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Midterm Review Flashcards

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1
Q

Define Hemostasis

A

A sequence of responses that stops bleeding

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2
Q

Increased tendency toward blood clotting (coagulation)

A

Hypercoagulability

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3
Q

Associated with conditions that produce turbulent blood flow and platelet adherence.

A

Arterial Thrombosis

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4
Q

Associated with conditions that cause stasis of blood flow. Composed of platelet aggregates and fibrin complexes (resulting from increased concentrations of clotting factors)

A

Venous Thrombosis

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5
Q

Pinpoint purplish-red spots

A

Petechiae

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6
Q

Purple areas of bruising

A

Purpura

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7
Q

Decrease in number of circulating platelets

A

Thrombocytopenia

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8
Q

Abnormally low number of circulating red blood cells or level of hemoglobin, resulting in diminished oxygen carrying capacity

A

Anemia

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9
Q

Decrease in number of white blood cells, most often affects neutrophil

A

Leukopenia

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10
Q

Excessive or inappropriate activation of immune system

A

Hypersensitivity Disorder

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11
Q

Acquired Immunodeficiency Syndrome, caused by HIV

A

AIDS

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12
Q

Retrovirus that attacks CD4 lymphocytes (immune cells responsible for coordinating the immune response to infection)

A

HIV

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13
Q

What are the 2 conditions that can lead to hypercoagulability? Explain each condition and give examples

A

1) Increased Platelet Function:
- Platelet adhesion, formation of platelet clots and disruption of blood flow
- Atherosclerosis
- Diabetes Mellitus
- Smoking
- Elevated Blood Lipid (Cholesterol)
- Increased Platelet Levels

2) Increased Clotting Activity:
- Thrombus formation because of activation of coagulation system can result from primary (genetic) or secondary disorders affecting coagulation compents of blood clotting
- Pregnancy
- Birth Control
- Post Surgical Site
- Immobility
- Congestive Heart Failure
- Malignant Disease

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14
Q

What can cause a bleeding disorder?

A

1) Platelet # or Function
2) Coagulation Factors
3) Blood Vessel Integrity

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15
Q

Describe Hemophilia A

A
  • Clotting Factor VIII (8) deficiency
  • X-linked recessive disorder primarily affects males
  • 90% diagnosed produce insufficient factor, 10% produce defective
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16
Q

List the 4 primary causes of anemia:

A

1) Excessive loss of red blood cells from bleeding
2) Destruction (Hemolysis) of RBC
3) defective RBC production
4) inadequate RBC production b/c of bone marrow failure

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17
Q

What is Sickle Cell Anemia?

A

Inherited disorder in which abnormal hemoglobin (S) leads to chronic hemolytic anemia, pain and organ failure

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18
Q

Sickle Cell Anemia Contributing Factors

A 
Cold
Stress
Physical exertion
Infection
Illnesses causing hypoxia, dehydration, acidosis
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19
Q

Complications of Sickle Cell Anemia

A
  • Severe sudden pain in the body (abdomen, chest, bones, joints)
  • Infarctions in liver, spleen, heart, kidneys, retina
  • Acute chest syndrome
  • Growth retardation, osteomyelitis, infarction in marrow
  • Damage to spleen
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20
Q

What is the most common type of anemia?

A

Iron Deficiency Anemia

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21
Q

What are the possible causes of Iron Deficiency anemia? Briefly describe each cause.

A

1) Dietary Deficiency
Iron used repeatedly, RBC break down iron is released and reused to produce more RBC
2) Loss of Iron through Bleeding
Chronic blood loss (peptic ulcers, hemorrhoids, cancer)
3) Increase Demands
Pregnancy, increase growth demand (children)

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22
Q

What are the signs and symptoms associated with iron deficiency anemia?

A

1) Fatigue, Palpitations, Dyspnea, Angina, Tachycardia
2) Epithelial Atrophy (brittle nails/hair, smooth tongue, etc)
3) Pica
4) In Kids: neurological manifestation; stroke, cranial nerve palsies

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23
Q

Eating disorder, eating non-nutritious items (soils, chalk, etc)

A

Pica

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24
Q

What happens to the RBCs when there is a deficiency of vitamin B12?

A
  • Nuclear maturation and cell division fail to occur

- RBC are larger and oval (short life span)

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25
Q

B12 deficiency and Folic Acid deficiency have similar manifestations – what is the biggest difference between the two deficiencies?

A

NO neurological manifestation with Folic Acid deficiency

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26
Q

Describe Aplastic Anemia and its causes

A
  • Primary condition of bone marrow stem cells that result in reduction of all 3 hematopoietic blood lines (RBC, WBC, platelets)
  • Bone marrow replaced with fatty tissue

Causes:
Radiation
Chemicals
Toxins

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27
Q

Chemotherapy can suppress bone marrow function – what is a common condition that results from this?

A

Neutropenia

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28
Q

What are the signs and symptoms associated with Infectious Mononucleosis?

A

Fever, Generalized Lymphadenopathy, Sore throat, Appearance in blood of atypical lymphocytes and several antibodies

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29
Q

Which virus causes Infectious Mononucleosis?

A

Epstein-Barr (herpes family, mono)

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29
Q

Which virus causes Infectious Mononucleosis?

A

Epstein-Barr (herpes family, mono)

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30
Q

Compare the difference between Hodgkins and Non-Hodgkins lymphoma:

A

1) Non-Hodgkins:
- Lymphoma from B-Cell, T-Cell, NK-Cell
- Alterations in development process of these can lead to any subtype of lymphoid neoplasm
- Spreads to various tissue in the body and bone marrow

2) Hodgkins:
- Specialized form of lymphoma, presence of abnormal cell “Reed-Sternberg”
- Begins as malignancy in single lymph node and spread to contiguous lymph nodes

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31
Q

Bone marrow stem cells are replaced by malignant neoplasms

A

Leukemia

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32
Q

Signs and symptoms of Leukemia

A
  • Fatigue
  • Pallor
  • Weight loss
  • Repeated infections
  • Easy bruising
  • Nosebleeds
  • Appear sudden in children
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33
Q

Explain the 4 types of hypersensitivity disorders

A

a. Type I: Immediate Hypersensitivity Disorder
IgE mediated immune response leads to release of inflammatory mediators (Allergic reactions)

b. Type II: Antibody Mediated Disorder
IgG or IgM antibodies directed against target antigens on surface of cells or other tissue components
Mismatch blood type, Hemolytic Disease, Drug reactions

c. Type III: Immune Complex-Mediated Disorder
IgG or IgM, formation of antigen-antibody immune complex in blood stream, later deposit in vascular epithelium tissues
Autoimmune disease

d. Type IV: Cell-mediated Hypersensitivity Disorder
T-lymphocytes, response to variety of microorganisms including intracellular pathogens (virus) or extracell (fungi)
Hepatitis, Allergic contact dermatitis, Exposure to inhaled dust

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34
Q

What causes AIDS?

A

HIV

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35
Q

a retrovirus that attacks the CD4 T lymphocytes (immune cells responsible for coordinating the immune response to infection)

A

HIV

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36
Q

How is HIV transmitted?

A

1) Exchange of blood/fluids
2) Sexual contact
3) Contaminated blood through needles
4) Infected mother to newborn
5) Infectious with no symptoms present

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37
Q

What is the pathogenesis of HIV?

A
  • In the process of taking over the CD4 T cell, the virus attaches to its receptors, fuses to and enters the cell, incorporates its RNA into the cell’s
  • DNA to reproduce large amounts of HIV, which is released into the blood. 60-70% develop AIDS 10-11 years after infection
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38
Q

List and explain each phase of an HIV infection:

A

Primary Infection Phase:
Fever, fatigue, myalgia, sore throat, night sweats, GI problems, rash, headache, oral ulcers

Latency (Chronic asymptomatic):
No sx & sx

Overt AIDS:
CD4 cells count falls to low levels, signs of opportunistic infections and other disease manifestations develop

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39
Q

Decrease in arterial flow that is not sufficient to meet the oxygen demands of the tissues

A

Ischemia

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40
Q

Harding of the arteries, formation of fibrofatty lesions in the intimal lining of the large and medium sized arteries such as the aorta and its branches, the coronary arteries, and the cerebral arteries that supply the brain

A

Atherosclerosis

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41
Q

a condition where arterial wall thickens. Larger the arteries

A

Arteriosclerosis

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42
Q

Major risk factor for Atherosclerosis. Serum marker for systemic inflammation

A

CRP

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43
Q

Disorder causing inflammatory injury and necrosis of the blood vessel wall

A

Vasculitis

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44
Q

Dilation of a blood vessel due to stretching of BV walls (weakening)

A

Aneurysm

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45
Q

Elevation in systolic and/or diastolic blood pressure

A

Hypertension

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46
Q

List the 3 disorders of arterial circulation:

A

1) Narrowing of blood vessels
2) Thrombus formation
3) Weakening of vessel walls

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47
Q

What are the primary risk factors associated with Atherosclerosis?

A

1) Increasing age
2) Gender (male) ~ estrogen decrease risk
3) Family history

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48
Q

What lifestyle changes can be made to lessen the risk of developing atherosclerosis?

A

1) Stop smoking
2) Diet
3) Hypertension
4) Hyperlipidemia
5) Cholesterol
6) Type 2 Diabetes

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49
Q

Describe a fatty streak that can develop with atherosclerosis:

A

Thin, flat, yellow discoloration that progressively enlarge, becoming thicker, and slightly elevated as they grow in length.

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50
Q

Describe a fibrous atheromatous plaque that can develop with atherosclerosis:

A
  • Basic lesions of atherosclerosis
  • Characterized by the buildup of intracellular and extracellular lipids, proliferation of vascular smooth muscle cells, formation of scar tissue, and calcification
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51
Q

Which vessels can be affected by vasculitis?

A

Arteries, Veins, Capillaries

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52
Q

What are the signs and symptoms associated with vasculitis?

A

Fever, Myalgia, Arthralgia, Malaise

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53
Q

Sudden event that interrupts arterial flow to affected tissue and organs

A

acute arterial occlusion

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54
Q

How does arterial occlusion develop?

A

Most result in embolus or thrombus

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55
Q

What are the clinical manifestations associated with AAC? (list the 7 Ps)

A

1) Pistol Shot (Acute onset)
2) Pallor
3) Polar (cold)
4) Pulselessness
5) Pain
6) Paresthesia
7) Paralysis

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56
Q

Compare how a thrombus and embolus cause AAC:

A

Thrombus:
Erosion/rupture of fibrous cap of ateriosclerotic plaque (promotes blood clotting)

Embolus:
Arise from heart, caused by conditions that cause blood clot formation of walls of heart chamber/valve

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57
Q

Which type of atherosclerosis is seen most commonly in the lower extremities?

A

Arteriosclerosis Obliterans

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58
Q

Which two arteries are most commonly affected atherosclerosis?

A

Superficial Femoral & Popliteal

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59
Q

List the manifestations associated with atherosclerosis

A

1) Gradual onset
2) Intermittent Claudication
3) Signs of ischemia (atrophic change, thin skin, decreased leg mm, cool foot, popliteal pulse absent, limb color blanch)
4) Blood flow reduced doesn’t meet min needs of resting mm and nerves (ischemic pain at rest, ulceration, gangrene)

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60
Q

What is ischemic pain?

A

-Pain causing pressure and compression

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61
Q

What can result from the blood flow demands of the tissue not being met?

A

Ischemic pain, gangrene, tissue/skin breakdown, ulceration

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62
Q

What is Buerger’s Disease?

A
  • Thromboangitis Obliterans

- Inflammatory arterial disorder causing thrombus formation

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63
Q

Which arteries are most commonly affected Buerger’s Disease?

A

Medium sized arteries, hands and feet

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64
Q

What are the risk factors of Buerger’s disease?

A
  • Heavy smoking

- Men, but becoming common in young female smokers

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65
Q

List the signs and symptoms associated with Buerger’s Disease:

A

Pain, Increased sensitivity to Cold, Decreased Peripheral Pulse, Change of color Extremity, Lack of Blood Flow, Chronic Ischemia, Ulceration, Gangrene

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66
Q

Which disease is caused by intense vasospasm of the arteries and fingers?

A

Raynaud’s Disease

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67
Q

Compare Type 1 and Type 2 of Raynauds

A

Type 1: Raynaud’s Disease (Primary)

  • Occurs without cause
  • Exposure to cold or strong emotion
  • Limited to fingers
  • Unknown cause

Type 2: Raynaud’s Phenomenon:

  • Associated with other disease of known vasospasm
  • Previous vessel injury (frostbite, vibrating tools, hot/cold temps)
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68
Q

What are the signs and symptoms associated with Raynauds

A

1) Ischemia (change in color, temp, sensory)
2) After episode, redness, throbbing, pain
3) Usually fingers affected sometimes feet
4) Trophic change can develop, brittle nails, skin becomes thick

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69
Q

Where is the most common location for an aneurysm?

A

Arteries/Veins most common in Aorta

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70
Q

What are some common causes for an aneurysm?

A

1) Congenital defects
2) Trauma
3) Infections
4) Atherosclerosis

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71
Q

How can a ruptured aneurysm be dangerous?

A

Severe bleeding

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72
Q

How can an unruptured aneurysm be dangerous?

A

Cause damage by pressure on surrounding structures, interrupting blood flow

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73
Q

Describe a berry aneurysm:

A

Small, sphere dilation of vessel at bifurcation

74
Q

Describe a fusiform aneurysm:

A

Entire circumference of vessel

75
Q

Describe a saccular aneurysm:

A

Extends over part of circumference of the vessel

76
Q

Describe a dissecting aneurysm:

A

False aneurysm, from treat in intimal layer of vessel, blood to enter between layers, causing blood filled cavity

77
Q

What is the only type of aneurysm that is considered a “false” aneurysm?

A

Dissecting Aneurysm

78
Q

What can result from disorders of the venous circulatory system?

A

Produce congestion of the affected tissues and predispose to clot formation (b/c of stagnation of blood flow and activation of the clotting system)

79
Q

What is a varicose vein?

A

Dilated and tortuous veins

80
Q

How do varicose veins develop?

A

Prolonged standing, Increased intra-abdominal pressure (Pregnancy, heavy lifting, obesity)

81
Q

What are the signs and symptoms of varicose veins?

A

1) Superficial appearance
2) Aching in lower limbs
3) Edema

82
Q

How can varicose veins be treated?

A
  • Little can be done to restore, prevention is key.

- Avoid long periods of standing, proper lifting, support stocking

83
Q

Describe the two possible ways that chronic venous insufficiency can develop?

A
  • Deep vein thrombosis (DVT)- causes deformity of the valve leaflets, so they cannot close properly
  • Valvular incompetence- without proper closing of the valves unidirectional blood flow and emptying of the deep veins cannot occur. Muscle pump is ineffective (blood flows backwards)
84
Q

What is venous thrombosis?

A

The presence of thrombus in a vein and accompanying inflammatory response in the vessel wall

85
Q

What are the risk factors of venous thrombosis?

A

1) Venous stasis
2) Hyperactivity of blood coagulation
3) Vascular Trauma

86
Q

What are the signs and symptoms associated with venous thrombosis?

A

1) Asymptomatic
2) Inflammation (Pain, swelling)
3) Other ind. Inflammation (fever, malaise, elevated WBC)
4) Tenderness/pain along the vein
5) Swelling

87
Q

How is venous thrombosis treated?

A

Anticoagulants

88
Q

What is compartment syndrome?

A

A condition of increased pressure in an anatomic space that cannot expand

89
Q

What are its causes compartment syndrome

A
  • Decreased Compartment Size
  • Constrictive dressings and casts
  • Infiltration of intravenous fluids
  • Thermal injury/ frostbite
  • Surgical closure of fascial defects
  • Increased Compartment Volume
  • Fractures and orthopedic surgery
  • Trauma and bleeding
  • Post-ischemic Injury
  • Severe exercise
  • Prolonged immobilization with limb compression
90
Q

How is compartment syndrome treated

A
  • Reducing compartmental pressures
  • Limb elevation is not recommended
  • Fasciotomy: fascia is cut longitudinally and separated to relieve pressure and reestablish blood flow (last resort)
91
Q

What is a pressure ulcer?

A

Ischemic lesions of the skin and underlying structures caused by external pressure that impairs blood/lymph flow

92
Q

What are two other names for a pressure ulcer?

A

Decubitus Ulcers and Bedsores

93
Q

How do pressure ulcer develop

A

External pressure compress blood vessel, Friction forces

94
Q

How are pressure ulcer treated?

A

Prevention of further damage, frequent turning, moist dressing, promote healing

95
Q

Which steps can be taken to prevent pressure ulcer?

A

Frequent position change, skin care, observation is key

96
Q

Compare primary hypertension to secondary hypertension

A

Primary Hypertension:
Chronic high blood pressure without other disease

Secondary Hypertension:
High blood pressure resulting from other disorder

97
Q

What is considered “Normal” blood pressure?

A

Less than 120/80

98
Q

b. Which risk factors of hypertension can NOT be changed?

A

Family history, Race, Age, Insulin Resistance

99
Q

Which risk factors of hypertension CAN be changed?

A

Salt intake, Obesity, Alcohol, Potassium, Cal, Magn, Birth Control, Stress

100
Q

What are the signs and symptoms associated with hypertension?

A
  • Asymptomatic
  • When symptoms occur:
  • Kidneys
  • Heart
  • Left ventricular hypertrophy
  • Angina
  • Heart failure
  • Eyes
101
Q

How is hypertension treated?

A
  • Lifestyle changes
  • Weight reduction
  • Diet rich in nutrients and reduced saturated fat
  • Dietary sodium reduction
  • Physical activity
  • Moderation of alcohol consumption
  • Stop smoking (increases risk for heart disease)
  • Drugs
102
Q

What other diseases/disorders/problems can result from hypertension?

A

Atherosclerosis, Heart failure, stroke, Coronary Artery Disease

103
Q

What is orthostatic hypotension?

A

Abnormal decrease in BP on assumption of the upright position

104
Q

What are the signs and symptoms of orthostatic hypotension?

A

Decrease in cerebral blood supply; feeling light-headed, dizzy, fainting

105
Q

What can cause orthostatic hypotension?

A
  • Decrease vascular volume (dehydration)
  • Impaired mm pump function (bed rest, spinal cord injury)
  • Cardiovascular Reflex (med that decrease heart rate)
106
Q

What is the term for fluid accumulating in the pericardial cavity?

A

Pericardial Effusion

107
Q

How does pericardial effusion affect the heart?

A

Depends on the amount of fluid, how fast it accumulates and elasticity of pericardium

108
Q

What other problem can occur as a result of pericardial effusion?

A

Cardiac Tramponade

109
Q

What can cause pericardial effusion?

A

Injury, Inflammation, Altered Capillary Filtration Pressure

110
Q

What is cardiac tamponade?

A

Slow/rapid compression on heart due to accumulation of fluid, blood or pus in pericardial sac (Life threatening)

111
Q

What are the causes cardiac tamponade

A

Trauma, Cardiac Surgery, Cancer, Uremia, Cardiac Rupture

112
Q

How does cardiac tamponade affect the heart function?

A
  • Increasing intracardiac pressure
  • Progressively limits ventricular diastolic filling
  • Reduces stroke volume/cardiac output
113
Q

What are the symptoms of Rapid accumulation

A
  • Elevation of central venous pressure
  • Jugular venous distention
  • Decline in venous return of the heart
  • Decrease in cardiac output despite an increase in heart rate
  • Fall in systolic BP
  • Signs of circulatory shock
  • Heart sounds may be hard to hear
114
Q

What are the symptoms of Slow development

A

acutely ill, but not to the same degree as rapid accumulation. Dyspnea is common

115
Q

What is pericarditis?

A

Inflammation process of pericardium

116
Q

What are the causes pericarditis

A

Infection, Trauma, 2ndry to other systemic/cardiac Disease

117
Q

What will result from pericarditis? (hint: clinical manifestation)

A

Evoke acute inflammatory process

118
Q

What are the signs and symptoms of acute pericarditis

A

Fever, Malaise, Flu-like symptoms

119
Q

What is exudate?

A

Fluid that seeps out of blood vessels

120
Q

How long can pericarditis last?

A
  • Last 2-6 weeks in Acute

- Chronic can last for years

121
Q

Where will the pain be felt pericarditis

A
  • Abrupt onset
  • Precordial area (over/below heart)
  • Sharp pain
  • Radiate to neck, back, abdomen, side
  • Worse with deep breath, coughing, swallowing
122
Q

What are the clinical manifestations of chronic pericarditis?

A

Minimal (through xray), accumulation of fluid compress

123
Q

What are the signs and symptoms of constrictive pericarditis?

A
  • Ascites (accumulation in abdomen of fluid, swelling)
  • Pedal edema
  • Dyspnea on exertion
  • Fatigue
  • Jugular vein distension
124
Q

What causes constrictive pericarditis?

A

Fibrous scar tissue formation between layers of the serous pericardium

125
Q

What is coronary artery disease?

A

Heart disease caused by imparied coronary blood flow

126
Q

What can result from coronary artery disease?

A
  • Angina
  • Myocardial Infarction
  • Cardiac arrhythmias
  • Conductions defects
  • Heart failure
  • Sudden death
127
Q

What is the most common cause of CAD?

A

Atherosclerosis

128
Q

What are the two types of CAD? Describe each.

A

1) Acute coronary syndrome

2) Chronic ischemic heart disease

129
Q

What are the two types of atherosclerotic plaques?

A

1) Stable artherosclerotic plaque

2) Unstable artherosclerotic plaque

130
Q

What is the effect of Aspirin?

A
  • Anticoagulant used to prevent aggregation at the site of plaque
  • Targets pathway formation of fibrin clot
  • Irreversible, last for lifetime of platelet (8-10 days)
131
Q

How long to the effects of aspirin last on the platelets that were in the body at the time the medication was administered?

A

8-10 days, lifetime of the platelet

132
Q

What is Angina?

A

Chest pain “to choke”

133
Q

What are the 3 types of anginas?

A

1) Angina Pectoris
Sudden chest pain associated with transient myocardial ischemia

2) Chronic Stable Angina
Fixed coronary obstruction that prevents heart from getting sufficient blood flow to meet its metabolic demands

3) Unstable Angina 
Pain is more persistent and severe course
Caused by:
Artherscleortic plaque disruption
Platelet aggregation
Secondary hemostasis
134
Q

What is a heart attack?

A
  • Myocardial Infarction

- Ischemic death of myocardial tissue

135
Q

What are the manifestations of MI

A
  • Abrupt onset
  • Severe crushing pain, radiating to left arm, neck/jaw
  • GI complaints
  • Complaints of fatigue/weakness
  • Tachycardia, anxiety, restlessness, feelings of doom
  • Pale, cool and moist skin
  • Sudden death
136
Q

What is myocarditis?

A

Inflammation of heart muscle and conduction system without evidence of myocardial infarction

137
Q

What are the manifestations myocarditis

A
  • Range from asymptomatic to profound heart failure or sudden death
  • In children/young adults is often asymptomatic
  • Acute symptomatic myocarditis flu-like symptoms
  • Upper respiratory tract/GI tract infection
138
Q

How does myocarditis resolve

A
  • Transient, symptoms subside within 1-2 months
  • Heart failure/life-threatening arrhythmias occur
  • Progression to subacute and chronic disease
139
Q

What is the most common cause myocarditis

A

Viral infection

140
Q

Group of disorders that affect the heart muscle

A

Cardiomyopathy

141
Q

What are the 2 types of cardiomyopathies?

A

1) Dilated Cardiomyopathies
Progressive cardiac hypertrophy/dilation and imparied pumping ability of one or more ventricles
Wall thinning and hypertrophy

2) Hypertrophic Cardiomyopathies
Abnormality that involves excessive ventricular growth (hypertrophy)
Common young adults, and cause of sudden death in young

142
Q

Bacterial Infection of the endocardial surface of the heart, including valves.

A

infective endocarditis

143
Q

What are the manifestations of endocarditis

A

Fever and signs of systemic infection (malaise, anorexia, lethargy)

144
Q

Compare Valve Stenosis to Valve Regurgitation

A

1) Valve Stenosis

2) Valve Regurgitation

145
Q

Ductus arteriosus remains open beyond 3 months in full term infant

A

Patent Ductus Arteriosus

146
Q

Persistent opening that allows shunting of blood across atrial septum from left to right

A

Atrial Septal Defect

147
Q

Opening in ventricular septum that results from incomplete separation of ventricles during early fetal development

A

Ventricular Septal Defect

148
Q

Most common cyanotic heart defect

A

Tetralogy of Fallot

149
Q

Aorta arises from right ventricle and pulmonary artery arises from left ventricle

A

Transposition of the great vessels

150
Q

localized narrowing of aorta prox to distal or opposite the entry of ductus arteriosus

A

Coarctation of the aorta

151
Q

localized narrowing of aorta prox to distal or opposite the entry of ductus arteriosus

A

Coarctation of the aorta

152
Q

What is the function of the heart?

A

Move deoxygenated blood from venous system through the right heart, and move oxygenated blood from pulmonary circulation through the left heart into arterial system

153
Q

What is heart failure?

A

Inability of heart to keep up with demand on it and failure of heart to pump blood with normal efficiency

154
Q

How is cardiac output regulated?

A
  • The amount of blood the heart pumps each minute
  • Regulated by balance between activity of the sympathetic nervous system (increase heart rate) and parasympathetic nervous system (slow heart rate)
155
Q

What is the equation used to calculate cardiac output?

A

Heart rate x Stroke volume

156
Q

What is stroke volume?

A

How much blood the heart pumps each beat

157
Q

Shortness of breath

A

Dyspnea

158
Q

Shortness of breath with lying down

A

Orthopnea

159
Q

Sensation of shortness of breath that awakens

A

Paroxysmal nocturnal dyspnea

160
Q

Periodic breathing

A

Cheyne-stokes respiration

161
Q

Extreme tiredness progress with activity during the day, diminished blood output from heart, mental confusion, disturbed behavior

A

Cardiac Fatigue

162
Q

Bluish discolored of skin/mucous

A

Cyanosis

163
Q

What is the Frank-Starling Mechanism?

A
  • Increases stroke volume by increasing ventricular end-diastolic volume
  • Increase filling causes increased stretching of fibers ~ increase next contraction
164
Q

What are the causes of Heart Failure?

A

Congestion of body tissues. After initial compensatory period

165
Q

Compare Systolic and Diastolic dysfunction

A

Systolic:
Impaired ejection of blood from heart during systole
Decrease cardiac contractility and ejection fraction

Diastolic: 
Due to impaired filling resulting in congestion 
Smaller ventricular chamber size
Ventricular hypertrophy 
Poor ventricular compliance
166
Q

Define left side heart failure

A
  • Failure of left heart to move blood from pulmonary circulation and systemic circulation
  • Blood back up into pulmonary circulation (impairs gas exchange)
167
Q

What tissues are affected left side heart failure?

A 
Pulmonary edema (cough with frothy sputum, orthopnea)
Usually at night
168
Q

What are the causes left side heart failure

A
  • Acute myocardial infarction
  • Cardiomyopathy
  • Stenosis/regurgitation of aortic/mitral valves
  • Rapid infusion of intravenous fluid/blood transfusion
169
Q

Define right side heart failure

A
  • Failure of the right heart to pump deoxygenated blood forward into pulmonary circulation
  • Blood backs up into systemic circulation
170
Q

What tissues are affected right side heart failure

A
  • Lower extremity (Swelling)
  • Liver (Congestion)
  • Spleen (Ascites)
  • GI Tract (Congestion, anorexia)
  • Jugular veins (Distension)
171
Q

What are the causes right side heart failure

A

Conditions that restrict blood flow into lung (stenosis of tricuspid valves, right ventricular infarction, cardiomyopathy)

172
Q

What is congestive heart failure?

A

Heart muscle is weakened and can’t pump as well as it usually does

173
Q

What are the signs and symptoms of heart failure

A
  • Fluid retention/edema
  • Respiratory manifestations
  • Fatigue and limited exercise tolerance
  • Cachexia malnutrition
  • Cyanosis
174
Q

How is CHF treated?

A
  • Correction of reversible causes
  • Surgical repair of ventricular defect or an improperly functioning valve
  • Pharmacologic control of afterload stress
  • Modification of activity/lifestyle consistent with functional limitations of reduce cardiac reserve
  • Use of medications to improve cardiac function
  • Mechanical Aids (Resynchronization, Implantable cardioverter defibrillators, Assist devices, Heart transplant
175
Q

What is acute pulmonary edema?

A

Capillary fluid moves into alveoli, causes lung stiffness, makes lung expansion more difficult and impairs the gas exchange function of the lung

176
Q

What can result from pulmonary edema?

A
  • Shortness of breath
  • Rapid pulse
  • Moist/cool skin
  • Cyanosis
177
Q

What is circulatory failure/Shock?

A

Acute failure of circulatory system to supply the peripheral tissues and organs of the body with adequate blood supply resulting in cellular hypoxia

178
Q

What can cause circulatory failure?

A
  • Decrease in blood volume
  • Obstruction of blood flow
  • Vasodilation with redistribution of blood flow
179
Q

What are the 4 types of shock? Describe each.

A

1) Cardiogenic
Failure of the heart to pump blood adequately

2) Hypovolemic
Diminished blood volume in that there is inadequate filing of the vascular compartment

3) Obstructive
Circulatory shock that results from mechanical obstruction of flow of blood through the central circulation (great veins, heart, lung)

4) Distributive
Loss of blood vessel tone, enlargement of vascular compartment, displacement of vascular volume away from the heart and central circulation

180
Q

What is the clinical course of hypovolemic shock? Describe each stage.

A

1) Initial Stage
Circulatory blood volume is decrease, not enough to cause effects

2) Second (Compensatory) Stage
Blood volume reduce, are able to maintain BP and tissue perfusion enough to prevent tissue damage

3) Third (Progressive) Stage
BP falls, blood flow to brain is impaired, capillary permeability, fluids leaves capillaries, blood flow sluggish

4) Forth (Final) Stage
Irreversible, blood volume may be restored the vital signs stabilized, death ensure eventually

181
Q

What are the 3 types of distributive shock? Include their cause and symptoms.

A

1) Neurogenic
Brain injury, Depressant action of drugs, General anesthesia, Hypoxia, Lack of Glucose
Sx: Heart rate is slower than normal, skin dry/warm

2) Anaphylactic
Immunological reactions
Sx: Sudden dvlp, apprehension, burning sensation, itching, hives, coughing, Drop in BP

3) Septic
Gram-negative Bacterium
Early Sx: Fever, Vasodilation, Warm skin, Mild hyperventilation, Respiratory alkalosis
Late Sx: Hypovolemia (B/c arterial/venous dilation and leakage of plasma into interstitial space)

182
Q

What are the complications of shock?

A

1) Acute respiratory distress syndrome
2) Acute renal failure
3) GI complications
4) Disseminated intravascular coagulation
5) Multiple organ dysfunction syndrome

Path 4 (2 decks)

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