase your risks for cardiovascular disease for each 20/10mmHg increase?

Answer 52

Doubles it per increase

Question 53

Elevated belly fat, high triglyceride levels, low HDL, HTN, and elevated fasting glucose all contribute to what syndrome?

Answer 53

Metabolic syndrome

Question 54

Intake of what ion causes HTN?

Answer 54

Sodium

Question 55

What % of HTN pts are salt-sensitive?

Answer 55

50-60%

Question 56

Low levels of what ion in the blood stimulates renin secretion, leading to HTN?

Answer 56

K+

Question 57

What food can u eat to maintain normal K levels?

Answer 57

Fruits and veggies and meats and milk and my anus

Question 58

Why do physicians recommend some dairy and milk for HTN pts? What ion are they looking at, which helps maintain normal BP?

Answer 58

Ca++

Question 59

This substance directly increases arterial pressure and can contirbute to stroke upon intake.

Answer 59

Alcohol

Question 60

People with what condition have a 2-6 fold increase of risk of developing HTN by increasing salt-sensitivity?

Answer 60

Obesity

Question 61

Taking this at least once a week could cut the chances in half of dying suddenly from heart failure due to an atherosclerotic thrombus.

Answer 61

Omega-3 FA's

Question 62

In what 2 ways does omega-3 fatty acids reduce the risk of thrombus formation?

Answer 62

1. inhibit blood platelet aggregation and clot formation | 2. prevent plaque formation in coronary arteries

Question 63

Which vitamin controls the production of proteins that are involved in blood clot formation?

Answer 63

vitamin K

Question 64

Potassium keeps what ion in the bone, thus preventing the buildup in the arteries and therefore arterial calcification?

Answer 64

Ca++

Question 65

The inadequate intake of folate, B12, B6, or riboflavin can cause impaired metabolism of what susbtance, which is an important cardiovascular risk factor?

Answer 65

Homocysteine

Question 66

Elevated homocysteine levels can cause the increase in which vascular mediator?

Answer 66

NO