Patho/PharmII- Test 2- Alterations in BP (8 points)

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Patho/PharmII- Test 2- Alterations in BP (8 points)
2012-10-03 18:06:35
Patho PharmII Test Alterations BP points

Patho/PharmII- Test 2- Alterations in BP (8 points)
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  1. What is the driving force for blood in the circulatory system? 
    Arterial BP
  2. What is the most controlled variable in the circulatory system?
    Arterial Blood Pressure
  3. What is the force exerted against wall during contraction?
    Systolic BP
  4. What is the force exerted against wall during relaxation? 
    Diastolic BP
  5. What is the difference between the systolic and diastolic pressure? 
    • Pulse Pressure
    • Normal: 30-40mmHg
  6. What is the determinate of oxygen or tissue perfusion?
    Mean Arterial Pressure: Average bp in systemic circulation
  7. How do you determine the mean arterial pressure? 
    • Systolic + 2 Diastolic 
    •             3
  8. What is the determinate of blood pressure? 
    Cardiac output x Peripheral Vascular Resistance
  9. What is cardiac output? 
    HR x SV
  10. What is PVR? 
    Reflects tone of resistance vessels and the viscosity of blood. 
  11. What are the short-term reugulators of blood pressure?
    • 1. Neural Mechanisms
    •      a. Intrinsic - for rapid and short-term reg
    •      b. Extrinsic - repsonse to pain, cold
    •      c. Higher neural centers- response due to mood

    2. Hormonal Mechanisms - Many

    **The barorecptro reflex**
  12. Epinephrine and Norepinephrine cause... 
  13. Renin-Angiotension-Aldosterone cause....
    • Vasoconstriction
    • Increase Blood Volume
    • Reabsorbs Na and water in kidneys
  14. Vasopressin (ADH) causes...
    • reabsorption of Na and water by the kidneys
    •         (not excreted through urine)
  15. Natriuretic peptides regulate....
    • Na excretion
    • Diuresis (increased uo)
    • Vasodilation (decreased bp)
    • and antagonism of the R-A-A system (so it vasodilates & decreases blood volume)
  16. Adrenomedullin
    • peptide
    • -vasodilates
    • -fluid and electrolyte balance
    • - cardiorenal regulation
  17. What is the long-term regulation of blood pressure and how does it work?
    • Renal-Body fluid system (Renin-angiotensin-aldosterone) 
    •    - kidneys response to changes in arterial pressure 
    •    - Increases salt and water excretion
  18. Hypertension
    intermittent or sustained elevation of systolic &/OR diastolic BP
  19. How do you determine someone has hypertension? 
    140/90 on three seperate occasions. 
  20. What type of HTN has an unknown cause? 
    Essential or primary 

    90% of cases
  21. What type of HTN has a known cause? 
    Secondary HTN 
  22. What are some risk factors for developing HTN? 
    • Family Hx
    • Age
    • Gender:  men<55, women > 75
    • Black
    • DM
    • Smoking
    • Obesity
    • Alcoholic
    • Stress
    • Diet: high-Na, sat fat; Low-K, Ca, Mg
  23. What are the clinical manifestations of HTN? 
    • Usually asymptomatic.
    • High: HR, BP, Bounding pulses
    • Abnormal heart sounds
    • Retinal changes in eye
    • Nocturia
  24. What are some complications of HTN? 
    CAD, HF, angina, MI, CVD, PVD, Renal failure, retinopathy, left ventricular hypertrophy
  25. How do you treat primary HTN?
    • Step 1: Implement lifestyle changes (non-pharm)
    • Step 2: Start Antihypertensive medications
  26. How do you treat secondary HTN?
    Treat the cause
  27. What are compelling indicators of HTN? 
    • Heart failure
    • Post MI
    • High CVD risk
    • Diabetes
    • CKD
    • Recurrent stroke prevention
  28. What are some non-pharmacological methods of controlling HTN?
    • Weight
    • Diet- restrict Na & fats
    • Exercise
    • Quit Smoking
    • Limit ETOH 
    • Reduce stress
  29. What is Malignant HTN and what can it lead to?
    rapidly progressing diastolic (>140)

    can lead to encephalopathy, organ dysfunction. 

    Considered an EMERGENCY - need IV agents