Eggena 6

Question 1

the patient had severe

Answer 1

anemia

Question 2

the patient’s anemia had resulted from

Answer 2

relatively slow bleeding into the GI tract which was responsible for producing black looking stools.

Question 3

guaiac test

Answer 3

demonstrates the presence of occult blood in the specimen.

Question 4

because blood loss had been gradual, the kidneys

Answer 4

had had ample time to retain extra salt and water and, thus, to keep the circulating blood volume normal.

Question 5

the concentration of hemoglobin and the hematocrite were reduced because

Answer 5

formation of red blood cells and synthesis of hemoglobin could not keep pace with the loss of blood.

Question 6

the oxygen content of his arterial blood was

Answer 6

reduced. The oxygen carrying capacity of blood was reduced by more than 1/2 and was only about 90% saturated because of age related changes in lung structure and the presence of edema fluid in the inferior lobes.

Question 7

when the brain does not obtain the oxygen it needs, a person becomes

Answer 7

nervous, irritable, sleepless, dizzy and may faint. It also leads to muscle weakness, which are the major complaints of the man.

Question 8

when oxygen demands of tissues are not met in anemia, vascular smooth muscle

Answer 8

in precapillary vessels relaxes and more blood flows to tissues as a compensatory response (autoregulation of blood flow)

Question 9

with increased blood flow in anemia

Answer 9

tissues can be supplied with adequate oxygen even though less oxygen is extracted from each unit of blood.

Question 10

the increased venous return to the heart leads to an

Answer 10

increase in cardiac ouput, which can be calculated by the Fick principle.

Question 11

The fick principle of CO was

Answer 11

twice the normal resting cardiac output, so the man has compensated for a two fold reduction in oxygen carrying capacity of blood by doubling cardiac output.

Question 12

While cardiac output was increased,

Answer 12

there is little or no reserve in cardiac output to meet the increased oxygen requirements of tissues on exertion, so that symptoms of feeling weak and faint typically appeared when the main walked or climbed a few stairs.

Question 13

the twofold increase in cardiac output was due to

Answer 13

a reduction in the resistance of his peripheral circulation.

Question 14

the reduction in peripheral resistance was due to

Answer 14

peripheral vasodilation and diminished blood viscosity. both an increase in diameter of vessels as well as a decrease in blood viscosity decreases the resistance to blood flow.

Question 15

stroke volume =

Answer 15

SV = CO/HR

Question 16

frank-starling law of the heart

Answer 16

an increase in venous return distends the ventricles more and causes more to be ejected. The greater the volume of blood ejected into the aorta, the higher the sysstolic blood pressure and pulse pressure.

Question 17

pulse pressure is proportional to

Answer 17

SV/C

Question 18

the compliance of arteries

Answer 18

decreases with advances. The reduction in arterial compliance together with an increase in stroke volume were responsible for the high systolic blood pressure.

Question 19

the reduction in total peripheral resistance was primarily responsible for

Answer 19

low diastolic blood pressure.

Question 20

the high pulse pressure was responsible for

Answer 20

the bounding forceful radial artery pulse and the capillary pulsations under his fingernails.

Question 21

high output failure

Answer 21

failure of the heart even though it pumps more than the normal amount of blood. The left ventricle cannot handle the increase in preload (venous return) and fails to eject the usual 2/3 of its end diastolic volume.

Question 22

left ventricular failure leads to

Answer 22

an increase in pulmonary capillary pressure and pulmonary edema.

Question 23

pulmonary edema starts at the

Answer 23

base of the lungs where it is detected on asucultation as moist rales.

Question 24

the patient stuggled for air when asked to lie down (orthopnea) because

Answer 24

lying flat causes a greater portion of his lungs than before to be beneath heart level, and his lungs became congested and difficult to expand.