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21 Cards in this Set
- Front
- Back
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What are causes of secondary hypertension?
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Kidney disease
Pheochromocytoma Primary aldosteronism EtOH Obesity |
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What is the definition of malignant hypertension?
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Marked increased blood pressure associated with acute arteriolar injury
Advanced retinopathy Acute organ damage: -Acute renal failure -Encephalopathy -Heart failure -Coronary ischemia |
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What histologic changes happen tot he interlobar arteries in malignant hypertension?
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Proliferative endarteritis: onionskinning
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What pathologic findings happen to the afferent arteries and glomerula capillaries in malignant hypertension?
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Fibrinoid necrosis
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What generalized process happens all throughout the body in malignant hypertension?
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Fibrinoid necrosis, which causes proliferative endarteritis
these things lead to... ISCHEMIA ALL OVER THE PLACE |
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What are the clinical features of malignant hypertension?
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It's an acute process
Accelerated, severe HTN Headache Blurred vision Renal failure Organ dysfunction High mortality |
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What are secondary causes of malignanat hypertension?
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Renal disease
Renovascular hypertension Vasculitis Oral contraceptives Scleroderma Endocrine HTN |
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What is the treatment for malignant hypertension?
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Rapid BP reduction:
Nitroprusside Labetalol Oral agents for long-term control |
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In the treatment of malignant hypertension, what is one thing that you've got to watch out for when reducing the blood pressure?
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After you've got the BP at a safe level, don't reduce things too fast; you'll cause more ischemia
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What are the clinical features of hypertensive nephrosclerosis?
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Older
M>F, B>W Longstanding HTN Slowly rising creatinine Normal urinalysis No serologic problems other then creatinine, |
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What are the top three complications in patients with untreated essential hypertension?
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Cardiac problems
Renal problems Retinal problems |
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What are the two most common causes of dialysis and transplant?
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1. DMII
2. HTN |
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What are the goals for the treatment of HTN and renal disease?
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1. Decrease systemic BP
2. Decrease glomerular capillary pressure 3. Target a really low BP |
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What is the effect of renal disease on blood pressure?
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It causes it to go up!
Renal disease is a CAUSE of hypertension! |
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What is the effect of hypertension on renal disease?
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It worsens it!
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What is the treatment of someone with renal diseasese secondary to hypertensioN?
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Essentially, it's the same as the treatment of a person who has HTN
Volume control: -Low salt -Diuretics ACDIs, ARBs |
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What are the clinical features of renovascular occlusive disease?
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Severe HTN
Acclerated, abrupt onset Abdominal bruit Flash pulmonary edema Ischemic nephropathy |
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Who typically gets fibromucsular dysplasia? when?
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<40
Females |
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Where does fibromuscular dysplasia effect the kidneys?
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Distal renal arteries; intrarenal branches of the reenal arteries
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What is the typical age of those effected by atherosclerotic renal disease? Male or female?
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>45
Male |
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Generally, where do the changes with atherosclerotic renal artery stenosis take place?
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Aortic orfice
Proximal renal artery |
