Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiovascular > Systemic hypertension > Flashcards

Systemic hypertension Flashcards

(51 cards)

Start Studying
1
Q

What is most important for tissue perfusion?

A

MAP

It plays the biggest role in tissue perfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two primary determinants of blood pressure?

A
  • CO (HR x SV)
  • SVR

CO is influenced by stroke volume (SV) and heart rate (HR).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What factors determine stroke volume (SV)?

A
  • Preload
  • Contractility
  • Afterload
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define preload.

A

Stretching of the ventricle prior to contraction, largely a function of venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is afterload?

A

Force needed to overcome aortic pressure and achieve left ventricular outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What determines heart rate (HR)?

A

Balance between sympathetic and parasympathetic nervous system inputs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What affects SVR?

A

systemic + local mediators –> vasoconstriction or vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which system primarily regulates basal systemic vascular tone and minute-to-minute regulation of BP?

A

Catecholaimes released by SNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is determines long-term regulation of vascular tone?

A
  • Angiotensin II (Potent vasoconstriction + sodium and water retention)
  • ADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name X local determinants of SVR.

A

Vasodilation: nitric oxide (NO), histamine, prostacyclin, carbon dioxide
Vasoconstriction: endothelin, thromboxane, thrombin

–> even though they are local mediators, excessive/systemic release can result in significant changes to SVR + BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What typically involves dysregulation in systemic hypertension (SHT)?

A

Increased systemic vascular resistance (SVR) with or without increased circulating volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What role does cortisol play in hypertension?

A

Supports SNS and increases vascular reactivity to catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What pathological triggers can lead to dysregulation and increased risk of SHT?

A
  • Stress response
  • AKI/CKD
  • Heart disease
  • ECV depletion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is angiotensin II’s action at the level of the glomerulum?

A
  • Efferent arteriolar vasoconstriction
  • increased GFR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can decreased renal blood flow trigger?

A

SNS Activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name X causes of systemic hypertension in renal disease.

A
  1. RAAS activation due to progressive nephron loss in order to maintain GFR
  2. SNS activation due to decreased renal perfusion
  3. decreased NO production due to chronic endothelial dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the tree of life

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 7 diseases associated with system hypertension?

A
  1. CKD –> most common cause
  2. AKI –> most common cause
  3. D. Mellitus
  4. Hyperadrenocorticism (2nd in dog)
  5. Phaeochromocytoma
  6. Hyperaldosteronism
  7. Hyerthyroidism (2nd in cat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 8 drugs/toxins associated with system hypertension?

A
  1. Glukokortikoids
  2. Mineralokortikoids
  3. Erythropoetin-stimulating agents
  4. Phenylpropanolamin
  5. Phenylephrin
  6. Ephedrin/psuedoephedrin
  7. Cocaine
  8. Metamphetamine/Amphetamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the three different types/groups of system hypertension?

A
  1. situational = artificial elevation in blood pressure created by the stress of being in the hospital setting, patient handling, and the very act of ob- taining blood pressure
  2. idiopathic = presence of SHT without a discernable underlying cause (up to 24% in cats)
  3. secondary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the incidence of systemic hypertension in dogs and cats with AKI?

Study These Flashcards
A

dogs: 75%
cats: 59%

22
Q

What is the incidence of systemic hypertension in dogs and cats with D. mellitus?

Study These Flashcards
A

dogs: 24-67%
cats: 0-15%

23
Q

Describe the autoregulatory mechanism of the kidney and how this is mediated.

24
Q

What are the underlying pathophysiological mechanisms of system hypertension leading to tissue damage and target-organ damage?

Study These Flashcards
A
  • increased vascular permeability + edema
  • vessel rupture + hemorrhage
  • excessive vasoconstriction + ischemic injury
25
What are 4 organ systems affected by target organ damage secondary to systmic hypertension?
1. Ocular 2. Renal 3. Neurologic 4. Cardiovascular
26
What are the signs of ocular hypertensive retinopathy?
* Retinal detachment * Turtuous vessels * Edema * Retinal hemorrhage * Acute blindness * Mydriasis ## Footnote These signs indicate damage to the retina due to hypertension.
27
At what systolic blood pressure (SBP) has ocular hypertensive retinopathy been reported?
SBP <180mmHg, but the risk is much higher when this pressure is acutely exceeded ## Footnote This suggests that even moderately high blood pressure can pose risks for retinal damage.
28
What can AKI and CKD cause?
Hypertension ## Footnote This can lead to the progression of AKI or CKD, creating a vicious cycle.
29
What is a consequence of increased glomerular filtration (GF) pressure?
* glomerular sclerosis * increased albumin loss into Bowman's capsule --> worsens renal disease + increases mortality ## Footnote This worsens renal disease and increases mortality.
30
What is one mechanism that leads to a decrease in renal blood flow in systemic hypertension?
Afferent arteriolar vasoconstriction due to autoregulatory mechanisms + tubuloglomerular feedback ## Footnote This occurs due to autoregulatory mechanisms and tubuloglomerular feedback.
31
What change does ischemic injury and release of inflammatory mediators cause in the renal parenchyma?
Tubulointerstitial fibrosis
32
What condition is associated with hypertensive encephalopathy?
sudden increase in SBP > 180mmHg ## Footnote Hypertensive encephalopathy occurs due to excessive blood pressure leading to neurological symptoms.
33
List the clinical signs of hypertensive encephalopathy.
* Change in mentation * Disorientation * Seizures * Vestibular signs (head tilt, ataxia, nystagmus) * Improve quickly with reduction in SBP ## Footnote These signs indicate neurological dysfunction due to high blood pressure.
34
What happens to clinical signs in acute vascular events compared to hypertensive encephalopathy?
Do not improve with reduction in SBP quickly ## Footnote Acute vascular events can mimic hypertensive encephalopathy but do not show rapid improvement with blood pressure reduction.
35
What are the types of acute vascular events that can occur?
* Ischemic * Haemorrhagic ## Footnote These types of events can lead to severe neurological symptoms.
36
What diagnostics are indicated for the work-up of systemic hypertension?
* CBC * biochemistry * Urinalysis Others: * UPC + urine culture * SDMA * T4 (cat) * adrenal axis testing (dog) * AUS * thoracic radiographs * serum/urine aldosterone (cat) * (nor)-metanephrine:creatinine ratio (dog)
37
How is systemic hypertension classified?
--> based on risk of target organ damage (TOD) 1. normotensiv (minimal risk) --> < SAP 140 mmHg 2. prehypertensive (low risk) --> 140-159 mmHg 3. hypertensive (modertae risk) -->160-179 mmHg 4. Severely hypertensive (high risk) --> ≥ 180 mmHg
38
What is the threshold for treating systemic hypertension?
SBP 160-179 mmHg or SBP ≥ 180 mmHg --> gradual control acceptable, BUT if TOD = hypertensive crisis --> emergency treatment necessary ## Footnote Hypertensive crisis requires emergency intervention.
39
What characterizes a hypertensive crisis?
Severe hypertension: SBP ≥ 180 mmHg + TOD (particularly ocular + neurological) ## Footnote TOD stands for target organ damage.
40
What is the recommended reduction in SBP in a hypertensive crisis?
1. Reduction in SBP of 10% over first hour, then 2. 15% over next several hours ## Footnote Followed by a 15% reduction over the next several hours.
41
What type of medication is preferred for acute management of hypertensive crisis? Give 4 examples.
IV preferred over PO * Fenoldapam * Nitroglycerine * Labetalol * Hydralazine ## Footnote Allows for titrated controlled reduction.
42
What is the definition of hypertensive urgency?
Severe hypertension without TOD ## Footnote Does not require immediate hospitalization.
43
What type of medication may be sufficient for hypertensive urgency? Give 2 examples.
Oral medication with faster onset of action * Hydralazine * Amlodipine ## Footnote Hydralazine and Amlodipine are examples.
44
Name 7 medications for the management of a hypertensive emergency and their mechanisms of action
45
What is the target BP for management of chronic hypertension and what is the overall goal?
Initially: <160 mmHg ultimately: <140 mmHg goal = reduce risk of TOD
46
What might vasodilation and reduction of BP lead to and how can this be managed?
RAAS activation --> addition of ACE inhibitor or angiotensin resceptor blocker
47
What diet restricutions exist for dogs with chronic systemic hypertension?
avoid diet high in sodium + chloride
48
What influences the choice of antihypertensive treatment? Give examples.
Underlying disease process: Phaeos: alpha- or beta-blockers Hyperaldosteronism: aldosterone antagonist CKD: ACEi = first linge therapy (decreases BP + proteinuria) if BP> 200mmHg --> calcium channel blocker (amlodipine) + ACEi
49
Why should a calcium channel inhibitor alone not be given as sole therapy for chronic systemic hypertension?
causes afferent arteriolar vasodilation --> may worsen intraglomerular pressure and worsen proteinuria
50
What antihypertensive medication is the first line therapy for cats with chronic hypertension? What other medication can be considered?
1. calcium channel blocker (amlodipine - for CKD + idiopathic) Other: angiotensin receptor blocker (telmisartan)
51
What is a possible renal side effect of ACEi and Angiotensin receptor blockers?
GFR reduction --> worsening of renal values (esp. in dehydrated azotemic patients)

Cardiovascular (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions