Module 1.4-1.6

Question 1

What is the definition of heart failure?

Answer 1

When the heart cannot pump blood at a rate that meets the metabolic demands, hence causing a backup of venous blood

Question 2

What is left sided heart failure? (aka MI)

Answer 2

Chronic HTN, L. valve deficits are causes
When the heart loses its ability to pump blood
- affects O2 in body
- Pulmonary congestion, impaired gas exchange, pulmonary oedema, increased HTN
- Cyanosis, orthopnea, frothy cough

Question 3

What is right sided heart failure?

Answer 3

Due to less muscle available therefore less ability to adapt
- decreased blood goes into peripheral tissues due to R ventricle weakened, causes congestion
- increased jugular venous pressure, liver congestion increased, portal vein affected
- systemic oedemas

Question 4

What are the medications used to treat heart failure?

Answer 4

• ACE inhibitors- acts on RAAS system
• Angiotensin II inhibitors- inhibits aldosterone release
• Diuretics- alleviate fluid overload to dec. BP
• Beta blockers- blocks b receptors on heart to dec HR and contractility

Question 5

What are causes of left sided heart failure in regards to afterload, preload and contractility?

Answer 5

AL: systemic HTN, aortic stenosis, AV stenosis
Contractility: MI, myopathy, infection and drugs
PL: Hypervolemia and leaky valve for inc. Mitral stenosis and anemia for dec.

Question 6

What are causes of right sided heart failure in regards to afterload, preload and contractility?

Answer 6

AL: COPD, L sided HF, pulmonary embolus
Contractility: MI infection, drugs, pericarditis
PL: hypervolemia, leaky valve, shunting inc. tricuspid stenosis and hypovolemia for dec.

Question 7

What is anaemia?

Answer 7

A reduction in the number of hameoglobin due to a dec. production of RBC and BP, inc erythrocyte production and dec. o2 capability

Question 8

What is the pathophysiology of RBC production?

Answer 8

• Haemopoetic stem cells in marrow creates RBC
• Pro-erythroblast turns into reticularcyte, still requires Hb, B9 and 12 and amino acids to be full RBC
• Reticularcyte condenses and pops out DNA and becomes mature RBC

Question 9

What is polycythemias?

Answer 9

Overproduction of RBC and erythrocytes
- causes neoplasm disorder

Question 10

What is the difference between macro, micro and normocytic disorders?
(Hint: cell size)

Answer 10

Marco: pernicious and folate-deficiency disorders
- B9 and B12 deficiency
Micro: iron-deficiency and thalassaemias
- issue with haem construction
Normo: Aplastic, haemolytic, and sickle cell anaemias
- loss/haemolysis

Question 11

What is the consequences of oxygen deficit?

Answer 11

• less energy production
• compensation for this includes tachycardia and peripheral vasoconstriction
• signs of anaemia (fatigue, pallor, dyspnoea)
• leads to angina, or hear failure

Question 12

What are medications used to treat anaemia?

Answer 12

• antiplatelets: aspirin and clopidogrel
• anticoagulants: hep (inhibits coag cascade) and warfarin (inihibits clotting factors)

Question 13

What is leukemia?

Answer 13

Malignant disorder of WBC that blocks or impairs differentiation of haemopoetic stem cells leading to several tumour cells circulating blood

Question 14

What is lymphoma?

Answer 14

malignancies of lymphoid and progenitor cells that don’t include bone marrow and are measured by the proliferation of these cells **

Question 15

What is the difference between Hodgkins and non-hodgkins lymphoma?

Answer 15

Hodgkins: presence of large lymphocytes, painless masses, T cell involvement
Non-hodgkins: low level of lymphocytes, painful, B-cell involvement

Question 16

What is the difference between acute and chronic luekaemia? ALL AND CLL

Answer 16

Acute: high amount of immature blast cells in circulation, onset is abrupt
Chronic: higher proportion of mature cells but reduced fuction, mild signs and better prognosis