Systemic hypertension I

Question 1

normotensive people at age 55 have what % lifetime risk for developing HTN?

Answer 1

90%

Question 2

JNC 8 makes recommendations for BP levels to begin drug therapy depending on what factors?

Answer 2

age
coexisting diseases
race

Question 3

how does a narrow or loose cuff affect estimation of BP?

Answer 3

overestimation

Question 4

what is the most accurate way to measure BP (3 factors)?

Answer 4

1. several readings
2. reconfirm with 3 readings, each a week apart
3. use both arms

Question 5

definition: borderline HTN

Answer 5

BP only occasionally exceeds normal

Question 6

definition: primary HTN

Answer 6

elevated systemic BP without known cause

Question 7

definition: secondary HTN

Answer 7

elevated BP for which a cause can be identified (renal failure, aldosteronism)

Question 8

definition: hypertensive emergency

Answer 8

life threatening circumstance of focal or generalized symptoms of acute, ongoing, target-oriented damage - retina / CNS, cardiac, etc

Question 9

definition: malignant HTN (hypertensive retinopathy grades III and IV and severe BP elevation)

Answer 9

indicative of target organ damage

Question 10

definition: hypertensive encephalopathy

Answer 10

signs and/or symptoms of cerebral edema caused by severe and/or sudden rises in BP

Question 11

hypertensive retinopathy grade 1

Answer 11

arteriolar narrowing

Question 12

hypertensive retinopathy grade 2

Answer 12

AV nicking

Question 13

hypertensive retinopathy grade 3

Answer 13

hemorrhages and exudates

Question 14

hypertensive retinopathy grade 4

Answer 14

papilledema

Question 15

AV nicking

Answer 15

hypertensive retinopathy grade 2

Question 16

arteriolar narrowing

Answer 16

hypertensive retinopathy grade 1

Question 17

papilledema

Answer 17

hypertensive retinopathy grade 4

Question 18

hemorrhages and exudates

Answer 18

hypertensive retinopathy grade 3

Question 19

what is korotkoff (indirect) BP measuremet?

Answer 19

inflate 20 mm Hg ABOVE anticipated sBP
deflate no faster than 3 mm Hg / sec
record 1st and 5th sounds

Question 20

what is the direct method of BP measurement?

Answer 20

intra-arterial catheter

Question 21

what are the CNS consequences of systemic HTN?

Answer 21

1. decreasing cognitive function with age
2. transient ischemic attack (extracranial atherosclerosis)
3. stroke, either thromboembolic or hemorrhagic

Question 22

what are the renal consequences of systemic HTN?

Answer 22

1. intraglomerular HTN results in albuminuria (glomerular leak)
2. nephrosclerosis results in loss of renal concentrating ability - renal failure and eventual uremia

Question 23

what is the leading cause of end stage renal disease?

Answer 23

systemic arterial HTN

Question 24

what is considered to be a root cause of primary systemic arterial HTN?

Answer 24

subtle renal dysfunction

Question 25

what are the EARLY cardiac consequences of systemic HTN?

Answer 25

increasing LV mass (thickness) resulting in loss of LV diastolic function (poor filling)

Question 26

what are the CHRONIC cardiac consequences of systemic HTN?

Answer 26

LVH with eventual LV dilation and failure with eventual death

Question 27

what are the vascular consequences of systemic HTN?

Answer 27

SAH is one the major risk factors for ASCVD, MI, HF, and sudden cardiac death

Question 28

is heart failure a syndrome or a disease?

Answer 28

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