Jeopardy

Question 0

What are the main determinants of MAP?

Answer 0

CO and TPR

Question 1

What are the 3 main mechanisms of regulating blood pressure?

Answer 1

Baroreceptor reflex
Renin-angiotensin
Aldosterone

Question 2

Define hypertension

Answer 2

A sustained elevation of systemic arterial BP >120/80

Question 3

What causes hypertension?

Answer 3

Hypertension is caused by increases in CO, peripheral resistance, or both

Question 4

True/False - Most cases of hypertension are secondary to other diseases?

Answer 4

FALSE - only 5-8% are secondary with the majority primary (idiopathic)

Question 5

What’s the 1st morphological change that occurs in the myocardium with hypertension?

Answer 5

Hypertrophy of the left ventricle

Question 6

Why do you get light-headed when standing after sitting down for extended periods?

Answer 6

Venous pooling (in legs and lower body) leading to a decreased BP when standing - orthostatic hypotension

Question 7

What are the 2 most common reasons for heart failure?

Answer 7

1. Damage to the heart muscle

2. Prolonged pumping against a chronically increased afterload

Question 8

What happens to the Frank-Starling law in the left ventricle in heart failure?

Answer 8

The curve is shifted downward and to the right

Question 9

How does the sympathetic nervous system help compensate to restore SV in heart failure?

Answer 9

Sympathetic activity to the heart is increased which increases HR and inotropy

Question 10

Is sympathetic compensation a long-term fix for decreased SV?

Answer 10

No - the heart becomes less responsive to norepi and the norepi in the nerve terminals becomes depleted (atrophy?)

Question 11

What does the term decompensated heart failure mean?

Answer 11

When the contractility of the heart deteriorates to the point where it is no longer able to pump out a normal SV despite the compensatory measures

Question 12

What 2 events directly affect mucous membrane color in a person with decreased cardiac function?

Answer 12

Blood flow slows in the capillaries which causes:
1 - a long contact time between the tissues and hemoglobin carrying RCBs
2 - development of metabolic acidosis

Question 13

What can a palpated pulse tell us about cardiac function?

Answer 13

It can tell us rate, rhythm, strength of ventricular systole (and more if measured bilaterally)

Question 14

In an adult when we would usually hear S3 or S4?

Answer 14

If the person has a stiffened left ventricle (heart failure is a usual cause)

Question 15

What type of heart failure leads to pulmonary edema?

Answer 15

Left heart failure

Question 16

What can we determine from a chest x-ray?

Answer 16

Mostly size and structure of the heart - and you can also see the lungs

Question 17

How do we get blood to the working muscles during exercise if we have high levels of norepi?

Answer 17

Metabolic trumps sympathetic - although the overall effect on the vasculature is vasoconstriction, blood flow to the working organs is primarily controlled by local metabolic factors

Question 18

During exercise what mechanisms are helping to increase venous return to the heart?

Answer 18

1. Venous constriction
2. Skeletal muscle pump
3. Respiratory pump

Question 19

When we need to control BP what mechanism is the fastest?

Answer 19

Baroreceptors - they sense the change and make adjustments in seconds

Question 20

T/F - Insulin resistance contributes to increased peripheral resistance?

Answer 20

True - along with inflammation and endothelial dysfunction

Question 21

For what 2 diseases would you put somebody on a sodium restricted diet?

Answer 21

Hypertension and heart failure

Question 22

Why does BP tend to increase with age?

Answer 22

As we age compliance of the blood vessels decreases (they get stiffer)

Question 23

Following training what happens to a persons resting CO?

Answer 23

It remains about the same as before training - this is because that although training decreases resting HR it increases SV

Question 24

During pregnancy - how is CO mainly increased?

Answer 24

The blood volume is increased leading to increased SV

Question 25

What type of exercise increases systemic vascular resistance?

Answer 25

Static exercise such as heavy weight lifting

Question 26

What 2 factors affect CO?

Answer 26

HR and SV

Question 27

T/F - Myocardial ischemia will always show up on an ECG?

Answer 27

False - often at rest an ECG will look normal and there needs to be a stressor before we can see changes on the ECG

Question 28

What would make you stop an exercise stress test?

Answer 28

Chest pain
Extreme fatigue
Dyspnea
Leg pain
Pt. asks to stop/stops
ST segment changes
Dysrhythmias
DP changes
Signs of cerebral hypoxia

Question 29

What is high output heart failure?

Answer 29

Inadequate perfusion despite normal or elevated CO (anemia, sepsis, hyperthyroidism, beriberi)