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(RES) Cardiology > Hypertension (Secondary) > Flashcards

Hypertension (Secondary) Flashcards

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1
Q

What is secondary hypertension?

A

Hypertension caused by an underlying condition

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2
Q

What condition is referred to as ‘renovascular hypertension’?

A

Hypertension caused by renal artery stenosis

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3
Q

What are the causes of renal artery stenosis?

A
  • Atherosclerosis (in older people)
  • Fibromuscular dysplasia (in young women)
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4
Q

What are the symptoms of renal artery stenosis?

A
  • Recent onset hypertension refractory to anti-hypertensives
  • Hypokalemia (due to RAA activation)
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5
Q

True or False: Atherosclerosis is a common cause of renal artery stenosis in younger individuals.

A

False

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6
Q

Fill in the blank: Renal artery stenosis is associated with _______ in young women.

A

fibromuscular dysplasia

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7
Q

What is a common symptom of renal artery stenosis related to potassium levels?

A

Hypokalemia

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8
Q

What does RAA stand for in the context of renal artery stenosis?

A

Renin-Angiotensin-Aldosterone

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9
Q

What is renal parenchymal disease?

A
  • also known as medical renal disease, refers to conditions that damage the functional parts of the kidneys.
  • These include the glomeruli, interstitium, tubules, and small blood vessels
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10
Q

What are common causes of renal parenchymal disease?

A
  • Diabetes
  • Hypertension
  • Glomerulonephritis
  • Polycystic kidney disease
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11
Q

What symptoms are associated with renal parenchymal disease?

A
  • Fatigue
  • Edema
  • Hypertension
  • Anemia
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12
Q

True or False: Renal parenchymal disease can lead to chronic kidney disease.

A

True

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13
Q

Fill in the blank: The primary function of renal parenchyma is _______.

A

[filtration and excretion of waste]

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14
Q

What diagnostic tests are used to assess renal parenchymal disease?

A
  • Urinalysis
  • Blood tests
  • Imaging studies (e.g., ultrasound)
  • Kidney biopsy
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15
Q

What is a potential complication of untreated renal parenchymal disease?

A

End-stage renal disease

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16
Q

What lifestyle modifications can help manage renal parenchymal disease?

A
  • Controlling blood sugar levels
  • Managing blood pressure
  • Reducing salt intake
  • Staying hydrated
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17
Q

True or False: Renal parenchymal disease can be completely reversed.

A

False

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18
Q

What is the role of glomeruli in renal parenchymal disease?

A

They are the filtering units of the kidney that can be damaged in this condition.

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19
Q

What is Coarctation of Aorta?

A

A condition characterized by constriction of the aorta, often found in children or young adults.

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20
Q

In which syndrome is Coarctation of Aorta seen in 35% of patients?

A

Turner syndrome

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21
Q

Where is the constriction usually located in Coarctation of Aorta?

A

At the origin of the left subclavian artery

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22
Q

What is a common exam finding in Coarctation of Aorta?

A

Diminished or delayed femoral pulse

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23
Q

What will a chest X-ray (CXR) show in cases of Coarctation of Aorta?

A

Aorta indentation at the level of coarctation and rib notching due to collateral flow developed.

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24
Q

True or False: Rib notching in Coarctation of Aorta is caused by collateral flow.

A

True

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25
Fill in the blank: Coarctation of Aorta is commonly seen in _______.
children or young adults
26
What is pheochromocytoma?
A rare tumor of the adrenal medulla composed of chromaffin cells, defined as an intra-adrenal paraganglioma (PGL) ## Footnote Pheochromocytoma is part of the larger family of paragangliomas.
27
What type of tumors are pheochromocytomas classified as?
Neuroendocrine tumors ## Footnote They are specifically classified as sympathetic tumors.
28
What do pheochromocytomas primarily release into the bloodstream?
Catecholamines ## Footnote Catecholamines are hormones produced by the adrenal glands, such as adrenaline and noradrenaline.
29
List the common symptoms caused by pheochromocytomas due to catecholamine release
* Hypertension (high blood pressure) * Tachycardia (fast heart rate) * Sweating * Headaches ## Footnote These symptoms are a direct result of catecholamine effects on the body.
30
True or False: Some paragangliomas secrete no catecholamines at all.
True ## Footnote Other PGLs may secrete catecholamines only episodically.
31
What is the most common clinical relevance of PGLs that do not secrete catecholamines?
Mass effect ## Footnote This is particularly common with head and neck paragangliomas.
32
Where are the sympathetic paragangliomas predominantly located?
In the abdomen and pelvis ## Footnote Specifically, they are concentrated at the organ of Zuckerkandl at the bifurcation of the aorta.
33
What type of PGLs are typically found in the head and neck?
Parasympathetic PGLs ## Footnote These differ from their sympathetic counterparts in location and function.
34
What is the classic triad of symptoms in sympathetic pheochromocytoma?
Headaches, tachycardia, diaphoresis ## Footnote Headaches are likely related to elevated blood pressure, or hypertension. Diaphoresis is excessive sweating, particularly at night, also known as hyperhidrosis.
35
What causes the symptoms of sympathetic pheochromocytoma?
Sympathetic nervous system hyperactivity
36
What are the 'attacks' or 'spells' associated with sympathetic pheochromocytoma?
Episodes where patients suddenly experience overwhelming symptoms
37
What can trigger attacks in symptomatic pheochromocytoma patients?
* Pharmaceutical agents (histamine, metoclopramide, glucagon, adrenocorticotropic hormone) * Foods containing tyramine (cheese, wine) * Intraoperative tumor manipulation * Intubation * Anesthetic induction
38
What is the location of pheochromocytoma in the adrenal gland?
The medulla (center) of the adrenal gland
39
What are some other clinical manifestations of sympathetic pheochromocytoma?
* Pallor * Heat intolerance * Weight loss * Chest and/or abdominal discomfort * Palpitations * Nausea/vomiting * Constipation * Orthostatic hypotension * Psychiatric manifestations (anxiety, panic attacks, nervousness, tremors) * Hyperglycemia
40
True or False: Patients with sympathetic pheochromocytoma experience continuous symptoms.
False
41
Fill in the blank: Symptoms of sympathetic pheochromocytoma are related to _______ nervous system hyperactivity.
sympathetic
42
What is orthostatic hypotension?
Becoming light-headed or dizzy after swiftly changing positions
43
What is hyperglycemia?
High blood sugar
44
What is hyperaldosteronism?
A condition characterized by the adrenal glands producing too much aldosterone, regulating blood pressure and electrolyte balance.
45
What are the two main types of hyperaldosteronism?
* Primary hyperaldosteronism * Secondary hyperaldosteronism
46
What causes primary hyperaldosteronism?
A problem within the adrenal glands, often due to a tumor.
47
What triggers secondary hyperaldosteronism?
Excessive activation of the renin-angiotensin-aldosterone system (RAAS), often due to conditions like heart failure or kidney disease.
48
What is a common symptom of hyperaldosteronism?
High blood pressure, often resistant to standard treatments.
49
What can low potassium levels (hypokalemia) cause?
* Muscle weakness * Fatigue * Paralysis
50
What are additional symptoms associated with hyperaldosteronism?
* Headaches * Numbness
51
What is the primary method for diagnosing hyperaldosteronism?
Blood tests measuring aldosterone and renin levels.
52
What imaging techniques may be used in the diagnosis of hyperaldosteronism?
* CT scans * MRIs
53
What treatment may be necessary if a tumor is identified in hyperaldosteronism?
Surgical removal of the tumor.
54
What types of medications are used in the treatment of hyperaldosteronism?
Medications to manage high blood pressure and low potassium levels.
55
In secondary hyperaldosteronism, what is crucial to address?
The underlying cause of the condition.
56
Fill in the blank: Hyperaldosteronism leads to ________ blood pressure.
[high]
57
True or False: Hyperaldosteronism can cause only high potassium levels.
False
58
What are lifestyle modifications for treating secondary hypertension?
Weight reduction, sodium restriction, exercise ## Footnote These changes can significantly improve blood pressure control.
59
What class of drugs is commonly used as diuretics?
Thiazides, loop diuretics ## Footnote Diuretics help reduce blood pressure by eliminating excess fluid.
60
What is a side effect of thiazides and loop diuretics?
Hypokalemia ## Footnote Hypokalemia refers to low potassium levels in the blood.
61
What is a side effect of aldosterone antagonists?
Hyperkalemia ## Footnote Hyperkalemia refers to high potassium levels in the blood.
62
Name a potassium-sparing diuretic.
Amiloride ## Footnote Amiloride helps prevent potassium loss while promoting diuresis.
63
What are ACE inhibitors commonly abbreviated as?
ACEis ## Footnote ACE inhibitors lower blood pressure by inhibiting the angiotensin-converting enzyme.
64
What do ARBs stand for?
Angiotensin II receptor blockers ## Footnote ARBs block the action of angiotensin II, leading to vasodilation.
65
What is one class of medications used as calcium channel blockers?
CCBs ## Footnote Calcium channel blockers help relax and widen blood vessels.
66
Which medication is the first choice for treating hypertension in pregnancy?
Methyldopa ## Footnote Methyldopa is considered safe and effective for managing hypertension during pregnancy.
67
Name two alternative medications for hypertension during pregnancy.
Labetalol, hydralazine ## Footnote Both are used for blood pressure control in pregnant patients.
68
What is contraindicated for use in pregnancy for hypertension?
ACE inhibitors and ARBs ## Footnote These medications can cause harm to the developing fetus.

(RES) Cardiology (23 decks)

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