Hypertension Quiz: Causes and Complications
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Questions and Answers

What percentage of hypertension cases are classified as idiopathic (essential) hypertension?

  • 90% (correct)
  • 5%
  • 10%
  • 50%

    • Malignant hypertension affects 5% of hypertensive patients and can lead to death within 1 to 2 years if untreated.

    True

    Name one complication associated with hypertension.

    Atherosclerosis

    Patients with clinically significant hypertension have diastolic pressures greater than __________ mm Hg.

    <p>80</p> Signup and view all the answers

    Which of the following is a potential identifiable cause of secondary hypertension?

    <p>Primary aldosteronism</p> Signup and view all the answers

    Which of the following factors is NOT implicated in essential hypertension?

    <p>High HDL levels</p> Signup and view all the answers

    Match the following categories of hypertension to their descriptions:

    <p>Primary hypertension = 90% of cases, no identifiable cause Secondary hypertension = 10% of cases, identifiable underlying causes Malignant hypertension = Severe pressure elevations with high risk of death Hypertensive heart disease = Cardiac complications caused by chronic hypertension</p> Signup and view all the answers

    Hypertension can cause degenerative changes in the walls of arteries.

    <p>True</p> Signup and view all the answers

    Renal artery stenosis is an example of a condition that contributes to primary hypertension.

    <p>False</p> Signup and view all the answers

    Name one form of hypertension-related small vessel disease.

    <p>Hyaline arteriolosclerosis</p> Signup and view all the answers

    One significant risk factor for hypertension is __________, which influences vascular tone and cardiac output.

    <p>neural and hormonal inputs</p> Signup and view all the answers

    The process that leads to narrowing of renal arterioles in chronic hypertension is called __________.

    <p>nephrosclerosis</p> Signup and view all the answers

    Match the following forms of small vessel disease with their characteristics:

    <p>Hyaline arteriolosclerosis = Homogeneous, pink hyaline thickening Hyperplastic arteriolosclerosis = Onion-skin appearance of vessel walls Pulmonary hypertension = Increased blood pressure in pulmonary arteries</p> Signup and view all the answers

    Which condition can result from the degenerative changes caused by hypertension?

    <p>Aortic dissection</p> Signup and view all the answers

    Obesity is considered a risk factor for developing hypertension.

    <p>True</p> Signup and view all the answers

    Which substances are considered vasoconstrictors?

    <p>Angiotensin II</p> Signup and view all the answers

    Renin is released in response to high blood pressure in afferent arterioles.

    <p>False</p> Signup and view all the answers

    What enzyme converts angiotensin I to angiotensin II?

    <p>ACE</p> Signup and view all the answers

    Angiotensin II increases blood pressure by inducing ________ contraction.

    <p>vascular</p> Signup and view all the answers

    Match the following substances with their effects on blood pressure:

    <p>Aldosterone = Increases sodium resorption Prostaglandins = Counterbalance vasopressor effects ANP = Inhibits sodium resorption Catecholamines = Induces vasoconstriction</p> Signup and view all the answers

    Which of the following factors is NOT related to vasodilation?

    <p>Angiotensin II</p> Signup and view all the answers

    Volume expansion leads to the release of atrial natriuretic peptide (ANP).

    <p>True</p> Signup and view all the answers

    What happens to blood volume when aldosterone is released?

    <p>It increases.</p> Signup and view all the answers

    The primary function of renin is to cleave angiotensinogen to form ________.

    <p>angiotensin I</p> Signup and view all the answers

    What is primarily responsible for adjusting vascular tone in the body?

    <p>Hormonal signals</p> Signup and view all the answers

    Which of the following contributes minimally to blood pressure levels despite their individual genetic variations?

    <p>Genome-wide association studies</p> Signup and view all the answers

    Insufficient renal sodium excretion can be a key initiating event in the development of essential hypertension.

    <p>True</p> Signup and view all the answers

    What is the consequence of a new steady state of sodium balance through 'resetting of pressure natriuresis'?

    <p>An increase in blood pressure</p> Signup and view all the answers

    In essential hypertension, factors that induce __________ can affect peripheral resistance.

    <p>vasoconstriction</p> Signup and view all the answers

    Match the key factors to their descriptions in essential hypertension:

    <p>Genetic factors = Contribute minimally to blood pressure levels Renal sodium excretion = Key initiating event in hypertension Vasoconstrictive influences = Increase peripheral resistance Fluid volume = Affects cardiac output and blood pressure</p> Signup and view all the answers

    What is the role of sodium reabsorption related to hypertension?

    <p>Alters fluid volume and cardiac output</p> Signup and view all the answers

    Monozygotic twins show higher similarity in blood pressure levels compared to dizygotic twins.

    <p>True</p> Signup and view all the answers

    Which condition serves as a final common pathway for the pathogenesis of hypertension?

    <p>Insufficient renal sodium excretion</p> Signup and view all the answers

    The __________ response may occur in hypertension when sodium intake equals sodium excretion.

    <p>resetting of pressure natriuresis</p> Signup and view all the answers

    What is a consequence of vascular structural changes due to vasoconstrictive stimuli?

    <p>Increased peripheral resistance</p> Signup and view all the answers

    Which of the following hormones is primarily responsible for regulating blood pressure by affecting vascular tone and sodium resorption?

    <p>Angiotensin II</p> Signup and view all the answers

    Renal artery stenosis can lead to increased renin secretion.

    <p>True</p> Signup and view all the answers

    Name the condition characterized by chronic excess aldosterone secretion.

    <p>Primary hyperaldosteronism</p> Signup and view all the answers

    The main mechanism through which renal sodium is regulated involves ________ secretion.

    <p>aldosterone</p> Signup and view all the answers

    Match the following conditions with their descriptions:

    <p>Renovascular hypertension = Caused by renal artery stenosis leading to increased renin Primary hyperaldosteronism = Chronic excess aldosterone secretion causing hypertension Liddle syndrome = Distal tubular reabsorption of sodium in response to aldosterone Essential hypertension = Majority caused by genetic and environmental factors</p> Signup and view all the answers

    Which gene mutations are associated with severe forms of hypertension?

    <p>Mutations in aldosterone synthase</p> Signup and view all the answers

    Primary hyperaldosteronism is always caused by adrenal adenomas.

    <p>False</p> Signup and view all the answers

    What is the effect of angiotensin II on the adrenal glands?

    <p>It increases aldosterone secretion.</p> Signup and view all the answers

    The secretion of ________ is stimulated when blood pressure decreases in the afferent arterioles.

    <p>renin</p> Signup and view all the answers

    Which condition may lead to secondary hypertension due to decreased renal perfusion?

    <p>Congestive heart failure</p> Signup and view all the answers

    Study Notes

    Pathology of Hypertension

    • Hypertension is a condition of abnormally high blood pressure.
    • Clinically significant hypertension is diagnosed when diastolic pressure exceeds 80 mm Hg or systolic pressure exceeds 120 mm Hg.
    • The pathology of hypertension involves abnormalities in normal blood pressure homeostasis, pathogenic mechanisms, and changes in blood vessels.
    • Secondary hypertension (10%) is often caused by an identifiable underlying condition.
    • Adrenal disease, primary aldosteronism, Cushing syndrome, and pheochromocytoma are examples of adrenal conditions that can cause secondary hypertension.
    • Renal artery stenosis and renal disease can also cause secondary hypertension.
    • Idiopathic (essential) hypertension (90%) is not related to a specific identifiable cause.
    • Hypertension increases the risk of complications such as atherosclerosis, cardiac hypertrophy, hypertensive heart failure, multi-infarct dementia, aortic dissection, and renal failure.
    • The clinical presentation of severe hypertension can be silent for years.
    • Malignant hypertension is a rare and serious form in which blood pressure increases rapidly. Severe pressure elevations typically include systolic pressure > 200 mm Hg and diastolic pressure > 120 mm Hg.
    • Untreated malignant hypertension can lead to death within one to two years.

    Blood Pressure Regulation

    • Blood pressure is the product of cardiac output and peripheral resistance.
    • Cardiac output is the product of heart rate and stroke volume.
    • Blood volume affects cardiac output and influences blood pressure.
    • Peripheral resistance is determined by vascular tone (vasoconstriction and vasodilation) and is regulated by humoral and neural factors.
    • Humoral factors include hormones and other substances in the blood, while neural factors constitute the nervous system.
    • Sodium homeostasis plays a crucial role in regulating blood volume and, subsequently, blood pressure.
    • Renin is a proteolytic enzyme produced by the renal juxtaglomerular cells, which is involved in the renin-angiotensin-aldosterone system (RAAS). Renin cleaves angiotensinogen to angiotensin I, leading to angiotensin II, which influences blood pressure through increasing vascular tone and stimulating aldosterone secretion, which ultimately regulates sodium resorption in the kidneys and impacts blood volume and pressure.
    • Myocardial natriuretic peptides (and atrial natriuretic peptide) are released from the heart in response to blood volume expansion. ANP is a vasodilatory peptide regulating sodium excretion and fluid balance.
    • Factors from the kidneys, adrenals, and myocardium influence blood pressure regulation.
    • The kidneys and the heart contain cells that sense and respond to changes in blood pressure and volume.

    Hypertension Complications

    • Hypertension-related pathologies include atherosclerosis, cardiac hypertrophy, heart failure, multi-infarct dementia, aortic dissection, and renal failure. Malignant hypertension can also occur with severe pressure elevations that can result in rapid progression and serious health risks.
    • The kidneys play a crucial role in regulating blood pressure by adjusting sodium balance and fluid balance. The kidneys will eliminate excess salt and water when blood pressure is elevated.
    • Blood pressure can also be regulated by influencing vascular tone.
    • Hyaline arteriolosclerosis occurs due to protein leakage across injured endothelial cells and increased smooth muscle cell matrix synthesis in response to chronic hemodynamic pressure. This leads to thickening and narrowing of the arterioles.
    • Hyperplastic arteriolosclerosis is characterized by concentric, layered ("onion-skin") thickening of the arteriolar walls, which further reduces blood flow. This process occurs in severe hypertension.
    • Pulmonary hypertension is a hypertension-related condition affecting the small blood vessels in the lungs.

    Essential Hypertension

    • The vast majority of hypertension cases are considered essential hypertension, and result from complex interactions between genetic and environmental factors.
    • The pathogenesis of essential hypertension commonly involves insufficient renal sodium excretion.
    • Factors that induce vasoconstriction or structural changes in the vessel wall can also contribute to hypertension.
    • Implicated environmental factors in hypertension include: stress, obesity, smoking, physical inactivity and heavy salt consumption.

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    Pathology of Hypertension PDF

    Description

    Test your knowledge about hypertension with this quiz! From essential and secondary hypertension to complications and risk factors, explore the various aspects of this common cardiovascular condition. Understand the intricacies of hypertension and identify its categories and effects.

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