Hypertension-Strasser

Question 1

what fraction of patients with hypertension are unaware

Answer 1

1/3

Question 2

what is the formula for Blood Pressure

Answer 2

CO times TPR

Question 3

what is the formula for CO

Answer 3

SV times HR

Question 4

what are the JNC 7 regulations

Answer 4

normal: <80
prehypertenion 120-139 or 80-89
hypertension stage 1: 140-159 or 90-99
hypertensoin stage 2: greater than or equal to 160 or greater than equal to 100

Question 5

what are the JNC 8 regulations

Answer 5

greater than 60 years, target is less than 150/90
less than 60 years less than 140/90
greater than 18 years with CKD less than 140/90
greater than 18 years with diabetes less than 140/90

Question 6

what are the main differences in JNC8 versus 7

Answer 6

no stages of hypertension and similar treatment goals for all patients with high blood pressure but lower goals set for younger patients and those with comorbidities

Question 7

what are the four FIRST LINE treatment agents

Answer 7

ACEI’s
ARB
CCB
diuretics

Question 8

what system has the highest capacity to reduce intravascular volume

Answer 8

the Kidney!

Question 9

onset 20-50 years
family history of hypertension
normal vitamin K, urinalysis

Answer 9

essential hypertension

Question 10

increased creatinine and abnormal urinalysis

Answer 10

chronic renal disease hypertension

Question 11

decreased serum potassium

Answer 11

primary aldosteronism hypertension

Question 12

abdominal bruit, sudden onset esp after age 50 or less than 20 and decreased serum K

Answer 12

renovascular hypertension

Question 13

paraxosyms of palpitations, diaphoresis and headache, weight loss, episodic hypertension

Answer 13

pheochormocytoma hypertension

Question 14

blood pressure in arms is greater than the legs or right arm greater than left arm, midsystolic mumur between scapula and chest x ray aortic indencation and rib notching

Answer 14

coarctation of the aorta

Question 15

central obesity with hirsutism

Answer 15

cushing syndrome

Question 16

the diagnosis for essential hypertension is _____________

Answer 16

one of exlusion

Question 17

what are the hypothesized genetic abnormalities of essential hypertenion

Answer 17

defects in renal excretion of sodium
abnormal sodium export across cell membranes
increased autonomic NS response to stress

Question 18

what race is more proned to hypertension

Answer 18

African americans

Question 19

70% of essential hypertension patients have

Answer 19

inappropriate renin levels

Question 20

effects of hyperinsulinemia

Answer 20

stimulates renal reabsorption leading to increase vascular volume
increased SNS acivity leading to increase catecholamines in circulation; alters cell membrane ion transport leads to increased intercellular calcium and vascular tone

Question 21

is a protein synthesized by adipose tissue which promotes appetite suppresion and stimulates the SNS

Answer 21

Leptin

Question 22

what is the essential hypertension hemodynamic progression

Answer 22

from high CO, normal TPR to normal CO, high TPR

Question 23

what are five clues to secondary hypertension

Answer 23

age: less than 20 greater than 50
severe
abrupt
associated sign and symptoms
family history of sporadic hypertension

Question 24

examples of meds

Answer 24

oral contraceptives
glucocorticoids
cyclosporine A
erythropoietin
cocaine
ETOH
OTC cold remedies

Question 25

what is the mechanism for renal parenchymal disease

Answer 25

increased intravascular volume

Question 26

what is the mechanism for renal disease

Answer 26

decreased renal blood flow leads to renin secretion leading to increased angiotensin II and increased aldosterone leading to increased BP

Question 27

diagnosis of renal hypertension

Answer 27

abdominal bruits

decreased serum potassium due to increase aldosterone’s excessive renal excretion of potassium

Question 28

what is the treatment or correction to help with renal hypertension

Answer 28

atherosclerosis stending and ACEI for unilateral RAS which negates Renin by impeding formation of angiotensin II

Question 29

is a catecholamine secreting tumor that secretes Epi and Ne

Answer 29

pheochromocytoma

Question 30

thrombing HA, profuse sweating and palpitation

Answer 30

pheochromocytoma

Question 31

increased aldosterone and decreased renin plasma levels

Answer 31

primary aldosteronism

Question 32

secondary aldosteronism

Answer 32

rare renin secreting tumor that leads to increased angiotensin II

Question 33

function of cortisol

Answer 33

increases renin synthesis, blood volume expansion, and inhibits cholinergic vasodilation

Question 34

central obestiy, rounded facies, proximal weakness, hirsuitsm

Answer 34

Cushing’s syndrome

Question 35

action of thyroid hormone and hypertension

Answer 35

induces sodium potassium ATPases in heart and blood vessels which increases blood volume and stimulates tissue metabolism and oxygen demand thus modulates local vascular tone

Question 36

consequences of hypertension include symptoms of

Answer 36

dizziness, epistaxis and HA

Question 37

what are some common signs of hypertension

Answer 37

LVH, arterial bruits and retinoapthy

Question 38

the degree of organ damage reflects and is attributed to

Answer 38

increased workload on the heart and arterila damage (weakend vessel walls and accelerated atherosclerosis)