CHS Pathophysiology of Hypertension 3

Question 1

Vascular remodeling in chronic hypertension involves which structural change in resistance arteries?

Accepted Answer

Inward eutrophic remodeling with increased media-to-lumen ratio and reduced lumen diameter

Answer

Inward eutrophic remodeling, characterized by rearrangement of existing material around a smaller lumen without increased cell mass, increases the media-to-lumen ratio and vascular resistance in essential hypertension.

Question 2

Reactive oxygen species (ROS) contribute to hypertension by which of the following mechanisms?

Accepted Answer

Scavenging nitric oxide to form peroxynitrite, reducing vasodilatory capacity

Answer

Superoxide anion rapidly reacts with nitric oxide to form peroxynitrite, reducing NO bioavailability and impairing endothelium-dependent vasodilation, a key mechanism of oxidative stress in hypertension.

Question 3

Which enzyme is a major source of superoxide production in vascular tissue in hypertensive patients?

Accepted Answer

Xanthine oxidase and NADPH oxidase

Answer

NADPH oxidase (particularly Nox1, Nox2, Nox4) and xanthine oxidase are the principal sources of vascular superoxide in hypertension, driving oxidative stress and endothelial dysfunction.

Question 4

Chronic low-grade inflammation in hypertension is evidenced by elevated levels of which biomarker that also independently predicts cardiovascular risk?

Accepted Answer

High-sensitivity C-reactive protein (hsCRP)

Answer

Elevated hsCRP reflects vascular inflammation and is associated with endothelial dysfunction, oxidative stress, and increased cardiovascular risk in hypertensive patients.

Question 5

The concept of 'autoregulation' in the kidney explains which phenomenon relevant to hypertension?

Accepted Answer

The kidney's ability to maintain constant glomerular filtration rate despite changes in perfusion pressure

Answer

Renal autoregulation maintains relatively constant GFR and renal blood flow over a wide range of perfusion pressures through myogenic and tubuloglomerular feedback mechanisms, protecting glomeruli from barotrauma.

(CHS) Certified Hypertension Specialist Practice Test

(CHS) Certified Hypertension Specialist Practice Test

CHS Pathophysiology of Hypertension 3