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Patho > Patho Exam 3 > Flashcards

Patho Exam 3 Flashcards

1
Q

What is Aortic regurgitation?

A

Where the aortic valve leaks blood back into LV

-due to an inability of aortic valve leaflets to close properly during diastole

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2
Q

How does aortic regurgitation affect preload and afterload?

A
  • Preload increases due to volume overload from leakage

- Afterload increases bc there is more to pump out of LV from overload of blood

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3
Q

What is Mitral regurgitation?

A

Where the blood in the LV flows back into the LA during systole (contraction)

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4
Q

What are Primary causes of valvular regurgitation?

A
  • congenital

- valve degenerative (in elderly)

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5
Q

What are Secondary causes of valvular regurgitation?

A
  • chronic hypertension
  • rheumatic heart disease
  • bacterial endocarditis
  • syphilis
  • connective tissue disorders
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6
Q

How does mitral regurgitation affect preload and afterload?

A
  • Preload increases bc blood from LV flows back into LA

- Afterload decreases bc there is less blood volume for LV to push out in systole ( due back flow during systole)

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7
Q

What is Tricuspid regurgitation?

A

Where blood leaks back into RA

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8
Q

How does tricuspid regurgitation affect preload and afterload?

A

-Preload and afterload both increase due to volume overload

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9
Q

What is infective endocarditis?

A

inflammation of the endocardium

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10
Q

What are some causes of endocarditis?

A 
Bacteria
Viruses
Fungi
Rickettsiae (small bacteria transmitted by mites, ticks, lice, causes febrile illness)
Parasites
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11
Q

What are the three critical elements in the Pathogenesis of endocarditis?

A

3 Critical Elements:

  1. Damaged endocardium
    - from heart disease, trama etc.
    - endothelial damage causes inflammation
  2. Adherence of blood-borne microorganisms to the damaged endocardial surface
    - bacteria may enter blood stream during dental procedures, cardiac surgery, catheters, IV drug use etc.
  3. Formation of infective endocardial vegetations
    - bacteria and thrombi form lesions via clotting cascade
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12
Q

What are the clinical manifestations of infective endocarditis?

A

Classic findings:

  1. Fever
  2. New or changed cardiac murmur

Characteristic physical findings:

  1. Osler nodes:
    - painful erythematous nodules on the pads of the fingers and toes
  2. Petechial lesions of the skin, conjunctiva, and oral mucosa
    - small red, brown , or purple spots on body
  3. Janeway lesions
    - nonpainful hemorrhagic lesions on the palms and soles

Other: weight loss, back pain, night sweats, and heart failure

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13
Q

What is heart failure?

A

A general term that characterized by any cardiac disorder that results in inadequate CO for adequate tissue perfusion

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14
Q

What is the most common diagnosis upon admission for those 65yrs +?

A

Heart failure

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15
Q

What are the most common risk factors of heart failure?

A 
age
obesity
diabetes
renal failure
valvular heart disease
excessive alcohol use
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16
Q

What is Left heart failure or congestive heart failure?

How is it categorized?

A

This is heart failure characterized by:
-inadequate CO to perfuse vital tissues

Can be categorized by:

  • A reduced ejection fraction <40% (systolic)
  • A preserved ejection fraction (diastolic)
17
Q

What is systolic heart failure?

A

L side heart failure categorized by a reduced EF of < 40%

-due to fact that LV cannot pump with enough force to push blood into circulation (reduce CO)

18
Q

What is ventricular remodeling?

A

This is a change in the shape of fnx of the ventricles of the heart

Causes: MI, myocarditis, cardiomyopathy

  • can cause reduced afterload abilities bc of reduced contraction during systole
  • increases preload due to difficulty expelling blood into circulation
19
Q

What is diastolic heart failure?

A

L side heart failure is defined as pulmonary congestion despite normal stroke volume

Causes: myocardial hypertrophy, ischemia, diabetes, valvular and pericardial disease

20
Q

What are the manifestations of L heart failure?

A
  • pulmonary vascular congestion and inadequate perfusion
  • dyspnea (labored breathing), orthopnea (SOB), cough of frothy sputum, fatigue, decreased urine output, and edema
  • pulmonary edema (cyanosis, inspiratory crackles, pleural effusions), hypotension or hypertension, an S3 gallop, and evidence of underlying CAD or hypertension
21
Q

What is shock?

A

shock is where the cardiovascular system fails to perfuse the tissues adequately so that it impairs cellular metabolism

22
Q

What is multiple organ dysfunction syndrome?

A

This is where two or more organ systems fail after severe illness or injury

23
Q

What are the manifestations of shock?

A
  • hypotension
  • tachycardia
  • increases respirations

Cellular:

  • impaired oxygen use
  • impaired glucose use
24
Q

What is cariogenic shock?

A

Condition where the body cannot meet the bodies needs.

Characterized by:decreased cardiac output & tissue hypoxia

-in presence of adequate intravascular volume

25
Q

What is hypovolemic shock?

A

Loss of blood from hemorrhage

26
Q

How does the body try to compensate for hypovolemic shock?

A

The body tries to retain fluid and produce more blood to make up for the hemorragic blood loss.

  • ADH
  • RASS
  • Spleen makes RBC
  • Increased HR to increase perfusion (dry sponge)
  • Catecholamines (epi, norepi, aldosterone)
27
Q

What is Neurogenic shock? “vasogenic”

A

This is massive widespread vasodilation from:

  • parasyapathetic overstimulation
  • sympathetic understimulation
28
Q

what triggers neurogenic shock?

A

Depressive drugs
Anesthetic agents
Severe emotional stress or pain

29
Q

What are the manifestations of hypovolemic shock?

A
  • lactic acidosis
  • impaired cellular metabolism, nutrient delivery, anaerobic metabolism
  • increased SVR
  • thirst
  • oliguria
  • decreased preload
  • rapid HR
  • thready pulse
  • skin turgor
30
Q

What is Anaphylactic shock?

A

a result from a severe and widespread hypersensitivity reaction to an allergen

  • IgE, (immunoglobulin antibody)
  • vasoactive inflammatory cytokines
31
Q

What are the basic physiologic alterations of anaphylactic and neurogenic shock?

A
  • vasodilation
  • hypovolemia
  • decreased tissue perfusion
  • impaired cellular metabolism
32
Q

What is Septic shock?

A

Shock that stems from infection that progresses to a bacterium the n to systemic inflammatory response syndrome (SIRS)

  • sepsis
  • severe sepsis
  • septic shock
  • multiple organ dysfunction
33
Q

What are the main causes of multiple organ dysfunction?

A

Sepsis or septic shock

-any disease that activates a massive systemic inflammatory response

Patho (1 decks)

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