400 Exam 4 - Part 2

Question 1

What is the most common complication of valvular heart disease?

Answer 1

Heart Failure;

Question 2

• Which of the following disorders is also known as Barlow’s Syndrome?

Answer 2

Mitral Valve Prolapse

Question 3

• What is the most common cause of mitral regurgitation/heart failure in developing countries?

Answer 3

Rheumatic Fever;
inflammatory d/o that occurs after untreated strep throat

it affects the heart valves

Question 4

o Narrowing of the valve lumen

impeded blood flow through the valve

Answer 4

valvular stenosis

Question 5

o Stretching of the valve leaflet into the atrium during systole

Answer 5

valve prolapse

Question 6

• Occurs when the mitral valve leaflets prolapse backward in the left atrium during ventricular systole

most common valvular disorder in the US

Answer 6

mitral valve prolapse

Question 7

mitral valve prolapse AKA

Answer 7

barlow’s syndrome

Question 8

mitral valve prolapse is most common in ____ ____.

Answer 8

young women

Question 9

sx of mitral valve prolapse

Answer 9

o	Usually produces no symptoms
o	Dysrhythmias
o	Tachycardia 
o	Light-headedness
o	Syncope
o	Fatigue
o	Lethargy
o	Weakness
o	Dyspnea
o	Chest Tightness
o	Hyperventilation, Anxiety, Depression, Panic Attacks, Typical Chest Pain

Question 10

mitral valve prolapse is at risk for ____ ____.

Answer 10

embolic stroke

Question 11

what will be heard with mitral valve prolapse

Answer 11

“click and murmur”

Question 12

education with mitral valve prolapse

Answer 12

1st degree relatives need EKG

avoid alcohol/cafeine

good oral hygiene

no piercings/tattoos

Question 13

Occurs when the mitral valve fails to completely close during ventricular systole, allowing blood to flow backward into the left atrium

Answer 13

Mitral Regurgitation

Question 14

Mitral Regurgitation occurs more in ____.

Answer 14

men

Question 15

causes of mitral regurgitation

Answer 15

endocarditis
CAD
dilated cardiomyopathy
congenital malformation

Question 16

sx of mitral regurgitation

Answer 16

primary sx of HF: dyspnea, fatigue, weakness

Question 17

primary symptoms of mitral regurgitation

Answer 17

progressive dyspnea on exertion

pulmonar edema

do not have fatigue

CO remains sufficient

Question 18

diagnosis of mitral regurgitation by

Answer 18

blowing, high-pitched systolic murmur

Question 19

Impedes blood flow from the left atrium to the left ventricle during ventricular diastole (ventricular filling)

Answer 19

mitral stenosis

Question 20

40% of individuals with rheumatic heart disease develop ______ _____.

Answer 20

mitral stenosis

Question 21

mitral stenosis patients are at an increased for _____ _____

Answer 21

cardiac dysrhythmias

Question 22

50% of patients with mitral stenosis develop ____ _____.

Answer 22

A. Fib

Question 23

sx of mitral stenosis:

Answer 23

Fatigue

    Weakness

Dyspnea on exertion

Dry cough or wheezing

Orthopnea

Nocturnal dyspnea

Hemoptysis

Repeated respiratory infections

Ascites

Chest pain

Palpitations

Diastolic murmur

Question 24

tx of mild mitral stenosis:

Answer 24

diuretics and digitalis

Question 25

tx of moderate to severe mitral stenosis:

Answer 25

warfarin

Question 26

tx of severe mitral stenosis:

Answer 26

mitral valve replacement surgery

Question 27

patient education for mitral stenosis

Answer 27

Sodium-restricted diet to help prevent fluid retention and progressive heart failure Adjust activity to pt tolerance Avoid sudden increased in cardiac output Bleeding precautions if on anticoagulants

Question 28

Occurs when an incompetent aortic valve allows backflow of blood from the aorta into the left ventricle during diastole

Answer 28

Aortic Regurgitation

Question 29

causes of Aortic Regurgitation

Answer 29

inflammatory diseases congenital abnormalities rheumatic heart disease

Question 30

Associated with ascending dissecting aortic aneurysm

Answer 30

Acute aortic regurgitation:

Question 31

most common risk factor for Acute aortic regurgitation:

Answer 31

systemic HTN

Question 32

sx of Acute Aortic Regurgitation

Answer 32

mild dyspnea on exertion gradually symptoms of heart failure and pulmonary edema feeling of a "forceful" heartbeat

Question 33

hallmark finding of acute aortic regurgitation:

Answer 33

a diastolic murmur that is loudest over the aortic area widened pulse pressure

Question 34

asymptomatic Acute aortic regurgitation:

Answer 34

yearly EKG and CXR

Question 35

symptomatic Acute aortic regurgitation:

Answer 35

NEED valve surgery

Question 36

heart failure treatment:

Answer 36

digitalis and diuretic therapy

Question 37

what is C/I in Acute Aortic Regurgitation:

Answer 37

CCB (dilatizem and verapamil) b/c they decrease ventricular contractility and cause bradycardia

Question 38

Occurs when the aortic valve leaflets become stiff, fused, or calcified and impede blood flow from the left ventricle into the aorta during ventricular systole; usually occurs over several years to several decades

Answer 38

Aortic Stenosis

Question 39

causes of Aortic Stenosis:

Answer 39

Congenital malformations of the aortic valve Inflammatory heart disease (Endocarditis) Degenerative disease (Calcification)

Question 40

If patient is <30 years old the cause is usually _____ with aortic stenosis.

Answer 40

congenital

Question 41

early sx of aortic stenosis:

Answer 41

fatigue | dyspnea

Question 42

late sx of aortic stenosis:

Answer 42

``` heart failure angina syncope pulmonary congestion syncope myocardial ischemia ```

Question 43

hallmark sx of aortic stenosis:

Answer 43

murmur grade 3/6 or 4/6 over carotid artery

Question 44

tx of aortic stenosis

Answer 44

percutaneous balloon valvuoplasty

Question 45

balloon used to open a valve to alleviate aortic stenosis

Answer 45

Percutaneous balloon valvuoplasty:

Question 46

main therapy for aortic stenosis

Answer 46

valve replacement therapy

Question 47

patients with aortic stenosis are at risk for sudden _____ ____.

Answer 47

cardiac death

Question 48

HTN is defined as a BP of:

Answer 48

above 140/90 mmHg

Question 49

normal BP

Answer 49

120/80 mmHg

Question 50

• HTN IS A MAJOR MODIFIABLE RISK FACTOR FOR

Answer 50

CEREBROVASCULAR DISEASE, CARDIAC DISEASE, RENAL, AND OCULAR DISORDERS

Question 51

HTN is the "____ ____" because it is often symptom free

Answer 51

silent killer

Question 52

HTN is twice as prevalent with ?

Answer 52

African Americans

Question 53

risk factors for HTN

Answer 53

``` smoking dyslipidemia diabetes impaired renal function obesity physical inactivity age hx of cardiovascular disease ```

Question 54

Target Organ Damage or Clinical Cardiovascular Disease with HTN

Answer 54

heart disease stroke chronic kidney disease peripheral arterial disease

Question 55

modifiable risk factors with HTN

Answer 55

``` obesity smoking sedentary lifestyle excessive sodium intake alcohol chronic emotional stress atherosclerosis ```

Question 56

non-modifiable risk factors for HTN

Answer 56

o Post-menopausal women o Age greater than 60 o Hx of diabetes and high cholesterol o Positive family hx

Question 57

complications of HTN

Answer 57

``` MI HF Renal Failure Stroke Impaired vision ```

Question 58

sx of HTN

Answer 58

HA retinal changes cotton wool-spots arterial narrowing