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6 Cards in this Set
- Front
- Back
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What are the two endocrine mechanisms for maintaining BP? Subtypes of these mechanisms?
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Catecholamines
- nerve endings - adrenal medullary secretion Renin-angiotensin-aldo - direct ang II effect - indirect aldo effect on plasma volume |
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Is primary mineralocorticoid excess (adrenal adenoma secreting aldosterone) a relatively (common/uncommon) cause of HTN?
- characteristics (volume, Na, K)? - must be distinguished from what non-pathological etiology? - renin and ang II lvls? |
relatively uncommon
- Na retention, V expansion, K excretion. - pts w/ essential HTN taking diuretics - low |
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Identify the dz at the top of the DDx for the following:
- ^Plasma Renin (PRA), ^ Plasma Aldo (PAC), PAC/PRA~10 - \PRA, ^PAC; PAC/PRA >2 w/ PAC > 15 - \PRA, \PAC |
- 2ndary hyperaldosteronism (diuretic use, renovascular HTN, renin-secreting tumor, coarctation of aorta, malignant HTN)
- primary aldosteronism - Congenital adrenal hyperplasia, DOC-producing tumor, Cushing's, 11B-HSD def, exogenous mineralocorticoid, Liddle's syndrome. |
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Explain the pathologenesis of secondary hyperaldosteronism in the context of renal artery stenosis.
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decrease in blood flow --> ^renin --> ^ ang II --> ^ aldo --> ^ Na retention, \K rtn, increase plasma V
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What are the 4 classes of drugs that are available to block various components of the RAAS system?
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Renin inhibitors, ACE inhibitors, ARB's, Aldosterone receptor antagonists.
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Should you use stimulation tests in pts with suspected pheochromocytoma?
What is the preferred tx? - is there a sx focused medical therapy that works? |
No, it's dangerous.
Surgerical removal. - yes, a and b blocker combo tx is often useful to control HTN and cardiac arrythmias. |
