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Pathophysiology > Chapters 26 & 27 Quiz > Flashcards

Chapters 26 & 27 Quiz Flashcards

1
Q

Which one of the following lipoproteins is the major carrier of cholesterol?

A

LDLs

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2
Q

The receptors that bind and remove LDLs to carry cholesterol from the circulation are mainly located in the:

A

liver

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2
Q

The receptors that bind and remove LDLs to carry cholesterol from the circulation are mainly located in the:

A

liver

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3
Q

Which one of the following total serum cholesterol levels is considered desirable? A total serum cholesterol:

A

less than 200 mg/dL

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4
Q

Causes of secondary hyperlipoproteinemia include:

A

diabetes mellitus and obesity

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5
Q

Lifestyle factors that increase the risk of atherosclerosis by producing a decrease in HDLs include:

A

smoking cigarettes

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6
Q

Atherosclerosis is characterized by

A

formation of fibrofatty plaques in the intimal lining of arteries

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7
Q

Atherosclerosis exerts its effects through:

A

narrowing of the vessel lumen and production of ischemia, disruption of the endothelial lining of the vessel that leads to blood clot formation, weakening of the vessel wall with aneurysm formation

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8
Q

An embolus can involve all EXCEPT:
a blood clot in the arterial system
an obstruction of blood flow caused by a stable atherosclerotic plaque
a foreign mass that is transported in the bloodstream
a moving blood clot

A

an obstruction of blood flow caused by a stable atherosclerotic plaque

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9
Q

Redness that follows temporary occlusion of superficial blood vessels is caused by:

A

hyperemia associated with compensatory increase in capillary flow

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10
Q

Loss of subcutaneous fat, reduced muscle size, and thin, shiny skin with hair loss on both legs indicate:

A

chronic tissue ischemia

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11
Q

A dissecting aneurysm can be described as:

A

separation and bleeding between the layers of an arterial wall

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12
Q

Compression of the lumbar nerve roots causing low back and leg pain may be caused by which vascular disease?

A

Abdominal aortic aneurysm

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13
Q

Two factors that predispose people to the development of varicose veins are:

A

obesity and standing for long periods of time

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14
Q

Conditions that contribute to the development of venous thrombosis include:

A

immobility

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15
Q

If you found the following signs: reddish-brown discoloration above the medial malleolus, edema from the calf to the foot, plus Homans sign, and increased heat over the skin on the lower leg, what would you suspect has happened?

A

Chronic venous insufficiency with thrombophlebitis

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16
Q

The risk of developing a venous thrombosis is high in the presence of three groups of factors. Which group of factors DOES NOT increase risk?

A

hypertensive conditons

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17
Q

The sympathetic nervous system regulates blood pressure through its effect on:

A

heart rate, strength of myocardial contraction, and peripheral vascular resistance

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18
Q

Long-term regulation of blood pressure depends on function of the:

A

kidneys in terms of regulating body levels of salt and water

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19
Q

According to the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension (JNC VIII), which of the following systolic (SBP) and diastolic blood pressure (DBP) values is indicative of a diagnosis of hypertension (stage 1):

A

SBP > 130 and DBP > 80 mm Hg

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19
Q

According to the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension (JNC VIII), which of the following systolic (SBP) and diastolic blood pressure (DBP) values is indicative of a diagnosis of hypertension (stage 1):

A

SBP > 130 and DBP > 80 mm Hg

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20
Q

The diagnosis and follow-up treatment of hypertension requires accurate measurement of blood pressure. This requires:
carefully calibrated manometers
correct cuff size
inflation of the cuff to correct level and deflation at the appropriate rate
persons who are correctly trained in blood pressure measurement methods
all of the above

A

all of the above

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21
Q

Undercuffing (using a cuff that is too small) can result in:

A

blood pressures that are too high

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22
Q

Essential hypertension represents an elevation in blood pressure that occurs:

A

without an identified cause

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23
Q

Factors that predispose people to the development of essential hypertension include:

A

obesity and high sodium intake

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24
Q

Evidence of target organ damage in long-term hypertension includes:

A

chronic kidney disease

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25
Q

What group of medications for hypertension act by decreasing angiotensin II and its multiple effects on blood pressure?

A

ACE inhibitors

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26
Q

The most common cause of secondary hypertension is:

A

renal vascular diease

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27
Q

Pregnancy-induced hypertension is thought to be related to:

A

toxic mediators released as a result of impaired perfusion of the placenta that alter the function of the endothelial cells of blood vessels

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28
Q

Isolated systolic hypertension in the elderly can best be explained in terms of:

A

increased rigidity of the aorta that occurs with aging

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29
Q

Postural hypotension represents:

A

an abnormal drop in blood pressure on assumption of the upright position

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30
Q

Cardiac tamponade refers to:

A

compression of the heart caused by excess fluid in the pericardial sac

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31
Q

The reason that coronary blood flow is less during systole than during diastole is because:

A

the contracting myocardial fibers compress the intramyocardial blood vessels during systole

32
Q

Rest is beneficial in relieving the pain associated with angina because during rest:

A

the coronary circulation is adequate to meet the metabolic needs of the heart

33
Q

Which one of the following types of medication is frequently prescribed to reduce the risk of coronary thrombosis (in the absence of angina)?

A

Antiplatelet drugs such as aspirin

34
Q

The manifestations of unstable angina include:

A

symptoms at rest lasting longer than 20 minutes
marked limitations of ordinary activity (walking 1-2 blocks, climbing a flight of stairs)
recent acceleration in anginal signs

35
Q

The signs and symptoms of myocardial infarction include:

A

severe crushing chest pain and sensation of nausea and indigestion

36
Q

The most common complication of early myocardial infarction is:

A

dysrhythmias

37
Q

The predisposing factors associated with development of subacute infective endocarditis are:

A

a portal of entry for the microorganism and a damaged endocardium

38
Q

Causes of infective endocarditis include:
rheumatic fever
intravenous drug abuse
intravenous catheters that are used in hospitals
prosthetic heart valves
all of the above

A

all of the above

39
Q

The ejection fraction (normally about 65%) is often used as a measure of heart function. It is determined by:

A

dividing the amount of blood ejected from the heart during systole by the end-diastolic volume and multiplying by 100 to obtain a percentage

40
Q

Sympathetic stimulation of the heart will:

A

increase heart rate and increase the strength of cardiac contraction

41
Q

According to the Frank-Starling mechanism:

A

increasing venous return produces an increase in stroke volume output because of diastolic stretching of myocardial fibers

42
Q

Compensatory mechanisms that come into play in heart failure include:

A

myocardial hypertrophy, increased sympathetic stimulation, the RAA

43
Q

Heart failure can best be described as:

A

inability of the heart to pump sufficient blood to meet the needs of the body

44
Q

Manifestations of weight gain caused by peripheral edema, ascites, right upper quadrant abdominal pain, and anorexia suggest the presence of:

A

right-sided heart failure

45
Q

Signs and symptoms of left-sided heart failure include:

A

cyanosis, cough with frothy sputum, fine pulmonary crackles(rales)

46
Q

In heart failure, dyspnea often develops when the person has been lying down for several hours. This is because assumption of the supine position causes:

A

mobilization and redistribution of edema fluid from the dependent areas of the body to the lungs

47
Q

Acute pulmonary edema is characterized by:

A

dyspnea, air hunger, and cyanosis, cough that is productive of frothy sometimes blood-tinged sputum

48
Q

Cardiogenic shock represents the inability of the heart to pump blood consistent with the perfusion needs of body tissues. The most common cause of cardiogenic shock is:

A

MI

49
Q

Anaphylactic shock is associated with:

A

presence of vasodilator substances in the blood

50
Q

Obstructive shock results from mechanical obstruction to flow of blood through the central circulation. The most common cause of obstructive shock is:

A

pulmonary embolism

51
Q

Causes of hypovolemic shock include:

A

vomiting and loss of body fluids

52
Q

The pale, cool, and â clammyâ skin that is often observed in an individual with shock can best be explained in terms of:

A

the body’s attempt to shunt blood to vital organs by constricting skin vessels

53
Q

In shock, one of the best indicators of blood flow to vital organs is:

A

urine output

54
Q

Sepsis and septic shock are forms of:

A

distributive shock

55
Q

According to the American Heart Association, major risk factors for atherosclerosis that can be changed include:

A

hypertension, cigarette smoking, blood cholesterol levels

56
Q

The effects of hypertension on the heart are largely manifested in terms of:

A

left ventricular hypertrophy

57
Q

The functional cause of stable angina is:

A

disparity between oxygen supplied by the coronary vessels and the metabolic demand of the heart

58
Q

The acute coronary syndromes include

A

unstable angina
non-ST segment elevation (non-STEMI) myocardial infarction
ST-segment elevation (STEMI) myocardial infarction

59
Q

The acute coronary syndromes are caused by:

A

vulnerable atherosclerotic plaque

60
Q

Following a myocardial infarction, the myocardial tissue that has been replaced by scar tissue will:

A

serve to maintain the structural continuity of the myocardium

61
Q

The most common initial manifestations of dilated cardiomyopathies relate to:

A

heart failure

62
Q

Rheumatic fever is essentially a preventable form of heart disease that results from:

A

direct invasion of heart tissue by group-A hemolytic streptococcus

63
Q

The cardiac reserve refers to the:

A

ability to adjust pumping ability to meet the varying needs of the body

64
Q

The main preload work of the heart results from:

A

venous return to the heart

65
Q

Circulatory shock can best be described as a condition in which there is:

A

inadequate blood flow to meet the metabolic needs of body tissues

66
Q

Early signs of hypovolemic shock include:

A

restlessness, thirst, and increased heart rate

67
Q

The characteristic manifestations of early septic shock include all but which one of the following?

A

Vasoconstriction with cool, clammy skin

68
Q

Raynaud’s phenomenon is characterized by _____________, while thromboangiitis obliterans (Buergers disease) is characterized by ____________ of the arterial vessels in the hands and/or feet.

A

Vasospasm; inflammation

69
Q

The diastolic blood pressure represents the:

A

pressure maintained by the energy stored in the aorta during systole

70
Q

The systolic component of blood pressure most directly reflects the:

A

stroke volume output and the distensibility of the aorta

71
Q

Target-organ damage that occurs as the result of long-term uncontrolled hypertension is associated with:

A

atherosclerosis

72
Q

Anginal pain does not develop in a number of people with advanced coronary atherosclerosis because of:

A

the development of adequate collateral circulation

73
Q

About 30% to 50% of people die from acute myocardial infarction in the first few hours because of which complication?

A

Ventricular fibrillation

74
Q

The mechanisms of septic shock are thought to relate to:

A

dysregulated release of inflammatory mediators

75
Q

Angina caused by spasm of a coronary blood vessel is often referred to as:

A

variant (Prinzmetal) angina

76
Q

With advanced mitral stenosis, there is:

A

increased pressure in the pulmonary veins and pulmonary edema

77
Q

Because of its arterial location, often the first sign of an abdominal aneurysm is:

A

a pulsating abdominal mass

78
Q

The arterial blood pressure is directly determined by the:

A

cardiac output

79
Q

The arterial blood pressure is directly determined by the:

A

cardiac output

Pathophysiology (44 decks)

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