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Y1 Cardiovascular > Hypertension and Hyperlipidaemia > Flashcards

Hypertension and Hyperlipidaemia Flashcards

(71 cards)

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1
Q

Stage 1 Hypertension

A

clinic blood pressure is higher than 140/90 mmHg AND ambulatory BP is 135/85mmHg average

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2
Q

Stage 2 Hypertension

A

clinic BP is higher than 160/100mmHg AND ambulatory BP is 150/95mmHg or higher

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3
Q

Stage 3 hypertension

A

clinic systolic is 180mmHg or higher OR clinic diastolic is 110mmHg or higher

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4
Q

Potentially affected organs in hypertension (5)

A

Brain, Eyes, Kidneys, Heart, Arterial Tree

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5
Q

Potential effect of hypertension on the brain

A

stroke

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6
Q

Potential effect of hypertension on the eyes

A

Impaired vision

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7
Q

Potential effect of hypertension on the kidneys

A

narrowing and thickening of renal arteries leading to kidney damage

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8
Q

Potential effect of hypertension on the heart

A

MI, congestive heart failure

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9
Q

Potential effect of hypertension on the arteries

A

atherosclerosis

aortic aneurysm

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10
Q

Populations more likely to have high BP

A

African-americans

deprived areas

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11
Q

Structural changes that occur in the arteries due to hypertension

A

internal elastic lamina thickening
smooth muscle hypertrophy
fibrosis
all of these reduce the lumen and increase shear stress on the intima

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12
Q

artherosclerosis causes a(n) _______ in total peripheral resistance

A

increase

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13
Q

types of hypertension (2)

A

primary (essential) and secondary

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14
Q

Most common type of hypertension

A

primary (essential) 90-95% of cases

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15
Q

Good form of cholesterol

A

HDL

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16
Q

Bad form of cholesterol

A

LDL

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17
Q

4 major types of lipoproteins

A

HDL, LDL, VLDL, Chylomicrons

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18
Q

Lipid are soluble in water - True or false

A

false

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19
Q

What can lipids be used for? (3)

A

energy, hormones, signalling molecules

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20
Q

The hydrophobic core in lipoproteins contains?

A

esterified cholesterol and triglycerides

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21
Q

The hydrophillic coat of lipoproteins contains?

A

amphipathic cholesterol, phospholipids and one or more apoproteins

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22
Q

Cardiovascular disease is associated with which types of lipids?

A

elevated LDL, high triglycerides, low HDL

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23
Q

where does the majority of cholesterol come from?

A

from the bile, only 25% comes from the diet

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24
Q

The majority of LDL is cleared by…

A

the liver

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25
Rate limiting enzyme in de novo cholesterol synthesis
HMG CoA reductase
26
Released cholesterol causes: (3)
inhibition of HMG coA reductase; down regulation of LDL receptor express; storage of cholesterol as an ester
27
Clearance of LDL is dependent upon?
the LDL receptor on the liver and other tissues
28
Why is LDL cholesterol bad in the arteries?
it migrates into the intima and produces OXLDL which causes the migration of monocytes into the endothelium and the formation of foam cells and a fatty streak.
29
Why is HDL cholesterol the good cholesterol?
transports excess cholesterol back to the liver where it can be cleared from the body
30
Secondary dyslipidaemia is a consequence of other diseases such as...(4)
T2DM, hypothyroidism, alcoholism, liver disease
31
Statins act via...
inhibiting HMG CoA reductase
32
Examples of statins (2)
Simvastatin, atorvastatin
33
Where are statins not effective?
in homozygous familial hypercholesteraemia
34
What time of day should statins be taken?
at night
35
Other beneficial effects of statins?
reduce inflammation; reverse endothelial dysfunction; decrease thrombosis; stabilise atherothrombotic plaques
36
Where should statins be avoided?
pregnancy; rhabdomyolosis
37
Where are fibrates used?
in high triglycerides, also produce a modest decrease in LDL
38
Examples of fibrates (2)
benzofibrate | gemfibrozil
39
where are fibrates used as first line?
in patients with high triglycerides
40
Where are fibrates best avoided?
in alcoholics
41
Examples of drugs that inhibit cholesterol absorption (3)
cholestryamine, colestipol, celsevelam
42
How do drugs inhibiting cholesterol absorption act?
bile acid binding residues which binds cholesterol in the GI tract to prevent absorption
43
How does Ezetimibe work?
inhibits NPC1L1 transport protein in the enterocytes reducing the absorption of cholesterol - NOT FIRST LINE
44
Common causes of Atheroma
smoking, hypertension, hyperlipidaemia, diabetes, age, sex, genetics
45
4 stages of pathogenesis of Atheroma
1. Primary endothelial injury; 2. Accumulation of lipids and macrophages; 3. Migration of smooth muscle cells; 4. increase in size
46
5 complications of atheroma
Stenosis; Thrombosis; Aneurysm formation; Arterial dissection; Embolism
47
What is stenosis?
a narrowing of the lumenal calliper, reduced elasticity
48
Stenosis may produce tissue ischamia which may be seen in the forms of?
angina, MI, cardiac failure, cardiac fibrosis, carotid artery disease (TIA, stroke), renal artery hypertension
49
What infarctions may a thrombus cause?
MI, cerebral, renal, intestinal
50
What is an aneurysm?
a abnormal and persistant dilation of an artery due to a weakness in its wall
51
Commonest site of aneurysm formation
abdominal aorta
52
Conditions associated with arterial dissection
atheroma and hypertension, trauma, coarction, marfans, pregnancy
53
hypertension causes...
cardiac failure, atheroma, cerebral haemorrhage, renal failure, sudden cardiac death
54
what is masked hypertension?
when a patient has hypertension at home, but this appears normal in the clinic
55
Cardiac output is affected by (3)
Heart rate, contractility, blood volume
56
Peripheral resistance constrictors include?
catecholamines, AngII
57
Peripheral resistance dilators include?
NO, prostaglandins
58
How might primary hypertension be defined?
hypertension with no obvious cause which is likely to be affected by genetic and lifestyle factors
59
Secondary hypertension due to renal disease is salt sensitive - true or false?
true
60
Common causes of secondary hypertension
renal disease, obstructive sleep apnoea, aldosteronism, reno-vascular disease
61
Renal disease causes hypertension by what mechanism??
decreased renal blood flow leads to excessive renin secretion and thus salt and water overload
62
Benign hypertension can be described as...
hypertension that will cause serious life threatening conditions but is often asymptomatic
63
Benign hypertension can lead to...
LV hypertrophy, congestive heart failure, atheromas, aneurysm rupture, aortic dissection, berry aneurysms, renal disease
64
Anyone diagnosed with hypertension should have which 4 tests
urine (protein), Bloods, fundi for hypertensive retinopathy, 12 lead ECG
65
Bloods to be checked for in hypertension
glucose, electrolytes (ACEIs), creatinine, Glomerular Filtration rate, cholesterol and fasting lipids
66
Spironolactone is given at which step in hypertension treatment?
step 4
67
Other drugs that can be given when ACEIs, CCB and thiazide like diuretics are not successful
Beta blockers, Spironolacton
68
Malignant hypertension is seriously life threatening - it is described as...
diastolic > 130/140mmHg
69
malignant hypertension can result in...
papilloedema, acute renal failure, acute heart failure, head ache, cerebral haemorrhage, fibrinoid necrosis in arteries
70
Gestational hypertension causes
eclampsia and an increase in maternal and foetal mortality
71
pre-eclampsia is diagnosed as...
hypertension and proteinuria

Y1 Cardiovascular (12 decks)

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