Questions to prepare for classes and examination
• Principles of physiological control of systemic blood pressure.
• Typical forms of disorder of systemic blood pressure.
• Arterial hypotension: essential and symptomatic.
• Types and mechanisms of development of symptomatic arterial hypotension.
• Definition and principles of classification of arterial hypertension.
• Renal arterial hypertension: pathogenesis of renovascular, renoprival, renal parenchymal hypertension.
• Pathogenesis of endocrinogenic and neurogenic arterial hypertension.
• Essential hypertension: etiology and pathogenesis.
• Clinical variants, stages and principles of treatment of essential hypertension.
N 98
A 39-year-old patient visited his physician with complaints of regular headaches which he usually treated by aspirin. According to the patient's history the headaches first appeared four months ago, and before that the patient had no health problems, though occasionally he had elevations of blood pressure. On examination: the patient's skin and visible mucosal membranes are hyperemic; blood pressure is 185/125 mm Hg; the liver is enlarged: the shins and soles are swelled. The patient was addmitted to hospital. Blood test performed in the hospital showed erythrocytosis (r.b.c. count 7.2x1012/L), leukocytosis (w.b.c. count 11.2x109/L), thrombocytosis (platelets count 650x109/L).
Questions
• What forms of pathology developed in the patient? Substantiate your answer.
• Define the type of arterial hypertension which the patient suffers from, describe its pathogenesis.
• How can the observed changes in the blood contribute to pathogenesis of arterial hypertension in this patient? Explain the mechanism.