CVRN BC FINAL EXAMS ANSWERS AND QUESTIONS
SET A+
✔✔HTN urgency - ✔✔BP 180/110 or greater.
No end organ issues or symptoms.
Nosebleeds/HA/SOB present
✔✔HTN emergency - ✔✔BP greater than 180 systolic or 120 diastolic
Irreversible damage to one or more organs
CP or aortic dissection, pulm edema
Visual changes - retinal hemorrhage or optic nerve swelling
✔✔List the end organ damage of HTN emergency - ✔✔HTN encephalopathy
Pulm edema with resp failure
Decompensated HF
ACS - UA, acute MI
Aortic dissection
Retinopathy
Acute renal failure
Pregnancy - HELLP syndrome, severe pre-eclampsia
✔✔HELLP syndrome - ✔✔hemolysis, elevated liver enzymes, low platelets
✔✔How does baroreceptor reflex control BP - ✔✔High BP causes baroreceptors to
stretch, stimulating vagal cholinergic neurons thus lowering HR and causing
vasodilation.
Low BP creates less stretch causing stimulation of the sympathetic adrenergic neurons,
raising BP by increasing HR, improving myocardial contractility, increasing
vasoconstriction
✔✔Aldosterone raises BP by... - ✔✔retain sodium and water in the renal tubules, thus
increasing BP
, ✔✔Glomerular filtration and lowering BP - ✔✔high BP stimulates an increase in GFR in
the kidneys causing diuresis and lowering BP
✔✔renin-angiotensin-aldosterone system - ✔✔Hormone system involved in regulation
of plasma Na+ concentration and arterial BP
✔✔How does the renin-angiotensin system work to control BP? - ✔✔Low BP decreases
renal blood flow therefore decreases renal perfusion resulting in:
renin production in the juxtaglomerular cells of the kidneys reulting in:
Angiotensin I to be converted to Angiotensin II but the Angiotensin-Converting-Enzyme
(ACEI)
✔✔How does angiotensin II increase BP? - ✔✔causes peripheral vascular
vasoconstriction
✔✔How does Aldosterone work to increase BP - ✔✔low pressure stimulates the release
of aldosterone which causes the body to retain Na+ and water in the renal tubules to
increase BP
✔✔Classifications of BP - ✔✔Normal <120/<80
Pre-Hypertensive - 120-139/80-89
Stage 1 - 140-159/90-99
Stage 2 - 160 and up/100 and up
Stage 3 - >180/>110
✔✔HTN management for stage 1 and 2 - ✔✔diuretics
ACEI or ARB
BB or CCB
Alpha Antagonists
✔✔What diet is recommended to decrease HTN - ✔✔DASH diet
✔✔Med choice for young pts with HTN - ✔✔ACEI
a-blocker or BB
✔✔Med choices for HTN in African American pts - ✔✔Diuretic
CCB or a-blockers
ACEI (bb are less effective as monotherapy)
✔✔Med choices to tx HTN in elderly - ✔✔Diuretic
CCB
ACEI or a-blocker
BB -effective but cause more SE in elderly
SET A+
✔✔HTN urgency - ✔✔BP 180/110 or greater.
No end organ issues or symptoms.
Nosebleeds/HA/SOB present
✔✔HTN emergency - ✔✔BP greater than 180 systolic or 120 diastolic
Irreversible damage to one or more organs
CP or aortic dissection, pulm edema
Visual changes - retinal hemorrhage or optic nerve swelling
✔✔List the end organ damage of HTN emergency - ✔✔HTN encephalopathy
Pulm edema with resp failure
Decompensated HF
ACS - UA, acute MI
Aortic dissection
Retinopathy
Acute renal failure
Pregnancy - HELLP syndrome, severe pre-eclampsia
✔✔HELLP syndrome - ✔✔hemolysis, elevated liver enzymes, low platelets
✔✔How does baroreceptor reflex control BP - ✔✔High BP causes baroreceptors to
stretch, stimulating vagal cholinergic neurons thus lowering HR and causing
vasodilation.
Low BP creates less stretch causing stimulation of the sympathetic adrenergic neurons,
raising BP by increasing HR, improving myocardial contractility, increasing
vasoconstriction
✔✔Aldosterone raises BP by... - ✔✔retain sodium and water in the renal tubules, thus
increasing BP
, ✔✔Glomerular filtration and lowering BP - ✔✔high BP stimulates an increase in GFR in
the kidneys causing diuresis and lowering BP
✔✔renin-angiotensin-aldosterone system - ✔✔Hormone system involved in regulation
of plasma Na+ concentration and arterial BP
✔✔How does the renin-angiotensin system work to control BP? - ✔✔Low BP decreases
renal blood flow therefore decreases renal perfusion resulting in:
renin production in the juxtaglomerular cells of the kidneys reulting in:
Angiotensin I to be converted to Angiotensin II but the Angiotensin-Converting-Enzyme
(ACEI)
✔✔How does angiotensin II increase BP? - ✔✔causes peripheral vascular
vasoconstriction
✔✔How does Aldosterone work to increase BP - ✔✔low pressure stimulates the release
of aldosterone which causes the body to retain Na+ and water in the renal tubules to
increase BP
✔✔Classifications of BP - ✔✔Normal <120/<80
Pre-Hypertensive - 120-139/80-89
Stage 1 - 140-159/90-99
Stage 2 - 160 and up/100 and up
Stage 3 - >180/>110
✔✔HTN management for stage 1 and 2 - ✔✔diuretics
ACEI or ARB
BB or CCB
Alpha Antagonists
✔✔What diet is recommended to decrease HTN - ✔✔DASH diet
✔✔Med choice for young pts with HTN - ✔✔ACEI
a-blocker or BB
✔✔Med choices for HTN in African American pts - ✔✔Diuretic
CCB or a-blockers
ACEI (bb are less effective as monotherapy)
✔✔Med choices to tx HTN in elderly - ✔✔Diuretic
CCB
ACEI or a-blocker
BB -effective but cause more SE in elderly
