hypertension

Question 1

these pressure differences produce the gradient allowing for systemic movement of blood

Answer 1

the pressure difference between the right and the left side of the heart

Question 2

_____ is produced by the force of the left ventricular contraction overcoming the resistance of the aorta

Answer 2

arterial blood pressure

Question 3

know the distribution of pressure within the systemic circulation (e.g. from greatest to least pressure in mmHg)

Answer 3

the greatest pressure in the aorta, then it goes to the arteries then arterioles then the capillaries (pressure is greater on arteriole side of capillaries and gets lower on venule side). Then it goes to the venules, to the muscular veins then the central veins and finally the right atrium where the pressure is now 0mmHg

Question 4

_______+ __________ are the two determinants for arterial pressure

Answer 4

cardiac output and peripheral resistance

Question 5

what two determinants affect cardiac output

Answer 5

heart rate and stroke volume

Question 6

______ is related to myocardial contractility and to the size of the vascular component

Answer 6

stroke volume

Question 7

______ is the most common aetiology of secondary hypertension

Answer 7

primary renal disease

Question 8

______ is the peak pressure during cardiac systole

Answer 8

systolic bp

Question 9

______ is the lowest pressure during cardiac diastole

Answer 9

diastolic bp

Question 10

what is the primary factor influencing systolic blood pressure

Answer 10

stroke volume

Question 11

what is the major determinant for diastolic pressure

Answer 11

systemic vascular resistance (SVR)

Question 12

________ is the average arterial pressure throughout one cardiac cycle

Answer 12

mean arterial pressure

Question 13

______ requires intra-arterial catheter; usually in radial artery and this is the most accurate measurement of BP

Answer 13

direct BP

Question 14

______ requires intra-arterial catheter; usually in radial artery and this is the most accurate measurement of BP

Answer 14

direct BP

Question 15

_____ includes using a manual or automated method (e.g. BP cuff and stethoscope), requires careful techniques; auscultation of korotkoff sounds

Answer 15

indirect measurement of BP

Question 16

what are the 4 ways BP is regulated?

Answer 16

-lifestyle
-neural, humoral and renal factors
-suprachiasmatic nuclei
-circadian rhythm

Question 17

list the short term regulation of BP

Answer 17

• activation of the systemic nervous system to produce NE & epinephrine
• activation of the vasomotor centre by activation of baroreceptors which activates alpha and beta receptors

Question 18

what receptors are found in smooth muscle of arterioles and are post synaptic that lead to vasoconstriction

Answer 18

alpha 1

Question 19

what receptors are pre synaptic

Answer 19

alpha 2

Question 20

what receptors are found in vascular smooth muscle that lead to vasodilation and bronchodilation when activated

Answer 20

beta 2

Question 21

what receptors are found in the heart and increase muscle contraction when activated

Answer 21

beta 1

Question 22

are alpha or beta receptors epinephrine mediated

Answer 22

beta

Question 23

are alpha or beta receptors norepinephrine mediated

Answer 23

alpha

Question 24

liat examples of long term regulation of systemic BP

Answer 24

• increase in ECF leads to increase in CO and SVR which increases BP
• increase in serum sodium levels increases osmolality which increases ADH secretion
• angiotensin II increases SVR which increases BP
• ANP causes increase secretion of H2O and Na from an increase in GFR
• RAAS

Question 25

know how the RAAS is an important regulator of BP

Answer 25

due to its vasoconstrictive properties of angiotensin II and its Na retaining properties of aldosterone. renin secretes angiotensinogen which leads to inactive angiotensin I. ACE converts angiotensin I to angiotensin II. angiotensin II is a vasoconstrictor and it produces aldosterone. ACE also inactivates the vasodilator bradykinin

Question 26

what is a normal systolic and diastolic BP

Answer 26

systolic <120 diastolic <80

Question 27

what is an elevated systolic and diastolic BP

Answer 27

systolic 120-129 diastolic <80

Question 28

what systolic and diastolic BP's are associated with stage I hypertension

Answer 28

systolic 130-139 diastolic 80-89

Question 29

what systolic and diastolic BP's are associated with stage II hypertension

Answer 29

systolic greater than or equal to 140-149 diastolic >90

Question 30

_____ occurs when you have abnormally high BP that's not the result of a medical condition

Answer 30

primary/essential hypertension

Question 31

what are some non modifiable factors for primary hypertension

Answer 31

-family history/genetics -age -gender

Question 32

what are some modifiable risk factors for primary hypertension

Answer 32

-sedentary lifestyle -metabolic disorders -dietary factos -obesity

Question 33

what are some outcomes of primary hypertension

Answer 33

- increased myocardial work leads to heart failure - gomerlular damage leads to kidney failure - affects microcirculation in eyes - increased pressure in cerebral vasculature leads to hemorrhage

Question 34

when does atherosclerosis start to occur

Answer 34

after first decade of life

Question 35

know the pathogenesis of atherosclerosis

Answer 35

- after vascular injury, monocytes bind to epithelium and become activated microphages - macrophages take up oxidized LDL becoming foam cells -T cells release cytokines which also activate macrophages - cytokines cause smooth muscle cells to proliferate. under growth factors the smooth muscle cells then move to the subendothelial space where they produce collagen and take up LDL, adding to the production of foam cells

Question 36

what are some treatment interventions for primary hypertension

Answer 36

- dietary changes/lifestyle modifications - drug therapy

Question 37

_______ is hypertension attributed to an indentifiable pathology or condition. maybe related to pregnancy, obesity, endocrine disorders, etc

Answer 37

secondary hypertension

Question 38

what are some conditions that may cause hypertension

Answer 38

- sleep apnea - primary renal disease - glomerulonephritis -polycystic kidney disease - renal artery stenosis - hyperthyroidism - cushing disease - hypertensive nephrosclerosis

Question 39

what are some drugs/other substances that may cause hypertension

Answer 39

- NSAIDS - oral contraceptives - excessive alcohol - salt - stimulants (cocaine) - SSRIs - corticosteroids

Question 40

______ is a birth defect in which part of the aorta is narrower than usual. occurs distal to subclavian artery. BP is high in upper body and lower in the legs

Answer 40

coarction of aorta

Question 41

know what occurs in salt mediated hypertension

Answer 41

- G proteins (G12-13) activates myosin light chain kinase - Rho/Rho kinase = inhibited myosin light chain phosphorylase - ouabain release = decrease in Na+K+ ATPase = increase in intracellular Ca2+ = increase in smooth muscle tone = vasoconstriction

Question 42

how should secondary hypertension be treated

Answer 42

treat the disease causing the hypertension first! for e.g. hyperthyroidism - treat thyroid first