🧠Step 7 — Student Memory Support

Cardiovascular System (CVS) Module 3rd Year

🧠 STEP 10 — Student Memory Support

🃏 1️⃣ High-Yield Flashcards

What is the basic formula for arterial blood pressure?

BP = Cardiac Output × Total Peripheral Resistance

Which organ is most important for long-term blood pressure regulation?

Kidney, through sodium and water balance.

What does RAAS activation do in hypertension?

Causes vasoconstriction and aldosterone-mediated sodium and water retention.

What is the most common type of hypertension?

Primary / essential hypertension.

Name important causes of secondary hypertension.

Renal disease, renal artery stenosis, endocrine causes, drugs, obstructive sleep apnea, coarctation of aorta.

What is the hallmark arteriolar lesion of benign hypertension?

Hyaline arteriolosclerosis.

What is the hallmark lesion of malignant hypertension?

Hyperplastic arteriolosclerosis with fibrinoid necrosis.

What cardiac morphology is caused by chronic systemic hypertension?

Concentric left ventricular hypertrophy.

Which organs are commonly damaged by hypertension?

Heart, brain, kidney, retina, and large blood vessels.

What is the key mechanism of pre-eclampsia?

Abnormal placentation → placental ischemia → maternal endothelial dysfunction.

What clinical clue suggests pre-eclampsia?

Hypertension after 20 weeks with proteinuria or maternal organ dysfunction.

Which antihypertensive drug groups are contraindicated in pregnancy?

ACE inhibitors, ARBs, and direct renin inhibitors.

What is the mechanism of thiazide diuretics?

They inhibit NaCl reabsorption in the distal convoluted tubule.

Why do ACE inhibitors cause cough?

Due to bradykinin accumulation.

What is the common adverse effect of amlodipine?

Ankle edema.

What defines hypertensive emergency?

Severe BP elevation with acute target-organ damage.

🧠 2️⃣ Mnemonics

Mnemonic Title: BP Control

Mnemonic Word: HARK
Meaning:
H — Heart controls cardiac output
A — Arterioles control peripheral resistance
R — RAAS raises BP
K — Kidney controls long-term volume

Mnemonic Title: Target Organs in Hypertension

Mnemonic Word: HBKRV
Meaning:
H — Heart
B — Brain
K — Kidney
R — Retina
V — Vessels

Mnemonic Title: Main Antihypertensive Drug Groups

Mnemonic Word: DRSCD
Meaning:
D — Diuretics
R — RAAS blockers
S — Sympatholytics
C — Calcium channel blockers
D — Direct vasodilators

Mnemonic Title: Pre-eclampsia Danger Clues

Mnemonic Word: PHEVS
Meaning:
P — Proteinuria
H — Hypertension after 20 weeks
E — Edema / endothelial dysfunction
V — Visual symptoms
S — Seizures in eclampsia

📋 3️⃣ Memory Tables

Table 1: Hypertensive Urgency vs Hypertensive Emergency

Feature	Hypertensive Urgency	Hypertensive Emergency
Core issue	Severe BP elevation	Severe BP elevation
Organ damage	No acute target-organ damage	Acute target-organ damage present
Examples	Stable severe hypertension	Stroke, encephalopathy, AKI, pulmonary edema, aortic dissection, eclampsia
Treatment logic	Oral drug adjustment + follow-up	Controlled IV treatment + monitoring
Exam trap	Do not rapidly overcorrect	Emergency is defined by organ damage

Table 2: Antihypertensive Drug Memory Table

Drug Group	Main Mechanism	Key Use / Point	Major Trap
Diuretics	↓ Na⁺ and water	Volume control	Thiazides → hypokalemia, hyperuricemia
ACE inhibitors	↓ Ang II, ↑ bradykinin	HTN, CKD, HF	Cough, hyperkalemia, avoid pregnancy
ARBs	Block AT1 receptors	ACEi alternative	Less cough, still avoid pregnancy
β-blockers	↓ HR, contractility, renin	IHD, arrhythmias	Do not stop abruptly
α1-blockers	Vasodilation	HTN with BPH	First-dose hypotension
Central α2 agonists	↓ sympathetic outflow	Methyldopa in pregnancy	Sedation, positive Coombs
CCBs	↓ Ca²⁺ entry	Vascular relaxation	Amlodipine edema; verapamil AV block
Direct vasodilators	Relax vascular smooth muscle	Severe/resistant HTN	Hydralazine lupus; nitroprusside cyanide toxicity

⚡ 4️⃣ Rapid Revision Points

Must Remember

• BP depends on cardiac output × total peripheral resistance.
• Kidney sodium-water balance is the main long-term BP control system.
• RAAS increases BP by vasoconstriction and aldosterone release.
• Essential hypertension is the commonest type.
• Benign hypertension causes hyaline arteriolosclerosis.
• Malignant hypertension causes onion-skin arterioles and fibrinoid necrosis.
• Chronic hypertension causes concentric LV hypertrophy.
• Pre-eclampsia results from abnormal placentation and endothelial dysfunction.
• ACE inhibitors cause cough due to bradykinin.
• ACE inhibitors, ARBs, and renin inhibitors are contraindicated in pregnancy.
• Hypertensive emergency requires acute target-organ damage.
• Counselling is essential because hypertension is often silent.

🩺 5️⃣ Clinical Memory Hooks

Clinical Hook 1

Repeated high BP + no symptoms → silent hypertension → still causes target-organ damage.

Clinical Hook 2

Chronic hypertension + thick LV wall → pressure overload → concentric LV hypertrophy.

Clinical Hook 3

Severe BP + papilledema + renal injury → malignant hypertension / hypertensive emergency.

Clinical Hook 4

Pregnancy after 20 weeks + BP rise + proteinuria → pre-eclampsia.

Clinical Hook 5

ACE inhibitor + dry cough → bradykinin accumulation.

⭐ 6️⃣ Starred High-Yield Exam Points

• ⭐ BP = Cardiac Output × Total Peripheral Resistance.
• ⭐ Benign hypertension → hyaline arteriolosclerosis.
• ⭐ Malignant hypertension → hyperplastic arteriolosclerosis + fibrinoid necrosis.
• ⭐ Chronic pressure overload → concentric LV hypertrophy.
• ⭐ Pre-eclampsia = hypertension after 20 weeks + proteinuria/organ dysfunction.
• ⭐ ACE inhibitors cause cough due to bradykinin.
• ⭐ ACE inhibitors, ARBs, and renin inhibitors are contraindicated in pregnancy.
• ⭐ Hypertensive emergency = severe BP + acute target-organ damage.