Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Pathophysiology > Cardiac > Flashcards

Cardiac Flashcards

1
Q

macrophages adhere to vessel walls
then release enzymes and toxic oxygen radicals
that create oxidative stress=oxidized LDL (foam cells)
oxidized LDL further damages vessel walls

A

pathophysiology of artherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how much volume is in the ventricle after dialysis

A

increase in preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

systolic heart failure is associated with…

A

activation of the renin angiotensin aldosterone system (RAAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

best place to hear mitral valve prolapse murmur?

A

apex- 5th intercostal space at the midclavicular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where does mitral valve prolapse sound radiate to?

A

the axilla/back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical manifestations on clinical exam of mitral valve prolapse

A

mid to late systolic murmur

mid systolic click

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

biggest risk factor for HTN

A

African American race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
obesity
DM Type I & II
older age
Family Hx
ETOH abuse
smoking
increased Na+
Decreased K+, Mg+, Ca+
artherosclerosis
A

Risk Factors for HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complication of Uncontrolled HTN

A

end organ damage (brain, heart, kidneys, eyes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Main lab to test for end organ damage from HTN in kidneys

A

urine -micro albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Unstable (maintained) angina = _______

A

clot is not dissolving- MI w/ necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are you looking for in EKG with suspected MI?

A 
ST elevation (prolonged)
Q wave changes (deep, wide)
inverted T wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pain of MI caused by?

A

ischemia- lack of oxygen- tissue death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lab result associated w/ MI

A

increased troponin

increased CK-MB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is BP low during an MI?

A

decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is HR high during an MI?

A

sympathetic nervous system stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What side of the heart is more likely effected in MI?

A

left (due to greater workload- pushing blood out into periphery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q 
crackles/rales breath sounds
lactic acidosis
dysrythmia
hypoxia
autonomic nervous system imbalance
electrolyte imbalane
A

Clinical Manifestations of MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

elevation of CK-MBs for MI are seen in ____ hours

A

2-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

elevation of CK-MBs for MI peak in ____ hours

A

24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CK-MBs are normal after MI in _____ hours

A

48-72

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

leading cause of coronary artery disease and cerebrovascular disease is…

A

artherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q 
release of catecholamines
vasoconstriction
increase in HR
increase in LDL + decrease in HDL
(p 1073)
A

How smoking contributes to coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Blood Flow through Body/Heart

A

Venous Deoxygenated blood to heart via IVC & SVC  Right atria  through tricuspid valve  R ventricle  pulmonic valve  pulmonary arteries  Lungs (oxygenation of blood occurs)  pulmonary veins  L atria  mitral valve  L ventricle  aortic valve  aorta  Body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

RAAS and decreased glomerular filtration rate lead to…

A

fluid retention which increased preload and increased afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

pressure created in the L ventricle at the end of diastole; volume of blood & stretch in the ventricle after atrial contraction and ventricular filling
*the heart essentially loading up for the next big squeeze during systole.

A

preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

resistance to ejection during systole; the tension or pressure that must be generated by a chamber of the heart in order to contract and eject blood against resistance
*either vascular resistance or a stenosed aortic valve

A

afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how quickly the ventricle can develop a forceful contraction or contractility

A

intropy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

thickening of the heart muscle secondary to remodeling related to chronic increase in workload.

A

hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

______ is increased with:
decreased contractility
excess of plasma volume (too much IV fluid, renal failure, mitral valve disease, loss of contractility d/t MI injury)

A

preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

________ may improve cardiac output for a while but the increased stretching of the heart muscle eventually will lead to decreased contractility.

A

increase in preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

_______ is most commonly caused by peripheral vascular resistance (HTN or stenosis of the aortic valve)

A

increased afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

_______ results in left ventricle not emptying properly bc of resistance pressure and it works harder to pump the blood forward

A

increased afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Increased afterload leads to left ventricle hypertrophy under the influence of ….

A

angiotensin-2

catecholamines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Left sided heart failure may result from ______ heart failure or _______ heart failure

A

systolic or diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

the inability of the heart to generate adequate cardiac output to perfuse tissues (reduced myocardial contractility resulting in a low ejection fraction and reduced intropy during systole).

A

systolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

a reduced ventricular compliance during diastole resulting in a ventricle that does not fill effectively (the ejection fraction in this case remains normal)

A

diastolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

commonly caused by diffuse hypoxic pulmonary disease or it can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary circulation

A

right sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

inability of the heart to meet body requirements for bloodborne nutrients despite adequate blood volume and normal or elevated myocardial contractility
*could be caused by severe anemia

A

high-output failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

renal failure adds to _____

A

preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q 
\_\_\_\_\_\_\_ causes decreased contractility that will lead to:
decreased ejection fraction (EF) 
decreased renal perfusion
increased preload
increase in renin & angiotensin
A

viscous cycle of systolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q 
most often, \_\_\_\_\_\_ is associated with:
An MI in the left ventricle OR
systemic HTN OR
aortic valve stenosis OR
aortic regurgitation
A

left sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q 
\_\_\_\_\_\_\_ Effects of \_\_\_\_\_\_ Heart Failure
Dyspnea
Orthopnea
paroxysmal nocturnal dyspnea
cough with sputum production that is pink tinged and frothy
Crackles or rales
Hypoxemia & cyanosis are late signs
A

Backward Effects of L sided Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q 
\_\_\_\_\_\_\_ Heart Failure is caused by:
pulmonary disease
pulmonary HTN
COPD
untreated sleep apnea
A

Right Sided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

most common cause of right sided heart failure

A

pulmonary edema of L sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

______ will cause a high afterload on the right ventricle which is trying to push blood into the lung that is affected by the pulmonary HTN
* which will cause right ventricular hypertrophy.

A

Right sided Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q 
\_\_\_\_\_\_ Effects of \_\_\_\_\_\_ Heart Failure:
hepatomegaly
ascites
splenomegaly
anorexia
subcutaneous edema
JVD
A

Backward Effects of Right Sided Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q 
\_\_\_\_\_\_\_ Effects of \_\_\_\_\_ Heart Failure:
fatigue
oliguria
tachycardia
faint pulses
restlessness
confusion
anxiety
A

Forward Effects of BOTH Left and Right Sided Heart Failure

49
Q 
Common causes of \_\_\_\_\_\_\_:
Anemia- Decreased oxygen carrying capacity of blood
Septicemia- vasodilation and a fever
Hyperthyroidism
Beriberi (thiamine deficiency)
A

High Output Heart Failure

50
Q

diffuse inflammatory disease caused by delayed immune response to infection by group A, beta hemolytic streptococcus

A

rheumatic heart disease

51
Q

an example of antibody-antigen reaction, a type 3 hypersensitivity and it takes a while to occur

A

rheumatic heart disease

52
Q

causes rigidity and deformity of the valve cusps or shortening and fusion of the chordae tendinae; valvular stenosis or regurgitation will result.

A

rheumatic heart disease

53
Q

causes rigidity and deformity of the valve cusps or shortening and fusion of the chordae tendinae; valvular stenosis or regurgitation will result.

A

rheumatic heart disease

54
Q

in rheumatic heart disease, mitral and aortic valves are affected in _____ % of cases

A

20

55
Q

a distinctive truncal rash
never seen on the face
o appears as pink or red macules (flat spots) or papules (small lumps)
o spreads outward in a circular shape
o As the lesions advance, the edges become raised and red and the center clears
o lesions are not itchy or painful and sometimes go unnoticed by the patient.

A

Erythema maginatam in rheumatic heart disease

56
Q

failure of the valve to open completely resulting in extra pressure work (afterload) for the heart

A

stenosis

57
Q

inability of the valve to close completely resulting in extra volume work (preload) for the heart

A

regurgitation

58
Q

most common cause of the valvular disorders in rheumatic fever

A

mitral stenosis

59
Q

_____are more often affected with mitral stenosis

A

women

60
Q

Sounds/Location of _________:
low, pitched rumbling decrescendo diastolic murmur
best heard over the apex with radiation to the left axilla.
may hear an opening snap when the stenosed valve is forced open

A

mitral stenosis

61
Q

_______ can lead to chronic pulmonary HTN, right ventricular hypertrophy, and right sided heart failure.

A

mitral valve stenosis

62
Q

When the _____ valve is stenosed, the atria cannot force this blood through, so volume increases in the left atria and the back flow is to the lungs

A

mitral

63
Q

Common causes of _______:
o mitral valve prolapse
o rheumatic heart disease

A

mitral regurgitation

64
Q

Pathophysiology of _______:
o Back flow of the blood from the L ventricle to the L atrium during ventricular systole
o left atrium and L ventricle dilate
o Hypertrophy due to the extra volume occurs
o can lead to left side heart failure & eventually biventricular failure

A

Mitral Regurgitation

65
Q

Sound/Location of ________:
o high-pitched, loud, pansystolic, blowing murmur
o heard best at the apex with radiation to the back and axilla

A

Mitral Regurgitation

66
Q

displacement, ballooning, or billowing of the mitral valve leaflets into the left atrium during a ventricular systole

A

Mitral Valve Prolapse

67
Q

Most common valve disorder in the U.S.

A

Mitral Valve Prolapse

68
Q

______ are more often affected with Mitral Valve Prolapse

A

Women

69
Q

_______ may be due to genetic or environmental effects on the heart valve during the 5th or 6th week of gestation when the individual is still an embryo

A

Mitral Valve Prolapse

70
Q

Sound/Location of _______:

midsytolic click or midsystolic murmur that may progress to a regurgitant murmur over time or it may stay the same

A

Mitral Valve Prolapse

71
Q

Clinical Manifestation of _______:
o Typically asymptomatic
o If these patients are symptomatic, they will complain of palpitations
o May have rhythm abnormalities, dizziness, fatigue, dyspnea, chest pain, depression, or anxiety (prone to panic attacks)

A

Mitral Valve Prolapse

72
Q

very common valvular disorder affecting about 2% of adults who are older than 65.

A

aortic stenosis

73
Q

Pathophysiology of _______:
o Predominant cause is age related calcium deposits on the aortic cusp.
o Other causes congenital bicuspid valve and inflammation secondary to rheumatic heart disease.
o Results in obstruction of aortic outflow from the left ventricle in the aorta during systole.
o Left ventricular hypertrophy will develop d/t high afterload  left sided heart failure

A

aortic stenosis

74
Q

Sound/Location of ______:
o crescendo-decresendo systolic murmur during ventricular systole with prominent S4
o heard best at the second intercostal space on the right at the sternal border and it radiates to the neck.

A

aortic stenosis

75
Q

Clinical Manifestations of_____:

o syncope, fatigue, and angina

A

aortic stenosis

76
Q

incompetent aortic valve that allows blood to leak back from the aorta into the left ventricle during diastole caused by abnormal aortic valve or aortic root dilation that may be congenital or acquired due to rheumatic heart disease, atherosclerosis, or the over use of diet pills

A

aortic regurgitation

77
Q

______ leads to fluid overload in the left ventricle during diastole, hypertrophy, and dilation with eventual left sided heart failure

A

aortic regurgitation

78
Q

Sound/Location of______:
o high-pitched decrescendo blowing diastolic murmur during the ventricular diastole
o heard best at the sternal border of the right 2nd, 3rd, or 4th intercostal space and it may radiate to the neck

A

aortic regurgitation

79
Q 
Clinical Manifestations of \_\_\_\_\_\_:
high systolic blood pressure
low diastolic blood pressure
(wide pulse pressure)
palpitations
A

aortic regurgitation

80
Q

where to listen for mitral stenosis

A

diastolic murmur over the apex with radiation to the axilla

81
Q

where to listen for mitral regurgitation

A

pansystolic, blowing murmer over the apex with radiation to the axilla

82
Q

where to listen to mitral valve prolapse

A

apex

83
Q

where to listen for aortic stenosis

A

Second ICS on the right at the sternal border and radiates to the neck

84
Q

where to listen for aortic regurgitation

A

Best: diastolic murmur at 2nd ICS

Sternal border 2nd, 3rd or 4th ICS and may radiate to the neck

85
Q

where to listen for aortic regurgitation

A

Sternal border 2nd, 3rd or 4th ICS and may radiate to the neck

86
Q

autosomal dominant that can be passed within in a family

A

Familial hypercholesterolemia

87
Q

Autosomal recessive disorder that is identified in blacks on chromosome 22 and associated with HTN and kidney disease

A

Apolipoprotein L1 gene variants

88
Q

Autosomal recessive disorder that results in familial HDL deficiency

A

Familial apolipoprotein A1-deficiency

89
Q

genetic disorder due to channelopathies (abnormalities or variants in gene coding for ion channels)

A

arrythmias

90
Q

autosomal recessive disorder resulting in high LDL and triglycerides

A

Familial hyperlipidemia

91
Q

measures artherosclerotic plaque related to inflammation

A

c reactive protein

92
Q

condition of pale lower extremities when elevated and dark red extremities when dangled present in peripheral artery disease

A

rubarbed

93
Q

PAD is relieved with…

A

rest

94
Q

pain on ambulation seen with PAD

A

intermittent claudication

95
Q

any debris picked up on the venous side of the circulatory system will first go into….

A

right side of the heart

96
Q

the 6 P’s of acute arterial occlusion

A 
o	Pallor
o	Pain
o	Paresthesia
o	Paralysis (due to lack of oxygen)
o	Polar (cold skin)
o	Pulselessness
97
Q

late sign of arterial occlusion would be a _______

A

painful arterial ulcer

98
Q

embolus leaving the ______ ventricle will cause an ischemic stroke.

A

left

99
Q

embolus leaving the _____ ventricle will cause an pulmonary embolism

A

right

100
Q

caused by altered connective tissue proteins, increased proteolytic enzyme activity, and decreased transforming growth factor B in the vein walls.

A

varicose veins

101
Q

caused by obesity, pregnancy, right heart failure, and prolonged standing that produces varicose veins, chronic venous insufficiency, and possibly obstruction of the deep veins with a thrombus (DVT)

A

Venous Disorder

102
Q

obstruction of _______ causes edema, venous stasis ulcers, and pain.

A

deep veins

103
Q

arise when there is inadequate venous return that leads to venous HTN, circulatory stasis, tissue hypoxia, and inflammatory reaction in the vessels that leads to fibrous sclerotic remodeling of the skin and ulceration

A

venous stasis ulcers

104
Q

triad of factors that contribute to deep vein thrombosis including venous stasis, venous endothelial damage and inflammation, and hypercoagulable states such as pregnancy

A

Virschow’s Triad

105
Q

lab test for DVT

A

D-dimer

106
Q

caused by systemic disease or specific identifiable pathology/condition that raises the peripheral vascular resistance, cardiac output, or both and is most common in infant and preschool children.

A

Secondary HTN

107
Q

secondary HTN in children is commonly caused by:

A

coarctation of the aorta

renal disease

108
Q

Systolic BP above 160 with a variable diastolic BP > or equal to 95/100/110 that is seen more often in people older than 65. The wide (increased) pulse pressure (the difference between systolic and diastolic) is due to reduced vascular compliance of the large arteries; specifically, aortic stiffening.

A

Isolated Systolic HTN

109
Q

Inhereited defects of ______:
o Renal sodium excretion
o Insulin & insulin sensitivity
o Activity of the sympathetic nervous system
o renin-angiotensin-aldosterone system (RAAS)
o cell membrane sodium and calcium transport

A

HTN

110
Q

increases in troponin I and T are seen in ____ hour after MI

A

2-4

111
Q

increases in troponin I and T will be elevated for ______ days after MI

A

7-10

112
Q

source of the Q wave seen on EKG in MI, release of CK-MB and troponin before cells die and become silent

A

total ischemia

113
Q

epi-centers for cardiac arrythmias due to an abnormal ion flux

A

partially ischemic cells

114
Q

_______ will cause an increase in myocardial workload because of the increased heart rate and blood pressure and contractility of the heart

A

sympathetic nervous system

115
Q

diastolic murmur heard best at 2nd ICS

A

aortic regurgitation

116
Q

Systolic Murmurs

A

MR Peyton Manning AS MVP

mitral regurg, physiological, aortic stenosis, mitral valve prolapse

117
Q

Diastolic Murmurs

A

ARMS

aortic regurg, mitral stenosis

118
Q

most common cause of increased afterload

A

HTN

119
Q

when endothelial cells are injured, what contributes to artherosclerosis?

A

cells unable to make normal amount of vasodilating cytokines

Advanced Pathophysiology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions