Diseases Of Kidneys: Essential Hypertension

Front 1

What is the most common reason for a physician visit by an non-pregnant adult taking prescription drugs in the US?

Back 1

hypertension

Front 2

Hypertension is diagnosed upon ___ BP readings after ____ post-admitting visits.

Back 2

2 ; 2

Front 3

What classification is a BP reading of:
SP = 140-159 mmHg
DP = 90-99 mmHg

Back 3

Stage 1 HTN

Front 4

What classification is a BP reading of:
SP = 160 mmHg
DP = 100 mmHg

Back 4

Stage 2 HTN

Front 5

What classification is a BP reading of:
SP <120 mmHg
DP < 80 mmHg

Back 5

Normal

Front 6

What classification is a BP reading of:

DP > 120 mmHg w/o symptoms?

Back 6

HTN urgency

Front 7

What classification is a BP reading of:

DP > 120 mmHg w/ typical symptoms

Back 7

Malignant HTN

Front 8

The disparities of HTN occurence are:
Blacks _____ Whites (other races)
Men ______Women

Back 8

> greater
= equal

Front 9

HTN with no identifiable cause is referred to as?

Back 9

Essential HTN

Front 10

BP = _____ x _______

Back 10

CO (Cardiac Output)
TPR (Total Peripheral Resistance)

Front 11

Stress, smoking, obesity, physical inactivity and salt consumption (heavy) are _________ factors for __________?

Back 11

-environmental
-Essential Hypertension and/or local Clevelander

Front 12

Reduced sodium (Na+) excretion,
factors causing a vasoconstrictive state, and environmental factors characterizing your avg. Joe Cleveland summarizes essential hypertension as a _______ and ________ disorder

Back 12

-complex
-multifactorial

Front 13

A mutation at a single gene locus may be a major cause for essential HTN.

True or False?

Back 13

False:

-likely it results from mutations at several gene loci and polymorphisms that affect blood pressure coinciding with other environmental factors.

Front 14

Essential Hypertension makes up what percent of all Hypertensive disorders?

Back 14

95%

Front 15

In ______ Henry ______ at Case induced experimental hypertension in dog subjects by clamping the renal artery.

Back 15

-1934
-Goldblatt

Front 16

A decrease in renal perfusion leads to a _______ in production of ________ in the JG apparatus of the nephron.

Back 16

-increase
-renin

Front 17

ACE stands for ___ _____ _____ and is found where in the body?

Back 17

Angiotensin Converting Enzyme;
lung / kidney endothelium

Front 18

Angiotensin II acts on the adrenal _____ to release __________ causing a ________ of sodium in the ____and ____ causing a _______ in blood volume and thus ________ BP

Back 18

cortex
Aldosterone
retention
DCT / Collecting Ducts
increase
increase

Front 19

ADH (anti-diuretic hormone) is stimulated by _______ to be secreted from the ____ _____ of the _______ gland.

Back 19

Angiotensin II
posterior lobe ; pituitary

Front 20

The -pril drugs are _______ and the the -artan drugs are _______ that function to inhibit or impede RAS

Back 20

-ACE inhibitors (Captopril, Benazapril)
-ARBs {Angiotensin II Receptor Blockers}
(Candesartan, Eprosartan)

Front 21

ACE inhibitors would lead to _____ Sodium Na+) retention

Back 21

decreased

Front 22

HTN can cause these 2 diseases:

Back 22

Benign and Malignant Nephrosclerosis

Front 23

-Renal arterial stenosis (secondary to artherosclerosis; fibromuscular dysplasa)
-Acute glomerulonephritis
-Chronic renal disease
-Polycystic disease
-Renal vasculitis
-Renin producing tumors

are examples of what?

Back 23

Renal diseases that can lead to HTN

Front 24

What is the 2nd leading cause of end-stage renal disease (15-30%) and is caused by damage from essential hypertension?

Back 24

Benign Nephrosclerosis

Front 25

What condition presents with Clinical finding of :
-Asymptomatic
-gradual increase in serum creatine
-mild proteinuria

Gross findings of :
-small kidnesys fine granular surfaces??

Back 25

Benign Nephrosclerosis

Front 26

What renal damage is produced by malignant HTN?

Back 26

Malignant Nephrosclerosis

Front 27

What condition may come about from:
-essential HTN
-renal failure (irreversible)
-CVA,
-MI
-de novo

Back 27

Malignant Nephrosclerosis

Front 28

Constant high blood pressure due to heightened ALDO release, a perpetuating RAS cycle and the presence of fibrinoid necrosis and onion skin lesion: alludes to this condition

Back 28

Malignant Nephrosclerosis

Hint 28

Needs to be dealt with as an emergency.

Front 29

What is an uncommon cause of HTN making up 2-5% of the cases of HTN?

Back 29

Renal Artery Stenosis

Hint 29

curable by surgery

Front 30

2/3 of these cases are due to athersclerotic narrowing;
1/3 due to fibromuscular dysplasia

Back 30

Renovascular HTN (renal artery stenosis)

Front 31

What clinical presentations reflect renal artery stenosis?

Back 31

1) M>f
2) 50 yo +
3) Resistance to standard medication
4) bruit on auscultation
5) Unilateral 70% of cases

Hint 31

atherosclerotic

Front 32

What are the 2 forms of Renal Artery Stenosis?

Back 32

-Atherosclerotic
-Fibromuscular Dysplasia

Front 33

Microscopic findings of FD Renal Artery Stenosis reveal what?

Back 33

fibrous or fibromuscular thickening of the arterial wall

Front 34

What condition develops as a lesion of an unknown etiology,
-observed in young ---> middle-aged Women w/ HTN
-standard medication resistance
-bruit on auscultation
-'string of beads' on radiographs

Back 34

Renal Artery Stenosis (FD type)

Front 35

Unilateral lesions are observed in both types of Renal Stenosis as what percentages?
ATH:
FD:

Back 35

Atherosclerotic: 70%
Fibrous Dysplasia: 60%

Front 36

An abnormal localized dilation most commonly caused by atherosclerosis and cystic medial degeneration.

Back 36

-Aortic aneurysm

Front 37

What are the most common types of aortic aneurysms?

Back 37

Abdominal

Front 38

An intimal tear allowing blood to enter the Tunica Media associated with HTN.

Back 38

Aortic Dissection

Hint 38

not related to atherosclerosis

Front 39

What is the leading cause of death in the U.S. and industrialized nations

Back 39

Myocardial Infarction (death of myocardium due to ischemia)

Front 40

The chronology of MIs:
_________ leads to acute plaque rupture leads to the terminal occlusive thrombosis

Back 40

severe coronary atherosclerosis

Front 41

complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood

Back 41

CHF (Congestive Heart Failure)

Front 42

What disease is characterized by
-fatigue
-dyspnea
-fluid retention
and is the cause of 1/3 of HTN deaths

Back 42

CHF

Front 43

A sudden onset of a neurological deficit with clinical manifestations referable to the anatomic location of the lesion

Back 43

CVA ( Cerebral Vascular Accident)