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NYCC Visceral Pathology > Heart Failure & Shock > Flashcards

Heart Failure & Shock Flashcards

1
Q

What is the most common cause of cardiac failure?

A

Ischemic heart disease

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2
Q

_____ is seen in virtually all conditions associated with chronic heart failure?

A

Ventricular hypertrophy

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3
Q

What unique histological finding is present in the nuclei of a heart with hypertrophy?

A

Boxcar nuclei with hyperchromatic nuclei and thick, enlarged myocardial cells

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4
Q

What are the three classifications of heart failure?

A

Left-heart failure
Right-heart failure
Biventricular failure

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5
Q

What are the potential causes of left-sided heart failure?

A

Ischemic heart disease
Hypertension
Valvular disease

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6
Q

What is the most common cause of left-sided heart failure?

A

Ischemic heart disease

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7
Q

What are the clinical features of left heart failure?

A

Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Hemoptysis
Heart-Failure cells

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8
Q

What form of heart failure causes pulmonary edema in the lungs?

A

Left-heart failure

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9
Q

What cell is commonly seen in the lungs in a patient with left-sided heart failure?

A

Heart-failure cells

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10
Q

What is a heart failure cell and what pathology will it be present in?

A

Hemosiderin-laden macrophages in the alveolar air spaces of the lungs present in left-sided heart failure

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11
Q

What is orthopnea? What is it a clinical feature of?

A

Discomfort breathing while laying flat indicative of left-sided heart failure

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12
Q

What is paroxysmal nocturnal dyspnea? What is it a clinical feature of?

A

Short attacks of short breath occurring at night indicative of left-sided heart failure

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13
Q

With left heart failure, the lungs experience ____ failure?

A

Backward

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14
Q

With left heart failure, the kidneys, brain, and skeletal muscle all experience ____ failure?

A

Forward

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15
Q

What signs and symptoms will be present in a brain experiencing forward left heart failure?

A

Altered states of consciousness or personality changes

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16
Q

What signs and symptoms will be present in skeletal muscle experiencing left heart failure?

A

Atrophy, fatigue, weakness, and exercise intolerance

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17
Q

What signs and symptoms will be present related to the kidney in a patient with left heart failure?

A

Increased BUN and creatinine, decreased pH (acidic), increased renal pressure

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18
Q

What type of overload and myocardial hypertrophy causes pulmonary edema?

A

Pressure overload and concentric hypertrophy

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19
Q

Aortic stenosis can cause (Pressure/Volume) overload leading to (Concentric/Eccentric) hypertrophy and pulmonary edema?

A

Pressure, concentric

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20
Q

Aortic stenosis can cause (Right/Left) heart failure and pressure overload?

A

Left

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21
Q

Pulmonary stenosis can cause (Right/Left) heart failure?

A

Right

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22
Q

What is the most common etiology of right heart failure?

A

Left-heart failure

23
Q

What are common etiologies of right heart failure?

A

Left-heart failure
Pulmonary hypertension/Cor pulmonale
Intrinsic diseases

24
Q

Pulmonary hypertension results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?

A

Pressure, concentric, right

25
Q

Late stage cor pulmonale results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?

A

Volume, eccentric, right

26
Q

What does COPD stand for? What cardiac pathology can it cause?

A

Chronic obstructive pulmonary disease causing pulmonary hypertension and right-sided heart failure

27
Q

COPD results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?

A

Pressure, concentric, right

28
Q

What are the clinical features of right-sided heart failure?

A

Neck vein distension
Elevated jugular venous pressure (EJV)
Hepato-abdomino-jugular reflex
Hepatomegaly
Splenomegaly
Ascites
Bilateral pitting edema in the lower extremities

29
Q

Neck vein distension and elevated jugular venous pressure are clinical signs of (Right/Left) sided heart failure?

A

Right

30
Q

The hepato-abdomino-jugular reflex, hepatomegaly, and/or splenomegaly are clinical signs of (Right/Left) sided heart failure?

A

Right

31
Q

Ascites is a clinical sign indicative of (Right/Left) sided heart failure?

A

Right

32
Q

Bilateral pitting edema in the lower extremities is most likely caused by (Right/Left) sided heart failure?

A

Right

33
Q

Nutmeg liver is most commonly caused by (Right/Left) sided heart failure?

A

Right

34
Q

What is the criteria for determining the severity of pitting edema?

A

Depth of pit and time that pit lasts

35
Q

What is shock?

A

Global hypoperfusion of tissues

36
Q

What is hypovolemic shock?

A

Shock resulting from loss of blood volume and plasma

37
Q

What is septic shock?

A

Shock caused by a gram negative bacterial infection and lipid A endotoxins

38
Q

What is cardiogenic shock?

A

Shock that results when the heart is unable to meet the demands placed on it by the body

39
Q

What is anaphylactic shock?

A

Shock due to an allergic or hypersensitivity reaction resulting in increased IgE, histamine, eosinophils, and basophils

40
Q

What is neurogenic shock?

A

Shock caused by a brain or spinal cord injury

41
Q

What are the three sequential stages of shock?

A

Non-progressive
Progressive
Irreversible

42
Q

What systems are active in the non-progressive stage of shock?

A

RAAS, sympathetic nervous system, autoregulation

43
Q

What signs occur during the progressive stage of shock?

A

Metabolic acidosis and hypotension

44
Q

What signs occur during irreversible stage of shock?

A

Multi-system organ failure, increased LDH, CK, BUN, creatinine, amylase, and lipase

45
Q

What effect does shock have on the heart?

A

Decreased cardiac output, clotting, and possible MI

46
Q

What effect does shock have on the kidney?

A

Oliguria and increased BUN

47
Q

What is oliguria and what can cause it?

A

Decreased urine output by the kidney caused by shock

48
Q

What effect does shock have on the lungs?

A

Foamy cough, dyspnea, “deathrattle” sound

49
Q

What effect does shock have on the GI tract?

A

Ischemic infarct, gangrenous necrosis,
melena, and hematochezia

50
Q

What is hematochezia and what can cause it?

A

Bright red blood in the stool indicative of a lower GI bleed caused by shock, hemorrhoids, or neoplasias

51
Q

What is melena and what can cause it?

A

Black, tarry stool indicative of an upper GI bleed caused by shock or neoplasias

52
Q

What effect does shock have on the brain?

A

Loss of consciousness, dizziness, comatose state

53
Q

What effect does shock have on the skin?

A

Cold cyanosis

NYCC Visceral Pathology (40 decks)

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