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28 Cards in this Set
- Front
- Back
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These are 10 possible causes of secondary HTN
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Primary hyperaldosteronism, pheochromocytoma, renal artery stenosis (renovascular HTN), renal parenchymal disease, coarctation of the aorta, Cushing's, thyroid disease, alcohol, oral contraception, pregnancy-induced HTN
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This condition is characterized by hyperplasia or adenoma of the adrenal cortex
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Hyperaldosteronism
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Hypokalemia and metabolic acidosis may result from this secondary cause of HTN
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Hyperaldosteronism
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Low potassium, increased aldosterone and decreased renin suggest this diagnosis
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Hyperaldosteronism
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What percent of pheochromocytomas are maligant?
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Ten percent (10%)
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50% of patients with this disease have intermittent spells of HTN. The other half have sustained HTN.
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Pheochromocytoma patients
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These patients have paroxysms of HTN associated with vasoconstriction, pallor and bradycardia
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Patients with NE-secreting tumors (pheochromocytomas)
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These patients have paroxysms of HTN associated with orthostatic HTN and tachycardia
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Patients with E-secreting tumors (pheochromocytomas)
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A patient with metanephrines and vanillymandelic acid in the serum or urine may have this disease.
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Pheochromocytoma
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These are the two causes of renal artery stenosis
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Atherosclerosis in older men; fibromuscular hyperplasia in younger women (esp. smokers)
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A patient with different renin levels in the left and right renal veins may have this disease
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Renal artery stenosis (renovascular HTN)
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Hypokalemia is not characteristic of this secondary cause of HTN
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Pheochromocytoma
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The mechanism of these conditions is increased total blood volume
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Primary hyperaldosteronism, Cushing's syndrome, parenchymal disease (with Na retention)
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The mechanism of these conditions is increased cardiac output
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Hyperthyroidism, hyperkinetic heart syndrome
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The mechanism of these conditions is increased peripheral vascular tone
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Renal artery stenosis (renovascular HTN), hyperthyroidism, hypothyroidism
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These conditions are associated with high renin
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Conditions that cause increased peripheral vascular tone
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These conditions are associated with low renin
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Conditions that cause increased total blood volume
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Treatment for low renin conditions
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Diuretics
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Treatment for high renin conditions
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Vasodilators (Angiotensin II is a powerful vasoconstrictor)
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Treatment for conditions that cause increased cardiac output
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Beta-blockers
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A patient with elevated blood pressure in the arms, and decreased BP in the legs may have this disease
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Aortic coarctation
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A patient with a continuous murmur over the aorta may have this condition
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Aortic coarctation
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A patient with a CXR showing notching of the ribs may have this disease
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Aortic coarctation
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How do hyper- and hypothyroidism cause HTN?
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Increased thyroid hormone induces synthesis of Na/K pump and beta-1 receptors in the heart. Decreased thyroid hormone results in reduced beta-2 receptors in peripheral arterioles, leading to increased vascular resistance
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A patient with HTN who has high angiotensin II, high aldosterone, and low renin levels may have HTN secondary to this
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Oral contraceptives (estrogens induce synthesis of angiotensinogen by the liver, leading to increased ang II and aldosterone)
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A patient with PIH may present with these symptoms
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HTN, rapid weight gain, edema, renal abnormalities (eg, proteinuria)
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PIH occurs in this trimester of pregnancy
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Third
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Major and minor risk factors for atherosclerosis
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Major known: Age, gender, family hx, genetic, hyperlipidemia, hypertension, cigarette smoking, diabetes
Minor or uncertain: Postmenopausal estrogen deficiency, obesity, stress, inactivity, high carb intake, EtOH, lipoprotein Lp(a), chlamydia pneumoniae |
