Brainscape's Knowledge GenomeTM

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


See full index

Pathology > CVS Pathology I > Flashcards

CVS Pathology I Flashcards

1
Q

Congestive heart failure involves an interplay of what 2 factors?

A

1) Inability of the heart to maintain sufficient CO to support body functions
2) Recruitment of compensatory mechanisms to maintain cardiac reserve

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

Heart failure is characterized by?

A

1) Diminished cardiac output (forward failure)

2) Damming back of blood to the venous system (backward failure)

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

According to the Frank Starling Mechanism, the stroke volume increases in response to…

A

increased (end diastolic volume) volume of blood filling the heart

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

Compensatory mechanisms in CHF

A

Frank Starling mechanism, Myocardial hypertrophy (with or without dilation), Activation of the neurohumoral system

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

In the heart, pressure overload causes _____ while Volume overload causes ______

A

muscle hypertrophy; chamber dilation

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

Name 2 important things to take note in the histology of the hypertrophic heart

A

thickness of the myocardium & box-type nuclei (enlarged)

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

(T/F) CHF almost always presents with tachycardia.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 systems activated in the neurohumoral compensatory response in CHF

A

NE/Epinephrine, Renin-Angiotensin-Aldosterone System, Release of atrial-natriuretic peptide

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

Release of atrial natriuretic peptide (ANP) causes sodium and water _______ therefore causing ______

A

retention; edema

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

What is the role of the RAA system in the compensatory system of CHF?

A

RAA activation causes tubular reabsorption of sodium and water –> increased blood volume –> increased venous return –> increased volume to L ventricle –> augment failing heart

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

Pressure overload causes what kind of hypertrophy?

A

Concentric

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

Give examples of pathological states with pressure overload

A

systemic hypertension, pulmonary hypertension

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

Give examples of pathological states with volume overload

A

aortic/mitral regurgitation, shunting anomalies

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

(T/F) A 25 YO male’s heart was determined to weigh 350 grams. His heart is considered enlarged.

A

False. Normal for males: 300-350 grams; Females 250-300 grams

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

Give the basis for myocardial contractile failure

A

1) Death of myocytes/loss of vital pump elements
2) Overworked, fatigued cardiac muscles
3) Altered gene expression with prolonged hemodynamic overload
4) Re-expression of pattern of protein synthesis similar to fetal cardiac development

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

Give functional modifications in the heart in heart failure after neurohumoral stimulation

A

Increased inotropy; Increased HR; Vasoconstriction; Na and water retention

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

Give structural modifications in the heart in heart failure after neurohumoral stimulation

A

Hypertrophy, Increased nonmuscular tissue, Increased expression of adult cardiac genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give the end results of functional & structural modifications in the heart in heart failure after neurohumoral stimulation

A

1) Increased energy demand
2) Altered loading conditions
3) Altered vascular/diastolic properties
4) Proarrhythmogenic effect

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

Give some anatomic, biochemical and ultrastructural changes in the heart in CHF

A

1) Pathologic hypertrophy
2) Increased protein synthesis
3) Altered gene expression
4) Synthesis of abnormal proteins
5) Fibrosis
6) Decrease calcium
7) Microciculatory spasm (further ischemia)
8) Apoptosis

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

Mechanisms of cardiac dysfunction in CHF

A

Pump failure, Obstruction of flow, Regurgitant flow, Disorders of cardiac conduction, Disruption of normal circulatory continuity

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

Examples of diseases that cause myocardial dysfunction

A

IHD, Dilated cardiomyopathy

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

Examples of diseases that cause ventricular pressure overload

A

HTN, Aortic stenosis, Pulmonary embolism, cor pulmonale,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Examples of diseases that cause ventricular volume overload

A

Aortic/mitral regurgitation, high output state (pregnancy, anemia, thyrotoxicosis)

24
Q

Examples of diseases that cause restrictive disease

A

pathological tachycardia, heart block

25
Q

Examples of diseases that cause conduction system failure

A

AMI, Arrythmia

26
Q

Examples of diseases that cause valvular failure

A

endocarditis, Rheumatic heart disease, calcific aortic stenosis, Pulmonary stenosis, tricuspid atresia

27
Q

Examples of diseases that cause cardiac malformation

A

VSD< ASD, PDA, tetralogy of fallot, Coarctation of the aorta

28
Q

What are the most frequent clinical conditions associated with CHF

A

MI and valvular disease

29
Q

Iatrogenic causes of CHF

A

Drugs: cocaine, doxyrubicin, radiation

30
Q

Clinical conditions associated with CHF

A

Previous MI, CAD, HTN, Arrythmia, Heart valve disease, cardiomyopathy, congenital heart disease, alcohol and drug abuse

31
Q

DIfferntiate systolic vs diastolic dysfunction in terms of its main pathology

A

Systolic: problem during contraction; Diastolic: failure of muscle to relax

32
Q

Types of CHF in terms of anatomic location

A

1) Left-sided HF (Failure of LV)
2) Right-sided HF (Failure of RV)
3) Combined or biventricular

33
Q

What is the most common cause of heart failure?

A

Systolic dysfunction

34
Q

Give diseases that cause systolic dysfunction

A

IHD, hypertensive heart disease, dilated cardiomyopathy

35
Q

(T/F) Most systolic dysfunction affects the right ventricle

A

False. Left ventricle

36
Q

(T/F) You find s/s of pulmonary edema and congestion in systolic dysfunction

A

True

37
Q

Give causes of diastolic dysfunction in CHF

A

massive LV hypertrophy, amyloidosis, constructive myocarditis, myocardial fibrosis

38
Q

(T/F) In diastolic dysfunction the ejection fraction is decreased

A

False. The ejection fraction is normal

39
Q

Give an important clinical manifestation in left sided heart failure

A

Edema

40
Q

Effect of left sided heart failure on the brain

A

Hypoxic encephalitis

41
Q

Effect of left sided heart failure on the kidneys

A

Release of Renin = edema

42
Q

Effect of left sided heart failure on the lungs

A

acute congestion and edema; Chronic passive congestion

43
Q

Histologically, how do you differentiate acute vs passive congestion of the lung?

A

Acute = no heart failure cells; Chronic = (+) heart failure cells

44
Q

Give the clinical features of left-sided heart failure

A

Dyspnea, orthopnea, Paroxysmal Nocturnal Dyspnea, Increased HR, caridomegaly, Blood tinged sputum, cyanosis, elevated pulmonary wedge pressure, rales, cough, edema

45
Q

Give causes of right-sided heart failure

A

PE, Intrinsic lung disease (COPD, cystic fibrosis), Pulmonary HTN, kyphoscoliosis, pneumoconiosis, schistosomiasis

46
Q

Give the liver morphology in right-sided heart failure

A

Congestive hepatomegaly, nutmeg liver, centrilobular necrosis, sclerosis

47
Q

Give the spleen morphology in right-sided heart failure

A

congestive splenomegaly

48
Q

Give the heart morphology in right-sided heart failure

A

RV dilatation and hypertrophy

49
Q

Give the kidney morphology in right-sided heart failure

A

congestion

50
Q

Give the brain morphology in right-sided heart failure

A

hypoxic encepalopathy

51
Q

Clinical features of right-sided heart failure

A

Splanchic congestion (hepatosplenomegaly), hepatojugular reflex, Jugular venous distention, dependent edema, transudative effusions, cyanosis

52
Q

Give causes of high output failure

A

anemia, hyperthyroidism, high fever, shunts between the artery and veins

53
Q

What is the underlying physiological problem in high output heart failure

A

decreased systemic vascular resistance d/t arterio-venous shunting or peripheral vasodilation

54
Q

Which is more common, high or low output heart failure?

A

Low

55
Q

Give the major criteria in the diagnosis of CHF

A

PND, Neck vein distention, rales, cardiomegaly, acute pulmonary edema, S3 gallop, increased venous pressure & (+) hepatojugular reflux

56
Q

What are the minor criteria in the diagnosis of CHF

A

Extremity edema, night cough, dyspnea on exertion, hepatomegaly, pleural effusion, vital capacity reduced by 1/3 & tachycardia

57
Q

Weight loss of >4.5 kg over 5 days treatment is a (major/minor/both) criteria for diagnosis of CHF

A

both

Pathology (7 decks)

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