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pathophysiology > chapter 26: disorders of blood flow and blood pressure > Flashcards

chapter 26: disorders of blood flow and blood pressure Flashcards

1
Q

what is ARTERIOSCLEROSIS?

A

NATURAL degenerative disease that blocks arterial walls due to aging

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2
Q

what happens in ARTERIOSCLEROSIS?

A

small arteries and arterioles narrow resulting in ischemia

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3
Q

what is ATHEROSCLEROSIS?

A

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

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4
Q

when do the signs and symptoms of atherosclerosis appear?

A

when there is blood blockage or bv is severely narrowed

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5
Q

what are the stages of atherosclerosis?

A

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

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6
Q

what can unstable plaques do?

A

rupture creating a clot (thrombus) to form

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7
Q

what are non-modifiable factors of atherosclerosis?

A

age, gender, genetics

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8
Q

what are modifiable factors of atherosclerosis?

A

obesity or diet
cigarette smoking
sedentary life style
diabetes mellitus
htn

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9
Q

what are some additional and nontraditional factors of atherosclerosis?

A

inflammation markers
increased lipoprotein a

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10
Q

how can we treat atherosclerosis?

A

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

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11
Q

what does atherosclerosis in the heart lead to?

A

angina pectoris or mi (total occlusion)

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12
Q

what does atherosclerosis in the brain lead to?

A

transient ischemic attack or cerebrovascular accident (total occlusion)

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13
Q

what does atherosclerosis in the aorta lead to?

A

aneurysm (occlusion, rupture and hemorrhage)

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14
Q

what is atherosclerosis in the legs?

A

peripheral vascular disease (gangrene and amputation)

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15
Q

what is peripheral artery disease (pad)?

A

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

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16
Q

what causes pad?

A

atherosclerosis
inflammation

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17
Q

what are the risk factors of pad?

A

smoking
diabetes
obesity
high bp
high cholesterol

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18
Q

what are the s/s of pad?

A

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)

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19
Q

how do we treat pad?

A

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

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20
Q

what is vasculitis?

A

inflammation of the bv’s

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21
Q

what are the two ways you get vasculitis?

A

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

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22
Q

what are aneurysms?

A

bv wall is weakened, stretches, then forms a pocket

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23
Q

what is the difference between a true and false aneurysm?

A

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

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24
Q

what is a berry/saccular aneurysm?

A

sac that protrudes from where the bv branches out

25
Q

what is a fusiform aneurysm?

A

bulges on all sides within the vessel

26
Q

what is a dissecting aneurysm?

A

bleeding into vessel wall

27
Q

what do aortic aneurysms and dissections lead to?

A

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

28
Q

what are some causes of aneurysms?

A

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

29
Q

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

A

baroreceptors

30
Q

cardiac output

A

heart rate X stroke volume

31
Q

mean arterial pressure (map)

A

1/3 systolic + 2/3 diastolic

32
Q

pulse pressure

A

systolic - diastolic

33
Q

blood pressure

A

co X total peripheral resistance

34
Q

hypertension range pathophysiology

A

s: 140mmHg>
d: 90mmHg>

35
Q

what is pre hypertension?

A

systolic: 120-139
diastolic: 80-89

36
Q

what is stage 1 hypertension?

A

sys: 140-159
dias: 90-99

37
Q

what is stage 2 hypertension?

A

sys: >160
dias: >100

38
Q

what is primary/essential hypertension?

A

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

39
Q

what are the risk factors of primary/essential htn?

A

family
race
age

40
Q

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

A

insulin resistance
diet
obesity
alcohol

41
Q

what is secondary htn?

A

results from another disorder

42
Q

what disorders can secondary htn result from?

A

renal htn
adrenocortical hormones
pheochromocytoma
aortic coarctation
oral contraceptives

43
Q

which organs does htn target?

A

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

44
Q

how do we diagnose hypertension?

A

1) measure bp
2) scans + blood tests

45
Q

how do we treat hypertension?

A

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

46
Q

what is gestational hypertension?

A

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

47
Q

what are the characteristics of preeclampsia-eclampsia?

A

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

48
Q

what are the characteristics of chronic hypertension?

A

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

49
Q

what are the characteristics of preeclampsia superimposed on chronic htn?

A

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

50
Q

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

A

true. it’ll be quick due to the baroreflex

51
Q

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

A

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

52
Q

who is susceptible to orthostatic htn?

A

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

53
Q

how do we diagnose orthostatic htn?

A

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

54
Q

how do we treat orthostatic htn?

A

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

55
Q

what are varicose veins?

A

dilated veins (lower extremities)

56
Q

what is the difference between primary and secondary varicose veins?

A

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

57
Q

what are the s/s of dvt?

A

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

58
Q

what are some treatments of a dvt?

A

1) anticoagulants
2) pneumatic compression devices (preventative)

59
Q

what causes a dvt?

A

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)

pathophysiology (11 decks)

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