chapter 26: disorders of blood flow and blood pressure

Question 1

what is ARTERIOSCLEROSIS?

Answer 1

NATURAL degenerative disease that blocks arterial walls due to aging

Question 2

what happens in ARTERIOSCLEROSIS?

Answer 2

small arteries and arterioles narrow resulting in ischemia

Question 3

what is ATHEROSCLEROSIS?

Answer 3

build up of fats (atheroma) in & on artery walls (causes narrowing and blocks blood flow)

Question 4

when do the signs and symptoms of atherosclerosis appear?

Answer 4

when there is blood blockage or bv is severely narrowed

Question 5

what are the stages of atherosclerosis?

Answer 5

1) endothelial cell damage
2) fatty streak formation
3) plaque growth
4) plaque ruptures

Question 6

what can unstable plaques do?

Answer 6

rupture creating a clot (thrombus) to form

Question 7

what are non-modifiable factors of atherosclerosis?

Answer 7

age, gender, genetics

Question 8

what are modifiable factors of atherosclerosis?

Answer 8

obesity or diet
cigarette smoking
sedentary life style
diabetes mellitus
htn

Question 9

what are some additional and nontraditional factors of atherosclerosis?

Answer 9

inflammation markers
increased lipoprotein a

Question 10

how can we treat atherosclerosis?

Answer 10

1) diet
2) drugs (statins, cholesterol lowering drugs)
3) primary disorder control
4) stop smoking
5) angioplasty
6) bypass surgery

Question 11

what does atherosclerosis in the heart lead to?

Answer 11

angina pectoris or mi (total occlusion)

Question 12

what does atherosclerosis in the brain lead to?

Answer 12

transient ischemic attack or cerebrovascular accident (total occlusion)

Question 13

what does atherosclerosis in the aorta lead to?

Answer 13

aneurysm (occlusion, rupture and hemorrhage)

Question 14

what is atherosclerosis in the legs?

Answer 14

peripheral vascular disease (gangrene and amputation)

Question 15

what is peripheral artery disease (pad)?

Answer 15

obstruction of large arteries that supply your limbs (arms and legs)

Question 16

what causes pad?

Answer 16

atherosclerosis
inflammation

Question 17

what are the risk factors of pad?

Answer 17

smoking
diabetes
obesity
high bp
high cholesterol

Question 18

what are the s/s of pad?

Answer 18

1) gradual onset
2) pain while walking
3) foot cool to the touch
4) weak/absent pedal/femoral pulse
5) blood flow is severely reduced (ischemic pain at rest, ulcerations, gangrene)

Question 19

how do we treat pad?

Answer 19

1) walking (with claudication too!)
2) avoid injury
3) avoid risk factors
4) drugs (anti-platelet therapy, statins, vasodilator)
5) femoral bypass, stents, balloon angioplasty

Question 20

what is vasculitis?

Answer 20

inflammation of the bv’s

Question 21

what are the two ways you get vasculitis?

Answer 21

1) direct invasion of a pathogen, immune mediated
2) non-pathogen mediated by medications

Question 22

what are aneurysms?

Answer 22

bv wall is weakened, stretches, then forms a pocket

Question 23

what is the difference between a true and false aneurysm?

Answer 23

true: bound within the wall, blood present
false: tear in wall, forms a blood clot outside

Question 24

what is a berry/saccular aneurysm?

Answer 24

sac that protrudes from where the bv branches out

Question 25

what is a fusiform aneurysm?

Answer 25

bulges on all sides within the vessel

Question 26

what is a dissecting aneurysm?

Answer 26

bleeding into vessel wall

Question 27

what do aortic aneurysms and dissections lead to?

Answer 27

aneurysm: abdominal aortic or thoracic aneurysm dissection: bleeding into vessel wall w/longitude tear

Question 28

what are some causes of aneurysms?

Answer 28

1) congenital defects 2) trauma 3) infection 4) atherosclerosis

Question 29

which is responsible for short term regulation of bp? baroreceptors or renal mechanism?

Answer 29

baroreceptors

Question 30

cardiac output

Answer 30

heart rate X stroke volume

Question 31

mean arterial pressure (map)

Answer 31

1/3 systolic + 2/3 diastolic

Question 32

pulse pressure

Answer 32

systolic - diastolic

Question 33

blood pressure

Answer 33

co X total peripheral resistance

Question 34

hypertension range pathophysiology

Answer 34

s: 140mmHg> d: 90mmHg>

Question 35

what is pre hypertension?

Answer 35

systolic: 120-139 diastolic: 80-89

Question 36

what is stage 1 hypertension?

Answer 36

sys: 140-159 dias: 90-99

Question 37

what is stage 2 hypertension?

Answer 37

sys: >160 dias: >100

Question 38

what is primary/essential hypertension?

Answer 38

makes up 90-95% of all cases, no other disease present

Question 39

what are the risk factors of primary/essential htn?

Answer 39

family race age

Question 40

what are the life style risk factors of primary/essential htn?

Answer 40

insulin resistance diet obesity alcohol

Question 41

what is secondary htn?

Answer 41

results from another disorder

Question 42

what disorders can secondary htn result from?

Answer 42

renal htn adrenocortical hormones pheochromocytoma aortic coarctation oral contraceptives

Question 43

which organs does htn target?

Answer 43

1) heart (L ventricular atrophy, angina, heart failure, mi) 2) brain (stroke) 3) kidney (chronic kidney disease) 4) eyes (retinopathy) 5) blood vessels (pad)

Question 44

how do we diagnose hypertension?

Answer 44

1) measure bp 2) scans + blood tests

Question 45

how do we treat hypertension?

Answer 45

1) life style changes 2) reduce body weight 3) exercise 4) low salt diet 5) mild diuretics, ace inhibitors, beta blockers, calcium channel blockers, alpha blockers

Question 46

what is gestational hypertension?

Answer 46

high bp when you are ONLY pregnant; NO protein in urine (after 20 weeks, resolves after 12 weeks postpartum)

Question 47

what are the characteristics of preeclampsia-eclampsia?

Answer 47

1) htn after 20 weeks 2) proteinuria 3) elevates serum creatinine + liver enzymes 4) decreased platelets

Question 48

what are the characteristics of chronic hypertension?

Answer 48

1) htn UNRELATED to pregnancy 2) present BEFORE and AFTER pregnancy 3) increased risk of developing preeclampsia

Question 49

what are the characteristics of preeclampsia superimposed on chronic htn?

Answer 49

1) htn before 20 weeks 2) develop proteinuria 3) worse prognosis

Question 50

a normal drop in bp upon standing is considered normal. true or false?

Answer 50

true. it'll be quick due to the baroreflex

Question 51

an abnormal drop in bp upon standing is called orthostatic htn. true or false?

Answer 51

true. fall in CO > fall BP > fall in blood flow to brain

Question 52

who is susceptible to orthostatic htn?

Answer 52

1) low blood volume leads to dehydration 2) drug induced 3) aging 4) bed rest 5) ans problems

Question 53

how do we diagnose orthostatic htn?

Answer 53

1) measure bp (supine) 2) tilt table 3) 24 hr BP monitoring 3) patient hx

Question 54

how do we treat orthostatic htn?

Answer 54

1) get rid of identified cause (if possible) 2) learn to cope with it 3) pharmacological (change bp meds..)

Question 55

what are varicose veins?

Answer 55

dilated veins (lower extremities)

Question 56

what is the difference between primary and secondary varicose veins?

Answer 56

primary: prolonged standing and increased abdominal pressure secondary: ateriovenous fistula, venous malformations, prolonged increase pressure on abdominal veins

Question 57

what are the s/s of dvt?

Answer 57

1) inflammation (pain, swelling, deep muscle tenderness) 2) elevated wbc count 3) fever

Question 58

what are some treatments of a dvt?

Answer 58

1) anticoagulants 2) pneumatic compression devices (preventative)

Question 59

what causes a dvt?

Answer 59

1) stasis of blood (bed rest, immobility, chf) 2) increased blood coagulation (dehydration, pregnancy, genetic factors) 3) vessel wall injury (indwelling venous catheters, surgery, trauma/infection)