Hypertension Overview Quiz
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Questions and Answers

What is the primary function of aldosterone in the RAAS cycle?

  • Decrease blood pressure by reducing sodium and water retention
  • Inhibit the conversion of angiotensin I to angiotensin II
  • Increase blood pressure by promoting sodium and water retention (correct)
  • Promote vasodilation and release of sodium
  • What is the effect of consuming too much sodium on blood pressure?

  • It has no effect on blood pressure.
  • It causes a decrease in blood pressure due to increased sodium excretion.
  • It leads to a chronic elevation of blood pressure. (correct)
  • It leads to a temporary increase in blood pressure that quickly returns to normal.
  • How do ACE inhibitors work to lower blood pressure?

  • They inhibit the production of angiotensin II, preventing vasoconstriction and sodium retention. (correct)
  • They stimulate the release of aldosterone, increasing sodium and water excretion.
  • They directly promote vasodilation of blood vessels, reducing blood pressure.
  • They directly block the action of aldosterone on the kidneys.
  • What is the relationship between blood volume and blood pressure?

    <p>Increased blood volume leads to increased blood pressure. (D)</p> Signup and view all the answers

    Which of the following is a mechanism by which the RAAS cycle increases blood pressure?

    <p>Promoting the production of angiotensin II, a powerful vasoconstrictor. (B)</p> Signup and view all the answers

    Which of the following is NOT a direct result of LDL protein insudation into endothelial cells?

    <p>Formation of lipid core (B)</p> Signup and view all the answers

    What is the primary consequence of an increased number of LDL proteins in the bloodstream?

    <p>Damage to epithelial cells in the vasculature (D)</p> Signup and view all the answers

    What cellular component is primarily responsible for engulfing LDL proteins, leading to the formation of foam cells?

    <p>Macrophages (C)</p> Signup and view all the answers

    What is the role of foam cells in the development of coronary artery disease?

    <p>They release inflammatory mediators and growth factors, contributing to plaque formation. (D)</p> Signup and view all the answers

    What is a thrombus?

    <p>A clot of blood that can form in an artery (C)</p> Signup and view all the answers

    Which of the following is NOT a potential cause of orthostatic hypotension?

    <p>Increased blood volume (C)</p> Signup and view all the answers

    What is the key characteristic of hypotension?

    <p>An excessive increase in heart rate (B)</p> Signup and view all the answers

    What is the primary issue that leads to right ventricular hypertrophy in pulmonary stenosis?

    <p>Decreased blood flow to the lungs (A)</p> Signup and view all the answers

    Which of the following is TRUE regarding the relationship between LDL levels and coronary artery disease?

    <p>LDL levels are the primary focus when considering coronary artery disease risk (C)</p> Signup and view all the answers

    What is the defining characteristic of orthostatic hypotension?

    <p>A decrease in blood pressure of 20 mmHg or more within 3 minutes of standing (B)</p> Signup and view all the answers

    Which of the following conditions is NOT associated with secondary hypertension?

    <p>Idiopathic disorder (B)</p> Signup and view all the answers

    Which subtype of primary hypertension involves only increased diastolic blood pressure?

    <p>Isolated diastolic hypertension (C)</p> Signup and view all the answers

    What is the common characteristic of primary hypertension subtypes?

    <p>Each subtype involves different aspects of blood pressure elevation, but all involve a rise in overall blood pressure. (A)</p> Signup and view all the answers

    Which of the following is a modifiable risk factor for primary hypertension?

    <p>Diet (C)</p> Signup and view all the answers

    Which of the following organs is NOT likely to be affected by end-organ damage resulting from primary hypertension?

    <p>Lungs (A)</p> Signup and view all the answers

    In which population is secondary hypertension more commonly observed?

    <p>Children under 10 (B)</p> Signup and view all the answers

    What is a key characteristic that distinguishes primary hypertension from secondary hypertension?

    <p>Secondary hypertension has a known underlying cause, while primary hypertension does not. (B)</p> Signup and view all the answers

    Which of the following is least likely to be a contributing factor to primary hypertension?

    <p>Genetics (A)</p> Signup and view all the answers

    Which of the following types of angina is characterized by unpredictable attacks of chest pain unrelated to exertion?

    <p>Variant angina (B), Prinzmetal angina (C), Unstable angina (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of unstable angina?

    <p>Increased myocardial oxygen demand (B)</p> Signup and view all the answers

    What is the key difference between a STEMI and a non-STEMI?

    <p>STEMI is characterized by ST-segment elevation on an ECG, while a non-STEMI is not. (A)</p> Signup and view all the answers

    Which of the following is NOT a complication of acute coronary syndrome?

    <p>Rheumatic heart disease (B)</p> Signup and view all the answers

    Which of the following tests is considered the gold standard for diagnosing myocardial infarction?

    <p>Troponin (B)</p> Signup and view all the answers

    What is a primary characteristic of rheumatic heart disease?

    <p>It affects the connective tissue of the heart, joints, and skin. (B)</p> Signup and view all the answers

    Which of the following congenital heart defects is characterized by an underdeveloped or malformed tricuspid valve?

    <p>Tricuspid atresia (D)</p> Signup and view all the answers

    What is the primary consequence of coarctation of the aorta?

    <p>Decreased blood pressure in the upper extremities. (A)</p> Signup and view all the answers

    Which of the following congenital heart defects is characterized by the aorta being positioned above the ventricular septal opening?

    <p>Tetralogy of Fallot (B)</p> Signup and view all the answers

    What is the primary effect of left-sided heart failure on the body?

    <p>Fluid buildup in the lungs. (A)</p> Signup and view all the answers

    Which symptom is characteristic of paroxysmal nocturnal dyspnea?

    <p>Shortness of breath when lying down. (C)</p> Signup and view all the answers

    Which of the following conditions does NOT directly impair cardiac output?

    <p>Sinus arrhythmia (C)</p> Signup and view all the answers

    What is the primary mechanism by which cardiac tamponade decreases cardiac output?

    <p>Compression of the heart by fluid buildup in the pericardium. (B)</p> Signup and view all the answers

    What is the main cause of cor pulmonale?

    <p>Pulmonary embolism. (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of anaphylactic shock?

    <p>Increased cardiac output. (B)</p> Signup and view all the answers

    What is the primary mechanism by which septic shock causes cellular hypoxia?

    <p>Maldistribution of blood flow. (D)</p> Signup and view all the answers

    What is the most severe form of hypertension and what are its defining characteristics?

    <p>Hypertensive emergency is characterized by a sudden rise in blood pressure with evidence of end-organ damage. (D)</p> Signup and view all the answers

    Which of the following is NOT a modifiable risk factor for hypertension?

    <p>Genetics (D)</p> Signup and view all the answers

    What are some symptoms of hypotension?

    <p>Dizziness, blurred vision, confusion, syncope (C)</p> Signup and view all the answers

    Which of the following is NOT a potential end-organ damage caused by hypertension?

    <p>Osteoporosis (D)</p> Signup and view all the answers

    Which blood pressure range is considered to be Stage 1 Hypertension?

    <p>140 – 159 / 90 – 99 mmHg (C)</p> Signup and view all the answers

    What is the DASH diet and what is its role in managing hypertension?

    <p>A diet low in sodium and fat and high in fruits, vegetables, and whole grains to help lower blood pressure. (C)</p> Signup and view all the answers

    What is the role of baroreceptors in the kidneys in regulating blood pressure?

    <p>Baroreceptors in the kidneys detect changes in blood pressure and trigger the RAAS cycle by releasing hormones that constrict blood vessels and increase blood pressure. (B)</p> Signup and view all the answers

    Which of the following is a sign of end-organ damage due to hypertension?

    <p>Proteinuria (D)</p> Signup and view all the answers

    Which of the following lifestyle modifications can help reduce the risk of developing hypertension?

    <p>Regular physical activity (A)</p> Signup and view all the answers

    Which of the following is TRUE about hypertensive urgency?

    <p>It is a less severe form of hypertension than hypertensive emergency. (C)</p> Signup and view all the answers

    Flashcards

    Primary Hypertension

    Hypertension without a known direct cause; most common form.

    Isolated Systolic Hypertension

    High systolic pressure with stable diastolic pressure.

    Isolated Diastolic Hypertension

    High diastolic pressure with stable systolic pressure.

    Combined Hypertension

    Elevated both systolic and diastolic blood pressure.

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    Nonmodifiable Risk Factors

    Factors for hypertension that cannot be changed, like age and family history.

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    Modifiable Risk Factors

    Lifestyle-related factors that can be changed to reduce hypertension risk.

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    Secondary Hypertension

    Hypertension caused by identifiable conditions, often in children.

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    End-Organ Damage

    Damage to organs including heart, kidneys, eyes, brain from hypertension.

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    Hypertensive Urgency

    A sudden increase in blood pressure without end-organ damage.

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    Hypertensive Emergency

    A sudden increase in blood pressure with evidence of organ damage.

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    Symptoms of Hypotension

    Signs indicating low blood pressure, such as dizziness and fainting.

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    Risk Factors for Hypertension

    Lifestyle factors that contribute to high blood pressure, often modifiable.

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    Blood Pressure Classification - Normal

    Blood pressure reading less than 120/80 mmHg.

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    Blood Pressure Classification - Prehypertension

    Blood pressure reading between 120-140/80-89 mmHg.

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    DASH Diet

    Dietary approach recommended for lowering hypertension risk.

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    RAAS Cycle

    A hormone system that regulates blood pressure, activated by low BP.

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    Symptoms of Hypertension

    Typical symptoms include headaches, dizziness, and confusion.

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    Orthostatic Hypotension

    A condition of low blood pressure caused by physical body position changes.

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    Causes of Hypotension

    Factors include drug effects, arterial stiffness, and blood volume depletion.

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    Pulmonary Stenosis

    Narrowing of the pulmonary valve leading to right ventricular hypertrophy.

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    Right Ventricular Hypertrophy

    Thickening of the heart's right ventricle due to increased workload.

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    LDL and Coronary Artery Disease

    High levels of LDL are correlated with increased risk of heart disease.

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    Aldosterone

    A hormone that promotes sodium retention in the kidneys, influencing blood volume and pressure.

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    ACE Inhibitors

    Medications that inhibit the angiotensin-converting enzyme to lower blood pressure.

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    Sodium and Water Relationship

    Sodium retention leads to water retention, increasing blood volume and pressure.

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    Chronic Sodium Consumption

    Regular intake of high sodium leads to sustained high blood pressure and health issues.

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    Low-Density Lipoproteins (LDL)

    LDLs are lipoproteins that transport cholesterol and are linked to arterial damage.

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    LDL Insudation

    The process where LDL traps in the cell wall due to endothelial damage.

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    Foam Cells

    Macrophages filled with lipids that result from engulfing LDLs.

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    Thrombus Formation

    A blood clot that forms from lipids and debris on foam cells, narrowing arteries.

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    Endothelial Cell Damage

    Damage to cell lining caused by LDL that leads to inflammation and permeability.

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    Stable Angina

    Chest pain during predictable activities, relieved by rest or nitroglycerin.

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    Unstable Angina

    Unpredictable chest pain regardless of exertion, could lead to ischemia.

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    STEMI

    ST-Elevated Myocardial Infarction detected by ECG; indicates acute ischemia.

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    NSTEMI

    Non-ST-Elevated Myocardial Infarction; harder to detect on ECG than STEMI.

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    Cardiac Tamponade

    Fluid buildup in pericardium causing pressure on the heart, leading to output issues.

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    Rheumatic Heart Disease

    Inflammation from streptococcal infection affecting heart and connective tissue.

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    Atrial Septal Defect

    Opening between left and right atrium, causing excess pulmonary blood flow.

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    Ventricular Septal Defect

    Abnormal hole between left and right ventricles, causing volume overload.

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    Patent Ductus Arteriosus

    Failure of the ductus arteriosus to close after birth, affecting blood flow to the body.

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    Coarctation of the Aorta

    Narrowing of the aorta impeding blood flow, creating pressure differences in body regions.

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    Left Sided Heart Failure

    Heart's left side fails to pump effectively, leading to lack of blood flow and congestion.

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    Right Sided Heart Failure

    The right side fails to pump effectively, resulting in fluid buildup in the body.

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    Anaphylactic Shock

    Severe allergic reaction causing vasodilation, leading to inadequate cardiac output.

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    Septic Shock

    Systemic inflammatory response to infection causing hypotension and organ dysfunction.

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    Dysrhythmias

    Irregular heart rhythms that can impair cardiac output and indicate diseases.

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    Study Notes

    Hypertension

    • Primary hypertension is the most common type
    • Idiopathic; no direct cause
    • Rare in patients under 10
    • Three subtypes:
      • Isolated systolic hypertension: High systolic, stable diastolic
      • Isolated diastolic hypertension: High diastolic, stable systolic
      • Combined systolic and diastolic hypertension: Elevated both systolic and diastolic
    • Risk factors:
      • Nonmodifiable: Age, family history
      • Modifiable: Diet, sedentary lifestyle, obesity, metabolic syndrome
    • End-organ damage in: Heart (failure), kidneys (failure), eyes (microcirculation damage), brain (hemorrhage)

    Secondary Hypertension

    • Identifiable condition causing hypertension
    • Most common in children under 10 with specific conditions
    • Associated with: Renal disease, coarctation of the aorta, pregnancy, obesity, sleep apnea

    Hypertensive Urgency vs. Emergency

    • Hypertensive urgency: Least severe, sudden increase in BP without end-organ damage. Controlled over 24-48 hrs with medication
    • Hypertensive emergency: Severe, sudden increase in BP with end-organ damage. Requires ICU care

    End-Organ Damage

    • Impairment or damage of major organs due to hypertension
    • Examples in:
      • Vascular system (endothelial dysfunction, atherosclerosis, arteriosclerotic stenosis, aortic aneurysm)
      • Brain (stroke, hemorrhage)
      • Heart (left ventricular hypertrophy, chronic heart failure, myocardial infarction)
      • Kidneys (albuminuria, proteinuria, chronic renal insufficiency)

    Modifiable Risk Factors

    • Poor diet high in fat (increases LDL, atherosclerosis)
    • Sedentary lifestyle (weakens vasculature, heart)
    • Obesity (contributes to hypertension)
    • Metabolic syndrome

    Blood Pressure Classification

    • Normal: <120/<80 mmHg
    • Prehypertension: 120-139/80-89 mmHg
    • Stage 1 Hypertension: 140-159/90-99 mmHg
    • Stage 2 Hypertension: >160/>100 mmHg

    Sodium and Hypertension

    • RAAS (renin-angiotensin-aldosterone system) initiated with low BP.
    • Sodium retention leads to increased water retention, increased blood volume, and increased blood pressure.
    • High sodium intake associated with chronic elevation of blood pressure.

    ACE Inhibitors

    • Inhibit RAAS, reducing blood volume and blood pressure
    • Angiotensin I converted to Angiotensin II is prevented. This prevents vasodilation and release of aldosterone

    Orthostatic Hypotension Complications

    • 20 mmHg drop in blood pressure within 3 minutes.

    Hypotension - Causes

    • Vasomotor or baroreceptor response issues
    • Drug therapy adverse effects
    • Arterial stiffness
    • Blood volume depletion

    Pulmonary Stenosis

    • Abnormal fusion of the pulmonary valve cusps.
    • Right ventricular hypertrophy occurs

    Correlation of LDL and Coronary Artery Disease

    • High LDL is not easily broken down and stays in blood for longer
    • LDL may damage epithelial cells (inflammation, immune response).
    • This leads to endothelial cell and macrophage activity. (Foam cells and thrombus formation).

    Stable Angina vs Unstable Angina

    • Stable: Predictable chest pain relieved by rest. Usually due to chronic occlusion by atherosclerosis.
    • Unstable: Unpredictable, unrelated to exertion. Often due to vasospasm

    Complications of Acute Coronary Syndrome

    • STEMI (ST-elevation myocardial infarction), identified by ECG.
    • NSTEMI (non-ST-elevation myocardial infarction), not clearly shown on an ECG, but can lead to myocardial infarction
    • Complications: Heart failure, myocardial infarction, acute kidney failure

    Inverted T Waves

    • Possible indicator of ischemic myocardial damage.

    Rheumatic Heart Disease

    • Acute inflammatory disease, typically from beta-hemolytic streptococci.
    • Affects connective tissue in joints, heart, and skin.

    Congenital Heart Defects

    • Atrial Septal Defect (ASD): Opening between atria
    • Ventricular Septal Defect (VSD): Opening between ventricles
    • Patent Ductus Arteriosus (PDA): Failure of ductus arteriosus closure
    • Coarctation of the aorta: Narrowing of the aorta

    Left-Sided vs. Right-Sided Heart Failure

    • Left-sided: Systemic effects
    • Right-sided: Systemic effects

    Paroxysmal Nocturnal Dyspnea (PND)

    • Difficulty breathing during sleep

    Arrhythmias

    • Abnormal heart rhythms that interfere with cardiac output
    • Possible symptoms: Fatigue, dizziness, lightheadedness

    Cardiogenic Shock

    • Reduced cardiac output from left ventricular dysfunction

    Obstructive Shock

    • Reduced cardiac output by physical obstruction.
    • Examples: Pulmonary embolus, cardiac tamponade

    Distributive Shock (e.g., Anaphylactic Shock)

    • Shock with excessive vasodilation and reduced blood pressure.
    • Causes: Inflammatory or allergic responses.
    • Symptoms: Severe vasodilation, reduced cardiac output.

    Sepsis/Septic Shock

    • Body's response to severe infection.
    • Clotting cascade, complement system, kinin system are triggered.
    • Significant vasodilation, hypotension, blood flow maldistribution, cellular hypoxia, edema.

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    Description

    Test your knowledge on hypertension, including primary and secondary types, risk factors, and the differences between hypertensive urgency and emergency. This quiz covers essential information on causes, effects, and classifications relevant to hypertension-related conditions.

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