Brainscape's Knowledge GenomeTM

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


See full index

DT3- EXAM 1 > CHF- Melissa (3)* > Flashcards

CHF- Melissa (3)* Flashcards

1
Q

5 causes of cardiac dysfunction:

A
  1. pump failure (weak myocytes, inability to relax)
  2. Obstruction of flow ( ^ after load)
  3. Regurgitant flow ( ^ preload)
  4. Conduction anomalies
  5. Ventricular/ Vascular rupture (discontinuity of system)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 mechanisms by which the heart accommodates for ^ hemodynamic burden or myocardial contractility change:

A
  1. Frank Starling
    (^ preload = ^ dilation = ^contraction)
  2. Hypertrophy
    (physiologic / pathologic)
  3. Neurohumoral Activation
    (NE, Renin/ANG/Aldo, ANP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Generally, what structural change in the heart precedes failure?
What are 2 causes of this change?

A

Hypertrophy –> Heart failure

  1. ^ Mechanical workload
  2. ^ Trophic signals–> ^ protein synthesis–> ^ # sarcomeres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the CONCENTRIC pattern of cardiac hypertrophy:

  • 2 most common causes
  • Gross morphology
  • Sarcomere arrangment
A

“Pressure Overlaod Hypertrophy”

  • Causes: HTN, Aortic stenosis
  • ^ wall diameter, normal/ smaller cavity
  • Sarcomeres parallel to long axes of myocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe VOLUME-OVERLOAD cardiac hypertrophy:

  • 2 most common causes
  • Gross morphology
  • Sarcomere arrangment

*Is it always dangerous?

A
  • Causes: Mitral/ Aortic valve regurgitation
  • +/- increase in wall diameter, ventricular dilation
  • Sarcomeres assemble in seres (side-by-side) w/ existing

*may be caused physiologically by aerobic exercise

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

Which type of hypertrophy is a major risk for sudden cardiac death? What does it look like on EKG?

A

Left ventricular hypertrophy

Leads V2/3: see S waves > 30 mm.

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

Why is pathological cardiac hypertrophy dangerous to the heart (3)?

A
  1. No capillary growth to meet new O2/ nutrient demands
  2. Hypertrophied myocytes need more O2, nutrients, mitochondria than normal
  3. ^ Fibrous tissue (less elastic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 possible outcomes of sudden cardiac hypertrophy:

A
  1. inadequate organ perfusion (decompensation)
  2. cardiac failure/sudden death
  3. arrhythmia
  4. neurohumoral stimulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes physiological cardiac hypertrophy?

What type of hypertrophy is it + 2 reasons why it isn’t dangerous?

A

Aerobic* exercise (vs static) & pregnancy–
volume load hypertrophy
1. ^ capillary density to accommodate
2. DECREASED resting HR and blood pressure

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

Does static exercise cause physiological hypertrophy?

A

Yes, but with more detrimental effects!

Causes concentric/ pressure overload hypertrophy, aerobic causes volume overload hypertrophy.

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

What are the two types of heart failure?

A
  1. Forward failure–> poor perfusion

2. Backward failure–> pulm + peripheral edema

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

Most common cause of rt. heart failure?

A

Lt. heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which side of the heart fails more often? What is the ultimate result (2)?

A

LEFT HEART FAILURE–>

  1. Congestion of pulmonary circulation
  2. Poor peripheral blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Left sided heart failure effects on the HEART:

2 anatomical changes + 1 heart sound

A
  1. Hypertrophy of Lt ventricle (except mitral valve stenosis)
  2. S3 heart sound (^ blood volume/ stiff ventricle)
  3. Enlarged Lt atrium (A fib, stasis, embolus to brain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can enlargement of the Lt atrium cause as a result of L heart failure? (2)

A

A fib–> stasis–> thrombosis –> stroke
Also- compression of esophagus + left recurrent laryngeal nerve = hoarseness and dysphagia (FA)

Hoarse voice was a practice questions one of the few I got right: thanks, First Aid Guy!

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

What causes the S3 sound heard during left heart failure?

What does it sounds like?

A

^ blood in LV or stiff LV
Sound: “Ken-Tuck-y”, early diastolic murmur due to ^ ventricle filling pressure

*NOTE: this sound can be normal in kiddos or athletes.

17
Q

Left sided heart failure effects on the LUNG:

  • What do you see on X-ray ?
  • What do you see on tissue biopsy?
A

MOST EFFECTED ORGAN
^ pressure in pulm vv. –> pulm congestion + edema
- Kerley B lines on X-ray (interstitial transudate)
- Heart failure cells (Hemosiderin laden MQs)

18
Q

3 clinical manifestations of L heart failure in the lungs:

A
  1. cough
  2. orthopnea
  3. paroxysmal nocturnal dyspnea
19
Q

Left sided heart failure effects on kidneys:

A
  1. DECREASED renal perfusion–>
  2. ^ RENIN prodxn by JGA–>
  3. ^ ALDO–>
  4. ^ Na + H2O retention–> ^ Interstitial fluid volume–>
  5. ^ Pulm edema, ^ BUN, ^ Cr
20
Q

Release of what molecule can be checked to dx. heart failure?

A

BNP

21
Q

Left sided heart failure effects on brain:

A

Occur with advanced disease

Decreased perfusion–> Hypoxic encephalopathy

22
Q

What is the most common cause of L Heart failure: systolic or diastolic dysfunction?

A

systolic (LV) dysfunction + insufficient stroke volume

23
Q

What is the #1 cause of L heart failure + 2 other causative systolic dysfunctions:

What do these problems do the the ejection fraction?

A

1: ISCHEMIC HEART DISEASE

  1. HTN
  2. Dilated cardiomyopathy
  • DECREASED EF w/ DECREASED SV
24
Q

3 diastolic dysfunctions that lead to L heart failure:

What do these problems do to the ejection fraction?

A
  1. Massive LV hypertrophy
  2. Myocardial fibrosis
  3. Constrictive pericarditis
    (All things that prevent the heart from stretching)

*DECREASED SV w/ possibly normal EF

25
Q

What is “Cor Pulmonate”?
How common is this?
What are 3 common causes?

A

Isolated right heart failure (rare)

  • parenchymal diseases of lung
  • pulm vascular disorders (HTN, embolus)
  • diseases that cause hypoxia
26
Q

Rt heart failure effects on the heart (2):

A

Hypertrophy + dilation of RA, RV (whole right heart)

27
Q

Rt heart failure effects on the liver (3):

A

^ Portal venous pressure–>

  • Congestive hepatomegaly
  • Chronic edema of bowel wall
  • Ascitis
28
Q

What is nutmeg liver and what causes it?

A

Rt heart failure–> congestion around central vv. in liver–> red-brown discoloration + pale periphery

29
Q

What are three results of centrilobular necrosis of the liver caused by Rt heart failure? (Labs? Clinical findings?)

A

^^transaminases; jaundice; hepatomegaly

30
Q

Rt heart failure effects on the Kidneys (3):

A

VENOUS congestion–> decreased excretion–>

  1. WORSE fluid retention than lt. heart failure
  2. peripheral edema
  3. Azotemia (^ BUN)
31
Q

Describe effects of Rt heart failure on the brain; what specifically causes these effects?

A
  • similar to Lt heart failure

- caused by venous congestion + hypoxia

32
Q

How does Rt heart failure effect the plural and pericardial spaces?

A

EFFUSION!

Compression of lungs by fluid in thoracic cavity–> atelectasis

33
Q

What is the #2 sign of heart failure in a patient?

A

PERIPHERAL EDEMA of subcutaneous tissue:

  • Commonly “dependent” (more in lower extremities)
  • May be generalized ( anasarca)
34
Q

2 most common signs of heart failure in clinic?

A

SOB + GENERALIZED EDEMA

* patients generally present with simultaneous rt and lt syndromes

DT3- EXAM 1 (26 decks)

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