How the CVS fails

Question 1

Endothelium functions

Answer 1

blood vessel tone
fluid filtration
haemostasis
white blood cell recruitment
hormone trafficking

Question 2

ADH

Answer 2

a peptide

causes increased absorption

Question 3

Aldosterone

Answer 3

a steroid

causes increased absorption of NaCl, and decreased diuresis

Question 4

Angiotensin II

Answer 4

vasoconstriction
increases fluid retention
secreted by adrenal cortex
contributes to ventricular hypertrophy and remodelling

Question 5

Chronic heart failure treatments

Answer 5

ACE inhibitors (increase fluid loss)
Diuretics (increase fluid loss)
Beta blockers (decrease peripheral resistance)

Question 6

Ventricular Hypertrophy

Answer 6

eccentric: dilate due to volume overload
concentric: thickens due to pressure overload

Question 7

Cardiogenic Shock

Answer 7

critically low perfusion
progresses by positive feedback
low systolic BP - 90 mm Hg
treat: aggressive IV fluid, oxygen, airway maintained

Question 8

When the kidney accumulates fluid

Answer 8

decrease in glomerular filtration rate
increase in central venous pressure
increase venous return and preload

Question 9

Heart Failure

Answer 9

normal pressure, increased vascular resistance

ends with shock (common in elderly)

Question 10

Haemorrhage

Answer 10

loss of fluid –> loss of pressure
ends with shock (any age)
due to trauma

Question 11

Decompensated Heart Failure

Answer 11

kidney increases plasma volume to compensate for poor perfusion of renal tissue
kidney responds as if it is a haemorrhage
–> fluid overload
heart cannot pump the extra fluid - increased venous hydrostatic pressures
positive feedback loop
capillaries leak fluid