(精编)【高血压英文教学精品课件】 Hypertension and Hyperlipidemia.pptVIP

Hypertension, Hyperlipidemia: Are our children safe?;Hints and exam tips;Cardiovascular risk in your clinic patients;Who are my at risk patients – who should I be screening? (basically everyone!);New diagnosis of HTN;A 56-year-old man undergoes a routine physical examination. A funduscopic examination is performed.What does the funduscopic photograph show? ( A ) Arteriolar sclerosis and hypertensive retinopathy( B ) Diabetic proliferative retinopathy( C ) Papilledema( D ) Malignant hypertensive retinopathy; Correct Answer = A Characteristic changes are noted in the retinas of patients with longstanding hypertension. Narrowing of the terminal branches of retinal arterioles may be seen, as well as general narrowing of vessels with severe local constriction (as shown in this photograph). As the disease progresses, striate hemorrhages and soft exudates become visible. In a normal eye, retinal arterioles are transparent, so that blood flow is visible during ophthalmoscopy. A light streak from the ophthalmoscope will reflect from the convex wall of the healthy arteriole. In a sclerotic arteriole, thickening and fibrosis of the vessel wall develop as the sclerosis progresses. The central light reflex increases in width, and the walls of the vessel look like burnished copper, producing a copper-wire arteriole. With further progression and additional fibrosis, the entire width of the arteriole reflects the white stripe, producing silver-wire arteries. This patients funduscopic photograph shows both the copper and silver wires characteristic of arteriolar sclerosis and the characteristic changes of hypertensive retinopathy. ;A 62-year-old hypertensive woman is evaluated because of headaches and confusion. After her vital signs are recorded, a funduscopic examination is performed. Based on the funduscopic examination, which of the following conditions most likely present?( A ) Optic neuritis( B ) Arteriolar sclerosis( C ) Brain tumor( D ) Malignant hypertension