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Exam 2 > Chapter 33 > Flashcards

Chapter 33 Flashcards

1
Q

What is the initiating event that leads to the development of atherosclerosis?
a. Release of the inflammatory cytokines
b. Macrophages adhere to vessel walls.
c. Injury to the endothelial cells that line the artery walls
d. Release of the platelet-deprived growth factor

A

c. Injury to the endothelial cells that line the artery walls

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2
Q

What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis?
a. LDLs cause smooth muscle proliferation.
b. LDLs cause regression of atherosclerotic plaques.
c. LDLs increase levels of inflammatory cytokines.
d. LDLs direct macrophages to the site in the endothelium

A

a. LDLs cause smooth muscle proliferation.

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3
Q

Which inflammatory cytokines are released when endothelial cells are injured?
a. Granulocyte-macrophage colony-stimulating factor (GM-CFS)
b. Interferon-beta (IFN-β), interleukin 6 (IL-6) and granulocyte colony-stimulating factor (G-CFS)
c. Tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and interleukin 1 (IL-1)
d. Interferon-alpha (IFN-α), interleukin-12 (IL-12), and macrophage colony-stimulating factor (M-CSF)

A

c. Tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and interleukin 1 (IL-1)

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4
Q

When endothelial cells are injured, what alteration contributes to atherosclerosis?
a. The release of toxic oxygen radicals that oxidize low-density lipoproteins (LDLs).
b. Cells are unable to make the normal amount of vasodilating cytokines.
c. Cells produce an increased amount of antithrombotic cytokines.
d. Cells develop a hypersensitivity to homocysteine and lipids.

A

b. Cells are unable to make the normal amount of vasodilating cytokines.

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5
Q

Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
a. Increased norepinephrine
b. Adducin
c. Angiotensin II
d. Insulin resistance

A

c. Angiotensin II

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6
Q

What pathologic change occurs to the kidney’s glomeruli as a result of hypertension?
a. Compression of the renal tubules
b. Ischemia of the tubule
c. Increased pressure from within the tubule
d. Obstruction of the renal tubule

A

b. Ischemia of the tubule

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7
Q

What effect does atherosclerosis have on the development of an aneurysm?
a. Atherosclerosis causes ischemia of the intima.
b. It increases nitric oxide.
c. Atherosclerosis erodes the vessel wall.
d. It obstructs the vessel.

A

c. Atherosclerosis erodes the vessel wall.

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8
Q

Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
a. Inflammation and roughening of the endothelium of the artery are present.
b. Hypertrophy and vasoconstriction of the endothelium of the artery are present
c. Excessive clot formation and lipid accumulation in the endothelium of the artery are present.
d. Evidence of age-related changes that weaken the endothelium of the artery are present.

A

a. Inflammation and roughening of the endothelium of the artery are present.

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9
Q

What is the usual source of pulmonary emboli?
a. Deep venous thrombosis
b. Endocarditis
c. Valvular disease
d. Left heart failure

A

a. Deep venous thrombosis

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10
Q

Which factor can trigger an immune response in the bloodstream that may result in an embolus?
a. Amniotic fluid
b. Fat
c. Bacteria
d. Air

A

a. Amniotic fluid

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11
Q

Which statement best describes thromboangiitis obliterans (Buerger disease)?
a. Inflammatory disorder of small and medium-size arteries in the feet and sometimes in the hands
b. Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes
c. Autoimmune disorder of the large arteries and veins of the upper and lower extremities
d. Neoplastic disorder of the lining of the arteries and veins of the upper extremities

A

a. Inflammatory disorder of small and medium-size arteries in the feet and sometimes in the hands

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12
Q

1

A

1

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13
Q

What change in a vein supports the development of varicose veins?
a. Increase in osmotic pressure
b. Damage to the valves in veins
c. Damage to the venous endothelium
d. Increase in hydrostatic pressure

A

b. Damage to the valves in veins

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14
Q

Superior vena cava syndrome is a result of a progressive increase of which process?
a. Inflammation
b. Occlusion
c. Distention
d. Sclerosis

A

b. Occlusion

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15
Q

What term is used to identify when a cell is temporarily deprived of blood supply?
a. Infarction
b. Ischemia
c. Necrosis
d. Inflammation

A

b. Ischemia

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16
Q

The risk of developing coronary artery disease is increased up to threefold by which factor?
a. Diabetes mellitus
b. Hypertension
c. Obesity
d. High alcohol consumption

A

b. Hypertension

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17
Q

Which risk factor is associated with coronary artery disease (CAD) because of its relationship with the alteration of hepatic lipoprotein?
a. Diabetes mellitus
b. Hypertension
c. Obesity
d. High alcohol consumption

A

a. Diabetes mellitus

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18
Q

Nicotine increases atherosclerosis by the release of which neurotransmitter?
a. Histamine
b. Nitric oxide
c. Angiotensin II
d. Epinephrine

A

d. Epinephrine

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19
Q

Which substance is manufactured by the liver and primarily contains cholesterol and protein?
a. Very low:density lipoproteins (VLDLs)
b. Low-density lipoproteins (LDLs)
c. High-density lipoproteins (HDLs)
d. Triglycerides

A

b. Low-density lipoproteins (LDLs)

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20
Q

Which elevated value may be protective of the development of atherosclerosis?
a. Very low:density lipoproteins (VLDLs)
b. Low-density lipoproteins (LDLs)
c. High-density lipoproteins (HDLs)
d. Triglycerides

A

c. High-density lipoproteins (HDLs)

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21
Q

Which laboratory test is an indirect measure of atherosclerotic plaque?
a. Homocysteine
b. Low-density lipoprotein
c. Erythrocyte sedimentation rate (ESR)
d. C-reactive protein (CRP)

A

d. C-reactive protein (CRP)

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22
Q

Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
a. 10
b. 15
c. 20

A

c. 20

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23
Q

Which form of angina occurs most often during sleep as a result of vasospasms of one or more coronary arteries?
a. Unstable
b. Stable
c. Silent
d. Prinzmetal

A

d. Prinzmetal

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24
Q

When is the scar tissue that is formed after a myocardial infarction (MI+ most vulnerable to injury?
a. Between 5 and 9 days
b. Between 10 and 14 days
c. Between 15 and 20 days
d. Between 20 and 30 days

A

b. Between 10 and 14 days

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25
Q

An individual who is demonstrating elevated levels of troponin, creatine kinase-isoenzyme MB (CK-MB) and lactic dehydrogenase (LDH) is exhibiting indicators associated with which condition?
a. Myocardial ischemia
b. Hypertension
c. Myocardial infarction (MI)
d. Coronary artery disease (CAD)

A

c. Myocardial infarction (MI)

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26
Q

What is the expected electrocardiogram (ECG) pattern when a thrombus in a coronary artery permanently lodges in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?
a. Prolonged QT interval
b. ST elevation myocardial infarction (STEMI)
c. ST depression myocardial infarction (STDMI)
d. Non-ST elevation myocardial infarction (non-STEMI)

A

b. ST elevation myocardial infarction (STEMI)

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27
Q

How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)?
a. By increasing the peripheral vasoconstriction
b. By causing dysrhythmias as a result of hyperkalemia
c. By reducing the contractility of the myocardium
d. By stimulating the sympathetic nervous system

A

a. By increasing the peripheral vasoconstriction

28
Q

The pulsus paradoxus that occurs as a result of pericardial effusion is caused by a dysfunction in which mechanism?
a. Diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles
b. Blood ejected from the right atrium and reduction of blood volume in the right ventricle
c. Blood ejected from the left atrium and reduction of blood volume in the left ventricle
d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers.

A

d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers.

29
Q

A patient reports sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. These clinical manifestations describe:
a. Myocardial infarction (MI)
b. Pericardial effusion
c. Restrictive pericarditis
d. Acute pericarditis

A

d. Acute pericarditis

30
Q

Ventricular dilation and grossly impaired systolic function, leading to dilated heart failure, characterize which form of cardiomyopathy?
a. Congestive
b. Hypertrophic
c. Septal
d. Dystrophic

A

a. Congestive

31
Q

A disproportionate thickening of the interventricular septum is the hallmark of which form of cardiomyopathy?
a. Dystrophic
b. Hypertrophic
c. Restrictive
d. Dilated

A

b. Hypertrophic

32
Q

Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy?
a. Infiltrative
b. Restrictive
c. Septal
d. Hypertrophic

A

b. Restrictive

33
Q

Which condition is a cause of acquired aortic regurgitation?
a. Congenital malformation
b. Cardiac failure
c. Rheumatic fever
d. Coronary artery disease (CAD)

A

c. Rheumatic fever

34
Q

Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern, as well as being associated with connective tissue disease?
a. Mitral valve prolapse
b. Tricuspid stenosis
c. Tricuspid valve prolapse
d. Aortic insufficiency

A

a. Mitral valve prolapse

35
Q

Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center’ making them appear as a ringworm?
a. Fat emboli
b. Rheumatic fever
c. Bacterial endocarditis
d. Myocarditis of acquired immunodeficiency syndrome

A

b. Rheumatic fever

36
Q

What is the most common cause of infective endocarditis?
a. Virus
b. Fungus
c. Bacterium
d. Rickettsiae

A

c. Bacterium

37
Q

What is the most common cardiac disorder associated with acquired immunodeficiency syndrome (AIDS)?
a. Cardiomyopathy
b. Myocarditis
c. Left heart failure
d. Heart block

A

c. Left heart failure

38
Q

A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which form of heart failure may result from pulmonary disease and elevated pulmonary vascular resistance?
a. Right heart failure
b. Left heart failure
c. Low-output failure
d. High-output failure

A

a. Right heart failure

39
Q

What cardiac pathologic condition contributes to ventricular remodeling?
a. Left ventricular hypertrophy
b. Right ventricular failure
c. Myocardial ischemia
d. Contractile dysfunction

A

c. Myocardial ischemia

40
Q

In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?
a. Increases preload and decreases afterload.
b. Increases preload and increases afterload.
c. Decreases preload and increases afterload.
d. Decreases preload and decreases afterload.

A

b. Increases preload and increases afterload.

41
Q

What is the cause of the dyspnea resulting from a thoracic aneurysm?
a. Pressure on surrounding organs
b. Poor oxygenation
c. Formation of atherosclerotic lesions
d. Impaired blood flow

A

a. Pressure on surrounding organs

42
Q

Which statement is true concerning the cells’ ability to synthesize cholesterol?
a. Cell production of cholesterol is affected by the aging process.
b. Cells produce cholesterol only when dietary fat intake is low.
c. Most body cells are capable of producing cholesterol.
d. Most cholesterol produced by the cells is converted to the low-density form.

A

c. Most body cells are capable of producing cholesterol.

43
Q

What is the trigger for angina pectoris?
a. Atherosclerotic lesions
b. Hyperlipidemia
c. Myocardial necrosis
d. Myocardial ischemia

A

d. Myocardial ischemia

44
Q

Individuals being effectively managed for type 2 diabetes mellitus often experience a healthy decline in blood pressure as a result of what intervention?
a. Managed carbohydrate intake
b. Appropriate exercise
c. Insulin-sensitivity medication therapy
d. Introduction of minimal doses of insulin

A

c. Insulin-sensitivity medication therapy

45
Q

Which statements are true regarding fatty streaks?
(Select all that apply.)
a. Fatty streaks progressively damage vessel walls.
b. Fatty streaks are capable of producing toxic oxygen radials.
c. When present, inflammatory changes occur to the vessel walls.
d. Oxidized low-density lipoproteins (LDLs) are involved in their formation.
e. All of the above

A

e. All of the above

46
Q

What factors contribute to the development of orthostatic hypotension? (Select all that apply.)
a. Altered body chemistry
b. Drug action of certain antihypertensive agents
c. Prolonged immobility
d. Effects of aging on postural refle3es
e. All of the above

A

e. All of the above

47
Q

Which assessment findings are clinical manifestations of aortic stenosis? (Select all that apply.)
a. Jugular vein distention
b. Bounding pulses
c. Hypotension
d. Angina
e. Syncope

A

d. Angina
e. Syncope

48
Q

Which risk factors are associated with infective endocarditis? (Select all that apply.)
a. Rheumatic fever
b. Intravenous drug use
c. Long-term indwelling catheterization
d. Aortic regurgitation
e. Heart valve disease

A

b. Intravenous drug use
c. Long-term indwelling catheterization
e. Heart valve disease

49
Q

Aortic stenosis

A

Impairs flow from the left ventricle

50
Q

Aortic regurgitation

A

Backflow into left ventricle

51
Q

Mitral stenosis

A

Impairs flow from left atrium to left ventricle

52
Q

Tricuspid regurgitation

A

Backflow into right atrium

53
Q

Mitral regurgitation

A

Backflow into left atrium

54
Q

A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated
pulmonary vascular resistance. Which complication would the health care professional assess the
patient for?
a. Right heart failure
b. Left heart failure
c. Restrictive cardiomyopathy
d. Hypertrophic cardiomyopathy

A

a. Right heart failure

55
Q

A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information
should the healthcare professional elicit from this patient?
a. Family history of Marfan’s disease
b. History of a recent bacterial infection
c. History of any recent chest trauma
d. Any illnesses in family members

A

b. History of a recent bacterial infection

56
Q

A patient reports sudden onset of severe chest pain that radiates to the back and worsens with
breathing and when lying down. What action by the healthcare professional is most appropriate?
a. Prepare to assist with an immediate pericardiocentesis.
b. Inform the patient about the side effects of diuretics.
c. Facilitate the patient getting an immediate ECG.
d. Teach the patient about a course of antiinflammatory medications.

A

d. Teach the patient about a course of antiinflammatory medications.

57
Q

A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus
paradoxus. A student asks for an explanation of how this occurs. What description by the
professional is best?
a. Diastolic filling pressures of the right ventricle and reduction of blood volume in
both ventricles
b. Blood ejected from the right atrium and reduction of blood volume in the right
ventricle
c. Blood ejected from the left atrium and reduction of blood volume in the left
ventricle
d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all
four heart chambers

A

d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all
four heart chambers

58
Q

A patient in the Emergency department is suspected of having a myocardial infarction (MI). The
initial cardiac troponin 1 level was negative. What action by the healthcare professional is best?
a. Prepare the patient for thrombolytic therapy.
b. Dismiss the patient because the lab was negative.
c. Schedule repeat lab within a few hours.
d. Give the patient oxygen and pain medication.

A

c. Schedule repeat lab within a few hours.

59
Q

A patient who had a myocardial infarction is going to cardiac rehabilitation where progressive
exercise is monitored by health care professionals. When would this patient be most vulnerable
to injury and complications?
a. Between 5 and 9 days
b. Between 10 and 14 days
c. Between 15 and 20 days
d. Between 20 and 30 days

A

b. Between 10 and 14 days

60
Q

A patient reports chest pain that occurs most often during sleep. What treatment does the
healthcare professional discuss with the patient?
a. Treatment of obstructive sleep apnea
b. Short-acting nitroglycerin tablets
c. A low-dose aspirin regimen
d. Oral calcium channel blockers

A

d. Oral calcium channel blockers

61
Q

Cardiac cells can withstand ischemic conditions and still return to a viable state for how many
minutes?
a. 10
b. 15
c. 20
d. 25

A

c. 20

62
Q

A person wishes to reduce the risk of developing coronary artery disease. This person has a
normal lipid panel. What risk factor reduction would the healthcare professional advise for this
person?

a. Eating a low-fat diet
b. Controlling the blood pressure
c. Avoiding air pollution
d. Moderate alcohol use

A

b. Controlling the blood pressure

63
Q

A patient who has lung cancer calls the clinic reports facial and neck swelling severe enough so
that shirts no longer fit. What question by the healthcare professional there would be most
appropriate?
a. “Have you gained weight recently?”
b. “Are your feet and ankles swollen?”
c. “Does your voice sound hoarse?”
d. “When was your last chemotherapy?”

A

c. “Does your voice sound hoarse?”

64
Q

A patient has been diagnosed with Raynaud disease and asks for an explanation. What statement
by the healthcare professional is best?
a. Inflammatory disorder of small- and medium-size arteries in the feet and
sometimes in the hands
b. Neoplastic disorder of the lining of the arteries and veins of the upper extremities

c. Vasospastic disorder of the small arteries and arterioles of the fingers and, less
commonly, of the toes
d. Autoimmune disorder of the large arteries and veins of the upper and lower
extremities

A

c. Vasospastic disorder of the small arteries and arterioles of the fingers and, less
commonly, of the toes

65
Q

A healthcare professional is caring for four patients. Which patient does the professional assess
for pulmonary emboli (PE) as the priority?
a. Deep venous thrombosis
b. Endocarditis

c. Valvular disease
d. Left heart failure

A

a. Deep venous thrombosis

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