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37 Cards in this Set

  • Front
  • Back
What is the difference between prehypertension and hypertension
In prehypertension the systolic pressures are between 120-139 mm Hg and diastolic pressures between 80-89 mm Hg but in hypertension the systolic bp is 140 or higher and diastolic pressure is 90 mm Hg or higher
What are the categories of hypertension
Primary hypertension, Secondary hyptertension, Malignant hypertension and Systolic hypertension
What is primary hypertension
chronic elevation in blood pressure that occurs without evidence of other disease
What is Secondary hypertension
elevation of blood pressure that results from some other disorder, such as kidney disease
What is Malignant hypertension
an accelerated form of hypertension
What is Systolic hypertension
systolic pressure of 140 mm Hg or greater and a diastolic pressure of less than 90 mm Hg
What are risk factors for hypertension
*family history *age-related changes in blood pressure *ethnicity *insulin resistance and metabolic abnormalities *circadian variations *lifestyle factors *socioeconic pressures
What organ damage can hypertension cause
*Heart (hypertrophy) *Brain (dementia and cognitive impairment) *Peripheral vascular (atherosclerosis) *Kidney (nephrosclerosis) *Retinal complications
What drugs are used to treat hypertension
*Diuretics *B-adrenergic-blocking drugs *Angiotensin-converting enzyme (ACE) inhibitors *Angiotensin II receptor blockers *calcium-channel-blocking drugs *Central a2-adrenergic agonists *a1-adrenergic receptor blockers *vasodilators
What are blood pressure norms for children and adolescents based on
age, height and gender-specific percentiles
What is the most common form of high blood pressure in infants and children
Secondary hypertension (from kidney abnormalities, coarctation of the aorta, pheochromocytoma and adrenal cortical distorders to name a few)
Hypertension is most commonly associated with what in infants
Most commonly associated with high unbilical catheterization and renal artery obstruction caused by thrombosis
What is the definition and cause of orthostatic hypotension
It is defined as an abnormal decrease in blood pressure on assumption of the upright position and caused by decrease in venous return to the heart due to pooling of blood in lower part of the body and/or inadequate circulatory response to decreased cardiac output and a decrease in blood pressure
What are the common causes of orthostatic hypotension related to hypovolemia
*excessive use of diuretics *excessive diaphoresis *Loss of gastrointestinal fluids through vomiting and diarrhea *loss of fluid volume associated with prolonged bed rest
What are the clinical manifestations associated with orthostatic intolerance
*dizziness *visual changes *head and neck discomfort *poor concentration while standing *palpitations *tremor, anxiety *presyncope and in some cases syncope
What is the definition of heart disease and what can it cause
It is impaired coronary blood flow that may cause : angina, myocardial infarction (heart attack), other heart diseases (such as cardiomyopathy, heart failure, cardiac arrhythmias, conduction defects)
What is the route of coronary circulation
*Left main coronary artery *Left anterior descending artery *circumflex branch *right coronary artery *posterior descending artery
What are the lipids and what do they do
Triglycerides (used in energy metabolism) Phospholipids (important structural constituents of lipoproteins, blood-clotting components, the myelin sheath, and cell membranes) Cholesterol (chemical activity similar to other lipid substances)
What is hyperlipidema
Elevated levels of Triglycerides, phospholipids, or cholesterol
What are the lipoproteins and their purpose
*Chylomicrons *Very-low-density lipoprotein (VLDL)~carries large amounts of triglycerides *Intermediate-density lipoprotein (IDL) *Low-density lipoprotein (LDL) ~main carrier of cholesterol *High-density lipoprotein (HDL) ~50% protein
What do lipoprotein receptors do and what results in genetic abnormality
They are membrane proteins that facilitate cellular uptake of LDL, VLDL, chylomicrons, and ILDL proteins and a genetic abnormality may result in elevated levels with no dietary influence
What are the types of lesions associated with atherosclerosis
*fatty streaks ~thin, flat, yellow intimal discolorations that progressively enlarge *fibrous atheromatous plaque ~ the accumulation of intracellular and extracellular lipids, proliferation of vascular smooth muscle cells, and formation of scar tissue *Complicated lesion ~ contains hemorrhage, ulceration, and scar tissue deposits
What are the major risk factors for Atherosclerosis
*Obesity *Hypercholesterolemia *cigarette smoking *hypertension *family history of premature CHD in a first-degree relative *age (men >45 ; women > 55 years) *HDL cholesterol <40 mg/dL *C-reactive protein levels *Homocysteine levels
What are the 3 major complications of Atherosclerosis
*Ischemic heart disease *Stroke *Peripheral vascular disease
What are the clinical manifestations associated with Atherosclerosis
*narrowing of the vessel and production of ischemia *sudden vessel obstruction due to plaque hemorrhage or rupture *Thrombosis and formation of emboli resulting from damage to the vessel endothelium *Aneurysm formation due to weakening of the vessel wall
How are specific arteries involved in atherosclerosis
Large vessels : the important complications are those of thromubs formation and weakening of the vessel wall *Medium-sized arteries : ischemia and infarction due to vessel occlusion are more common *Arteries supplying the heart, brain, kidneys, lower extremities, and small intestine : most frequently involved
What are the two types of angina
*Chronic stable angina (associated with a fixed coronary obstruction that produces a disparity between coronary blood flow and metabolic demands of the myocardium *Stable angina : the initial manifestation of ischemic heart disease in approximatley half of people with CHD
What are nonpharmacologic treatments of angina
*smoking cessation in people who smoke *stress reduction *regular exercise program *limiting dietary intake of cholesterol and saturated fats *weight reduction if obesity is present *avoidance of cold or other stresses that produce vasoconstriction
What are the causes of unstable Angina
*Atherosclerotic plaque disruption *Platelet aggregation *Secondary hemostasis
What are the 3 characteristics of pain associated with unstable angina
(The pain is more persistent and severe course and is characterized by at least one of the three features) 1. It occurs at rest (or with minimal exertion) usually lasting more than 20 minutes (if not interrupted by nitroglycerin) 2. It is severe and described as frank pain and of new onset. 3. It occurs with a pattern that is more severe, prolonged, or frequent that previously experienced
What factors determine the workload of the heart
1.Preload (volume of blood the heart pumps out/end diastolic volume/ a function of the pressure exerted by the atria) 2. Afterload (pressure it must generate to pump blood out of the heart/ a function of the resistance in the aorta)
What is primary hypercholesterolemia
it describes elevated cholesterol levels that develop independent of other health problems of lifestyle behaviors
What is secondary hypercholesterolemia
is associated with other health problems and behaviors
What are the 5 phases of korotoff sounds
Phase 1. Marked by the first tapping sound (gradually increases in intensity) Phase 2. Period in which a murmur or swishing sound is heard Phase 3.Period during which sounds are crisper and greater intensity Phase 4. Period marked by distinct abrupt muffling or by a soft blowing sound Phase 5. Point at which sounds disappear
What are the 2 factors that influence mean arterial blood pressure
1. Physical (blood volume and the elastic properties of the blood vessels) 2. Physiologic factors (caridac output and peripheral vascular resistance)
What are the 5 steps in the RAAS System
1. When the incoming blood pressure in the kidneys drops below a certain level, the juxtaglomerular apparatus secretes renin into the blood 2.Renin, an enzyme, causes angiotensinogen (normal in the blood) to be converted to angiotensin 1 3.Angiotensin 1 circulates to the lungs where converting enzymes in the capillaries split the molecule forming angiotensin II, 4.Angiotensin II circulates to the adrenal cortex where it stimulates the secretion of aldosterone 5. Aldosterone causes increased reabsorption of sodium, which causes increased water retention As water is retained the volume of blood increases the increased volume of blood creates higher blood pressure, which then causes the renin secretion to stop
What are lifestyle factors that contribute to hypertension
*High salt intake *obesity *excess alcohol consuption *smoking tobacco *stress