Patho Unit 6 Flashcards

Question

FSH

Answer 1

Ova/Sperm development and production

Answer 2

Causes maturation of uterine lining, testosterone production, and ovulation

Answer 3

Stimulates release of Prolactin (PRL) from the Anterior Pituitary

Answer 4

Causes Lactation of mammary glands

Answer 5

Caused by infarction of the gland, removal/destruction of pituitary, space occupying adenomas, aneurysms that cause compression - Effects depend on the affected hormone

Answer 6

Absence of all hormones from the Anterior Pituitary | - Treatment may consist of replacing HGH, ACTH, TSH, and sex hormones

Answer 7

Results from insufficient HGH release during an individual's growth phase - Patient has normal face and intelligence, with normal body proportions

Answer 8

Caused by a Pituitary Adenoma - Excess HGH is released during an individual's growth phase - Now fairly rare because of early detection of Adenomas

Answer 9

Excess HGH is release during adulthood - Causes enlargement and elongation of the bones of the face jaw, cheeks, and hands - The long bones of the extremities are unaffected because the growth plates are closed - With bony and soft tissue overgrowth, nerves can be entrapped - Patient may demonstrate muscle weakness, foot drop, and sensory changes - Increase in the size and function of sebaceous and sweat glands (acne and increased body odor)

Answer 10

``` Secretes Thyroxine (T4) and Triiodothyronine (T3) - Stores a 100 day supply of hormones in sacs that make up most of the gland ```

Answer 11

- Regulate Oxygen use - Increase Basal Metabolic Rate (BMR) - Increase cellular carbohydrate and protein catabolism - Increase reactivity of the nervous system - Along with HGH, controls tissue growth and development

Answer 12

Most common, it can be a primary abnormality or appear secondary to another disorder - BMR decreased - Sympathetic Response decreased - Weight gain - Temperature tolerance: cold intolerance, decreased sweating - GI function: constipation, decreased appetite - Cardiac Function: low output, Bradycardia - Respiratory function: Hypoventilation - Muscle/tone reflexes decreased - Appearance: Myxedematous - General behavior: mental retardation (infants), mental and physical sluggishness

Answer 13

- BMR increased - Sympathetic Response increased - Weight loss - Temperature tolerance: heat intolerance, increased sweating - GI function: diarrhea - Cardiac Function: increased output, Tachycardia - Respiratory function: Dyspnea - Muscle/tone reflexes increased - Appearance: enlarged thyroid, decreased blinking - General behavior: restlessness, irritable, anxiety, wakefulness

Answer 14

An enlarged Thyroid Gland due to increased demand for Thyroid Hormones, or anything that causes and increase of TSH - Can occur in states of Euthyroid, Hypothyroidism, and Hyperthyroidism - Common causes include I2 deficiency, viral or genetic disease, puberty, and pregnancy

Answer 15

An autoimmune disorder where antibodies are made against TSH Receptors of Thyroid Cells - Antibodies act as TSH Receptor agonists (turn on the production of Thyroxin) - Excess Thyroxin secretion leads to Thyrotoxicosis (symptomatic HYPERTHYROIDISM) - Signs: diminished body weight, Exophthalmos (bulging eyes) due to periorbital connective deposition

Answer 16

A very dangerous worsening of the Thyrotoxic State - Rare, but still dangerous - Manifests as Hyperthermia, Tachycardia, nausea and vomiting, diarrhea, high-output heart failure, agitation, delirium - If untreated, patient can die within 48 hours - Treatment: prevent patient from becoming Hyperthyroid in the first place by blocking hormone production or ablating the gland (surgery or radiation)

Answer 17

Autoimmune destruction of the Thyroid Gland | - Primary Hypothyroid abnormality

Answer 18

- Toxic Thyroiditis from a bacterial infection of the Thyroid - Complication of Thyroid surgery

Answer 19

A rare but serious form of severe HYPOTHYROIDISM that results from prolonged insufficient Thyroxin during adulthood - The "Myxedema" comes from deposition of connective tissue fibers separated by excessive protein and mucopolysaccharides (these bind to water, causing boggy edema) - Results in brittle hair, dry skin (decreased perspiration and sebaceous gland secretion), lethargy, low BMR (temp and heart rate), gain weight easily

Answer 20

A CNS-Cardiovascular complication of the disease presenting as Hypothermia (no shivering), Hypoventilation, Hypotension, Hypoglycemia, Lactic Acidosis, and deterioration of mental status - Medical emergency, and if not promptly treated will result in permanent brain damage or death

Answer 21

- Congenital Hypothyroidism results from inadequate Thyroid Hormone during Intrauterine growth - Signs and Symptoms include lethargy, hypothermia, and bradycardia - Because Thyroid Hormones effect HGH, patient also has stunted growth, abdominal protrusion and umbilical hernia

Answer 22

Parathyroid Hormone (PTH) is secreted when the plasma Ca++ is low - Increases absorption of Ca++ from the GI tract, reabsorption from the kidneys and stimulates the release of Ca++ from bone (Osteoclast activity) - Osteoclast activity is a negative feedback with the Osteoblastic activity of Calcitonin (from the Thyroid) and doesn't involve the Pituitary

Answer 23

80-85% of cases are caused by Parathyroid Adenomas, but it can also be caused by a compensatory response to Hypocalcemia Hyperparathyroidism causes: - Increased Osteoclast activity - Fragile bones with fractures and abnormal curvatures and bone pain - High plasma calcium levels can lead to a number of systemic problems

Answer 24

Commonly caused by damage to the Parathyroid Glands during thyroid surgery Signs and Symptoms: - Tetany (muscle spasms due to low plasma Ca++ which lowers the threshold for nerve signals to muscle contraction) - Patients are treated with oral calcium and vitamin D - Can cause Hypoplastic Dentin, bone deformation, and basal ganglia calcifications

Answer 25

- 2 types: Type I and Type II - Signs and symptoms include Polydipsia, Polyuria, and Polyphagia Diagnosis: - More than one fasting glucose level above 126 mg/dl - 2-hour glucose tolerance test >200 mg/dl - Random blood glucose >200 mg/dl - Elevated levels of HbA1c

Answer 26

Typically an immune disease of children, with DESTRUCTION OF THE INSULIN PRODUCING β-ISLETS of the pancreas - Genetic factor plus a "trigger" of some sort (virus, food, chemical, or drug). The exact mechanism isn't known - As β-cells are gradually destroyed insulin levels fall and blood sugar levels rise - Usually diagnosed under 30 years of age

Answer 27

Genetic susceptibility is greater than Type I, but it is also triggered by environmental factors such as obesity - Usually develops after 45 years of age - The biggest problem is INSULIN RESISTANCE at the cellular level - Glucose accumulates in the blood but cannot be properly used by cells - Almost all associated with metabolic syndrome (Hyperglycemia, Hypertension, Dyslipidemea, truncal obesity)

Answer 28

Used to measure long term blood glucose control - Increased blood glucose plus insulin resistance, over a long period of time, leads to sugar being deposited on hemoglobin A molecules (HbA1c) - Should be around 5%

Answer 29

Blood glucose levels <60 mg/dl, and is related to activation of the sympathetic nervous system, cessation of glucose delivery to the brain, or both - Frequent occurrence in diabetics - especially those on insulin - Rapid onset - Patients are diaphoretic and appear weak, anxious, and confused - Treatment includes fast-acting carbohydrate solution (Coke/Orange juice), intravenous infusions of dextrose containing fluids, or an injection of glucagon

Answer 30

Due to a complete lack of insulin, Type I diabetics catabolize fatty acids as a source of energy when glucose is unavailable producing Keto acids - Nausea, vomiting, comatose, irritable, general diabetic symptoms - Dry, hot, flushed skin and mucous membranes - Glucose level >300 mg/dl - Treatment: insulin, electrolyte and fluid replacement

Answer 31

A condition that manifests as extremely elevated blood glucose levels >700 mg/dl, without acidosis - Usually comes on slowly, most often in elderly patients with Type II DM - Differs from DKA because of the presence of some small amount of insulin, so no Ketosis develops - Dehydration can be severe

Answer 32

- Hypoglycemia - Insulin Shock - DKA - HHNKS

Answer 33

- Microvascular Disease - Macrovascular Disease - Peripheral Neuropathy - Infections - Retinopathy (blindness; leading cause) - Nephropathy (leading cause)

Answer 34

A thickening of the capillary basement membrane; leading to decreased perfusion of tissues

Answer 35

Manifests as a 2-4 fold increase in heart disease

Answer 36

Results from multiple metabolic, genetic, and environmental factors, with over 60-70% of patients showing some form of nerve damage

Answer 37

- Glucocorticoids - Mineralocorticoids - Gonadocorticoids

Answer 38

- CORTISOL regulates metabolism by promoting the breakdown of proteins and fats, and the formation of glucose - This raises blood glucose levels and helps the body deal with stress - Powerful anti-inflammatory agents and they also possess immune suppressive properties

Answer 39

EXCESS CORTISOL usually caused by a tumor of the adrenal gland or a tumor causing excess secretion of ACTH - Develops from excess EXOGENOUS Glucocorticoids - Causes fat redistribution (moon face, buffalo hump, and a hanging abdomen) - Patients also exhibit slow wound healing, Hyperglycemia, acne, Osteoporosis, and susceptibility to infections

Answer 40

Aldosterone is the body's main mineralcordicoid, regulates water and electrolytes (Na+ and K+) - Conserves Na+ and H2O but promotes the excretion of H+ and K+

Answer 41

Primary Hyperaldosteroneism - Results from excessive aldosterone secretion usually as the result of a tumor in the adrenal cortex - Kidneys respond by conserving Na+ and H2O while wasting K+ - Signs and Symptoms: hypertension, and hypokalemia from renal K+ wasting with its attendant neuromuscular irritability (twitching and cramps)

Answer 42

Hypersecretion of weak androgens (DHEA) | - In women DHEA is masculinizing, causing deep voice and increased body hair

Answer 43

Adrenogenital Syndromes; congenital adrenal hyperplasia - Rare, congenital syndromes - A group of autosomal recessive conditions that lead to deficiency of an enzyme needed to make Cortisol - In an attempt to compensate, the pituitary produces high levels of ACTH, which results in overproduction of certain intermediary Androgens - These hormones have Testosterone-like effects on the fetus and child leading to virilization

Answer 44

The clitoris is enlarged, and may resemble the male penis to the point that the sex of the child is questioned or mistake

Answer 45

May have enlarged penile size, but the problem may go undetected - During development the Androgens may lead to early puberty, with a deep voice and increased body hair

Answer 46

Hypersecretion of estrogens | - In men Estrogens are feminizing, causing development of female secondary sex characteristics

Answer 47

Results from the autoimmune destruction of the adrenal cortex - Leads to hyposecretion of Cortisol and Aldosterone - Signs and Symptoms: weight loss, Na+ loss and hyponatremia, K+ retention and hyperkalemia, muscle weakness, dehydration, hypotension, and hypoglycemia

Answer 48

- Secretions are part of the sympathetic nervous system - Epinephrine and Norepinephrine - Innervated by sympathetic preganglionics - Acts similar to a sympathetic postganglionic neuron - The secretions of the medulla duplicate and prolong the sympathetic response

Answer 49

A benign tumor of medullary cells, and is the only common disorder of this part of the Adrenal Medulla - Results in increased secretion of high levels of Medullary Catecholamines, producing an exaggerated (and often dangerous) sympathetic response - Signs and Symptoms: malignant hypertension, tachycardia, palpitations, and other dysrhythmias, anxiety can sometimes be very severe and disconcerting

Answer 50

- A person experiences stress when a demand exceeds a person's coping abilities - Stress begins with a stimulus that the brain perceives as stressful and in turn promotes adaptational and survival-related physiologic responses - These responses can become dysregulated and cause pathophysiology

Answer 51

Demand exceeds a person's coping abilities

Answer 52

Individual differences - Genes, development, experience Behavioral responses - Fight or flight, personal behavior: diet, smoking, drinking, exercise Physiologic response

Answer 53

- Alarm stage - Resistance (adaptation) stage - Exhaustion stage

Answer 54

Activation of the CNS - Sympathetic response - Norepinephrine - Increased cardiac output - Increased BP - Promote Hyperglycemia - Cause vasoconstriction of vessels in skin, viscera, extremities, and kidneys - Causes vasodilation of vessels in the heart, skeletal muscles and the smooth muscle of bronchi

Answer 55

Activation of the Sympathetic Nervous System causes the Hypothalamus to stimulate the Pituitary Gland resulting in: - The adrenal cortex increases ACTH release (controls Aldosterone and Cortisol) - The adrenal medulla secretes epinephrine and norepinephrine - The pituitary gland secretes TSH - Increased secretion of HGH - Increased release of ADH from posterior pituitary

Answer 56

- Increases protein catabolism, hyperglycemia, promotes gluconeogenesis in liver cells, and delays the healing process - Promotes lipolysis in adipose tissue (especially in the extremities), increases gastric secretion, anti-inflammatory effects - Althogh there is an increase in antibody formation, there is an overall decrease in the immune response (decline in lymphocytes)

Answer 57

Increased Thyroxin (increased Basal Metabolic Rate)

Answer 58

- Increases NA+ and water retention | - Increases blood volume and pressure

Answer 59

- Water retention | - Increases blood volume and pressure

Answer 60

``` With continuous uncompensated stress, disease can result: Cardiovascular System - coronary artery disease - hypertension - stroke - arrhythmias Muscular System - tension headache - muscle contractions (spasms) Connective Tissues - rheumatoid arthritis - inflammatory diseases of connective tissue ```

Answer 61

A clot that forms in a blood vessel and remains attached - Can occlude vessels and cause ischemia or infarction of organs - Located in veins, systemic and coronary arteries - Cause: conditions encourage activation of the coagulation cascade (roughing of vessel wall, stasis or pooling of blood, infectious agents)

Answer 62

Thrombi form in veins, with associated inflammation

Answer 63

Due to endocardial inflammation or rheumatic fever

Answer 64

Obstruction of a vessel by moving chunk of material

Answer 65

Thrombi which break loose and travel to another site

Answer 66

Air bubble from injection, punctured lung, or open vessel

Answer 67

- Hip replacement surgery | - Broken bone

Answer 68

Usually arise from thrombophlebitis of veins in lower extremity

Answer 69

Originate in the left circulation - Left heart: thrombi after MI, Endocarditis, or Dysrhythmias - Renal Emboli - Mesenteric Emboli - Coronary Emboli - Cerebral Emboli

Answer 70

- Administration of anticoagulants to prevent clot formation: Aspirin, Heparin, Warfarin - Clot Busters - Slow or stop thrombus growth (aggressive reversal of risk factors)

Answer 71

Distended, tortuous, and palpable - Caused by damage to one or more venous valves due to standing for extended periods of time and the contributing force of gravity - A damage valve permits back flow of blood (venous incompetence) and distended veins - Because vein becomes swollen, the surrounding tissues become edematous - Can progress to chronic venous insufficiency

Answer 72

With age, deep veins become susceptible to thrombi (Deep Vein Thrombosis) - DVT is often asymptomatic, but can lead to pulmonary emboli - Treatment: thrombolytics, anti-embolism stockings, avoid prolonged sitting/immobility

Answer 73

Caused by increase in cardiac output, total peripheral resistance or both - Cardiac output: increase in heart rate or stroke volume - Peripheral resistance: increase in blood viscosity or reduction in vessel diameter, total length of vessels - Types: primary, secondary, and complicated

Answer 74

The cause is unknown (multifactorial) - 90-95% of patients - Contributing factors: family history, age, gender, race, diet, diabetes, obesity, cigarettes, heavy alcohol consumption

Answer 75

- Renal vascular stenosis - Renin-producing tumors - Renal failure - Primary sodium retention

Answer 76

- Acromegaly | - Thyroid/Adrenal disorders

Answer 77

- Arteriosclerosis | - Constriction of the aorta

Answer 78

- Pre-eclampsia | - Eclampsia

Answer 79

- Epinephrine - Norepinephrine - Glucocorticoids (cortisol)

Answer 80

Demonstrates pathologic effects beyond hemodynamic alterations - Vascular remodeling (smooth muscle hypertrophy) - Hypoperfusion: heart, kidneys, eyes and brain - Examples: aneurysm rupture, arteriosclerosis, vessel occlusion, uremia, left ventricular enlargement

Answer 81

Eliminating risk factors Pharmacologic: - Diuretics: decrease blood volume and cardiac output - ACE inhibitors and Angiotensin II RC Blockers: block the renin-angiotensin-aldosterone system - Drugs which relax blood vessel smooth muscle: Ca++ channel blockers prevents smooth muscle contraction Beta-blockers block catecholamines effects at beta-adrenergic RCS

Answer 82

- Decrease in systolic and diastolic arterial blood pressure upon standing from a reclining position - The vasoconstrictive response to changing blood pressure and blood flow is inadequate, and dizziness results - Causes: age, drugs (antihypertensive and antidepressant therapy), volume depletion, prolonged immobility (chronic illness), starvation, physical exhaustion

Answer 83

A dilation or pouching of a vessel wall or cardiac chamber - As tension increases, the wall becomes thinner - True aneurysms involve all three layers - 2 types: Saccular/Berry, Fusiform

Answer 84

A chronic disease of the arterial system, characterized by abnormal hardening and thickening of the vessel walls - Smooth muscle cells and collagen fibers migrate into the tunica interna, causing it to stiffen and thicken - This restricts the artery's ability to change lumen size (increased vascular resistance)

Answer 85

A form of arteriosclerosis; inflammatory disease - Thickening and hardening of the vessel walls are caused by deposits of intra-arterial fat (LDL cholesterol) and fibrin that harden over time - Not a single disease; it varies depending on location, age, and genetics

Answer 86

1- Endothelial injury 2- Fatty streak 3- Fibrous plaque 4- Complicated lesion

Answer 87

Endothelial Injury - Smoking, high cholesterol, hypertension Endothelial cells - Decreased release of antithrombotic and vasodilating cytokines - Increased release of inflammatory cytokines (TNF, interferon, and interleukins) - Increased release of growth factors (smooth muscle proliferates)

Answer 88

Macrophages adhere to the injured endothelium - Release enzymes and toxic oxygen free radicals - Free radicals oxidize low density lipoprotein (LDL) - This oxidized LDL is toxic to endothelial cells

Answer 89

Fatty Streak: an accumulation of Foam Cells - Macrophages engulf oxidized LDL - The macrophages filled with oxidized LDL are called Foam Cells - These produce even more oxygen free radicals

Answer 90

The Fibrous Plaque - Under the influence of growth factors, smooth muscle cells proliferate - Smooth muscle migrates over the fatty streak, forming a cap (Fibrous Plaque)

Answer 91

Complicated Lesion - Fibrous Plaques aren't stable: ulcerations, calcifications, apoptosis causes rupture - Platelets now have an adherence site and become activated

Answer 92

An inflammatory autoimmune disease of the peripheral arteries of the hands and feet resulting in the formation of Non-Atherosclerotic lesions which obliterate the vessel - Causes pain and hair loss (not on the head) in young men who use tobacco - Progresses to ulcers and gangrenous lesions of fingers/toes

Answer 93

A primary vasospastic disorder of unknown etiology causing episodic vasospasm in arteries of the fingers, and less commonly the toes (pallor/cyanosis) - Vasospasms cause pallor, numbness, and cold sensations in the digits - Cyanosis can also appear - There is a cycle of pallor, cyanosis, the rubor due to vasospasm, followed by relaxation - Treatment is to remove the stimulus

Answer 94

The same as Raynaud Disease, but it is secondary to other systemic diseases - Collagen vascular disease (scleroderma), smoking, pulmonary hypertension, and environmental factors (cold, prolonged exposure to vibrating machinery)

Answer 95

Diminishes the myocardial blood supply Can lead to: - Reversible myocardial ischemia (angina) - Irreversible myocardial infarction and death - Both inhibit and pumping ability of the heart (either temporary or permanent) due to lack of O2 and nutrients

Answer 96

``` Major - Increased age - Family history - Males or post menopausal females Modifiable - Dyslipidemia - Hypertension - Cigarette smoking - Diabetes mellitus - Obesity/sedentary lifestyle - Atherogenic diet ```

Answer 97

- Most commonly caused by atherosclerosis - Mass of plaque, platelets, fibrin and debris eventually narrows the artery lumen - Vasoconstriction encourages symptoms

Answer 98

An ischemia without pain | - Especially in diabetics

Answer 99

Death of heart muscle - Myocardial cells become ischemic within 10 seconds of a blockage - Cells remain viable for 20 minutes - If the arteries can't compensate for lack of O2, myocardial infarction is the result

Answer 100

- Variable and depend on the location and extent of necrosis - Dysrhythmias - Pulmonary congestion - Reduced myocardial contractility - Inflammation of the pericardium - Pain - Fever - Pleural effusion - Pulmonary emboli and strokes

Answer 101

When pericardial membranes become inflamed, and may produce an exudate - Usually a local manifestation of another disorder - Signs and symptoms: "Pleuritic" chest pain, pericardial "friction rub" - Treatment: analgesics and NSAIDs

Answer 102

Worsens with respiratory movements

Answer 103

An accumulation of fluid in the pericardial cavity accompanying all types of pericarditis - Signs and symptoms depend on severity and range from mild, pleuritic chest pain to compression of the heart causing reduced cardiac output, hypotension and even death

Answer 104

Occurs when the pressure from the pericardial fluid equals the diastolic filling pressure - In situations of severe trauma, a large pericardial effusion of fluid or blood cal lead to a serious compression of the heart - Right side of heart effected first - Treatment: emergency pericardiocentesis

Answer 105

- Fibrous scarring with possible calcification of the pericardium causes the visceral and pericardial layers to adhere to one another - Slower and more insidious onset and progression than Tamponade - Heart becomes constricted and reduces the cardiac output - Surgical removal of the pericardium may be required

Answer 106

Diseases that affect the myocardium - Often the results of infarction, longstanding hypertension, infections, toxins, connective tissue diseases, proliferative disorders or nutritional deficiencies - Categories: Ischemic, Hypertrophic, Restrictive, and Dilated

Answer 107

Thickening of the myocardium, often a result of hypertension and valve disease

Answer 108

- Due to infiltrative disease - The ventricular walls are excessively rigid and impede ventricular filling - No thickening of myocardium - Another common cause of heart failure in many under-developed countries

Answer 109

Ischemic is the most common type - Remodeling due to overfilling and weak myocardial contractions - Enlarging of heart without thickening of myocardium - Often the end result of the other cardiomyopathies

Answer 110

When any valve orifice is constricted or narrowed - The stenosis increases the workload of the chamber behind the valve and causes myocardial hypertrophy - Caused by calcification of degeneration of a valve

Answer 111

Most common - Aortic Stenosis - Mitral Stenosis

Answer 112

- Low stroke volume - Left ventricular hypertrophy - Systolic murmur

Answer 113

- Left atrial dilation - Pulmonary hypertension - Most commonly caused by acute rheumatic fever - 2-3x more common in women - Diastolic murmur

Answer 114

AKA valvular insufficiency or incompetence - When the cusps/leaflets of the valves fail to close, it permits backflow of blood during systole - Increased workload of pumping the blood "twice" causes myocardial HYPERTROPHY - All 4 valves can be affected, but the left valves are most common

Answer 115

- Widened pulse pressure - Dyspnea - Throbbing peripheral pulse - Diastolic murmur (backflow during diastole) - Dysrhythmias and endocarditis are common complications

Answer 116

- Pulmonary HTN - Systolic murmur (backflow during systole) - Left and right ventricle failure

Answer 117

- Right heart failure - Edema - Systolic murmur (backflow during systole)

Answer 118

Autosomal dominant disorder where the anterior and posterior mitral cusps prolapse into the left atrium during left ventricular systole - Usually asymptomatic - Can cause endocarditis, chest pain, and dysrhythmias - In severe cases, signs and symptoms are similar to those of mitral regurgitation

Answer 119

Hypersensitivity reaction (type II) that occurs in 1-3% of cases of untreated strep infections - Manifests as a systemic inflammatory attack on the heart and many other tissues in the body - Carditis of all 3 layers of the heart wall - Inflammation of the endocardium - Vegetative growths on valves and granulomas in the myocardium - Signs and symptoms: fever, lymphadenopathy, chorea, truncal rash, high anti-streptolysin O titer, leukocytosis, elevated C-reactive protein, and ECG abnormalities

Answer 120

Inflammation of the endocardium - Caused by Streptococci, Staphylococci, viruses, fungi, or Rickettsiae that enter the bloodstream - Risk factors: prior endothelial damage to valves, mitral valve, prolapse, prosthetic valves, septal defects, microbial colonization to damaged valve, adherence of microbes to form endocardial vegetations - IV drug abuse is the most common risk factor

Answer 121

- Fever - Lymphadenopathy - Chorea - Truncal rash - High anti-streptolysin O titer - Leukocytosis - Elevated C-reactive protein - ECG abnormalities

Answer 122

- Fever - Cardiac murmur - Positive blood cultures - ECG abnormalities - Treatment: long-term anti-microbial therapy, prophylactic antibiotics for procedures that increase risk bacteremia

Answer 123

Classified by abnormalities of rate or rhythm - Can cause heart failure due to impairment of normal heart pumping - Hypotension, dizziness, chest pain, feeling of impending doom

Answer 124

- Decreased ventricular filling leads to 20% drop in cardiac output - Risk of blood clot embolisms - Treated by cardioversion or with "watchful waiting"

Answer 125

- Refers to any rhythm faster than 100 bpm arising distal from the AV bundle - Usually hemodynamically unstable and required immediate treatment (usually cardiversion)

Answer 126

A dysfunction of cardiac muscle contractility that results in inadequate cardiac output and hypoperfusion of tissues - Failure of ventricle is failure of the pump - Left sided (most common): congestive heart failure - Right sided (less common): cor pulmonale

Answer 127

Failure of left ventricle leads to disorders of the lungs and pulmonary vessels Manifestations: - Fatigue - Dyspnea - Pulmonary edema, orthopnea, and a cough with frothy, blood-tinged discharge - Cyanosis - Rales (crackles)

Answer 128

``` Right-sided heart failure leads to systemic problems Manifestations: - Fatigue - Ascites (accumulation of fluid in abdominal cavity) - GI disorders - Liver and spleen enlargement - Cyanosis - Distended jugular veins - Elevated venous pressure - Peripheral and systemic edema ```

Answer 129

Anything that causes hypoperfusion of the vital organs, and will progress to death unless there is compensation for the abnormalities - General symptoms: "feeling sick", weak, cold and hot simultaneously, nauseated, dizzy, confused, thirsty, and short of breath - Clinical signs: decreased blood pressure, decreased cardiac output, and decreased urinary output

Answer 130

The heart isn't working - Ischemia - MI - Myocardial or Pericardial infections - Dysrhythmias

Answer 131

Insufficient intravascular fluid volume from loss of whole blood, blood plasma, interstitial fluid, or fluid sequestration outside the arterial vasculature

Answer 132

Widespread vasodilation from parasympathetic overstimulation and sympathetic understimulation - Causes: trauma to the spinal cord or medulla, depressive drugs, anesthetic agents, and severe emotional stress and pain - Persistant vasodilation causing RELATIVE HYPOVOLEMIA

Answer 133

Widespread Type I hypersensitivity reaction leading to vasodilation - Also causes relative hypovolemia

Answer 134

Bacteremia - Endotoxins and Exotoxins cause the host to initiate a sever inflammatory process leading to widespread vasodilation and vascular collapse - Also causing relative hypovolemia

Answer 135

Progressive dysfunction of 2 or more organ systems resulting from an uncontrolled inflammatory response to sever illness or injury - Most common cause of mortality in intensive care units - Most common cause is sepsis and septic shock - Other triggers: severe trauma, burns, acute pancreatitis, obstetric complications, major surgery, circulatory shock, some drugs, and gangrenous or necrotic tissue

Answer 136

Often a predictable pattern - After inciting event, patient develops a low-grade fever, tachycardia, dyspnea, altered mental status, and hyperdynamic and hypermetabolic stress - Lung often 1st organ to fail resulting in tachypnea, pulmonary edema with crackles and hypoxemia

Answer 137

- Inflammatory responses are triggered damaging the vascular endothelium - Endothelium leaks fluid and protein into interstitial space resulting in hypotension and hypoperfusion - Damaged endothelium activates platelets and tissue thromboplastin leading to systemic microvasculature coagulation that may lead to DIC - Complement, coagulation, and kinin systems are activated leading to a hyperinflammatory and hypercoagulative state (interstitial edema, cardiovascular instability, endothelial damage, and clotting abnormalities) - Decreased O2 delivery - Hypermetabolism starts as a compensatory mechanism but leads to consumption of needed O2 to cells

Answer 138

Beginning of Liver and Renal failure - Jaundice, abdominal distention, hepatic encephalopathy - Oliguria, uremia, and edema

Answer 139

Liver and Renal failure progress - Gi system involvement with damage to the gut mucosa - Bacteria and toxins move into the portal and systemic systems - Hematologic and myocardial failure follow - Death may occur from 14 days to several weeks after inciting event - Mortality 30-100%

Answer 140

- Developing fetus has special circulatory requirements because their lungs, kidneys and digestive tract are non-functional - Fetus derives its oxygen and nutrients and eliminates wastes through the maternal blood supply by way of the placenta - Normally there is no maternal/fetal mixing - The fetus is dependent on capillary exchange

Answer 141

- Placenta - Umbilical vein - Ductus venosus between umbilical vein and inferior vena cava (bypasses the liver) - Inferior vena cava to heart (foramen ovale bypasses the lungs, ductus arteriosus bypasses the lungs) - Aorta - Umbilical arteries

Answer 142

- Numerous causes - Most critical time is embryonic week 3 to week 8 - Right to Left shunts result in hypoxia and cyanosis - Left to Right shunts result in overload of pulmonary hypertension and right heart failure

Answer 143

Failure of the Dutus Arteriosus to close within the 1st few weeks of life - This increases the pressure in the pulmonary trunk and overworks the ventricles - Blood flows from the aorta (high pressure) to lower pressure pulmonary artery (left to right) - Patients present with a murmur and pulmonary vascular obstructive disease

Answer 144

- Failure of interatrial septum to properly form - Left to right shunt - Cardiomegaly and pulmonary vascular congestion will be a result

Answer 145

Foramen Ovale fails to close - Not a congenital heart defect, because foramen ovale is a normal structure - Usually asymptomatic

Answer 146

Defect in the intraventricular septum - Most common type of congenital heart defect - In large VSDs, pressures become equal, blood flows into the right ventricle due to systemic pressures, and large amounts of blood flow into the pulmonary vessels - Contributes to enlargement of the left ventricle

Answer 147

1- Pulmonary valve stenosis: blocks normal blood flow to lungs 2- Overriding aorta: emerges from both ventricles 3- Ventricular septal defect 4- Right ventricular hypertrophy The patient is often kept alive only because of mixing of blood in what turns out to be a common ventricle

Answer 148

- Congenital malformation causing narrowing of the aorta - If the defect occurs near the ductus arteriosus, it will cause increased blood flow to the head and upper extremities and a decreased blood flow in the lower extremities - Left heart failure is a potential result

Answer 149

A switch between the pulmonary and the systemic circulation - Aorta emerges from the right ventricle - Pulmonary artery emerges from the left ventricle - 2 completely separate pump systems where the blood never mixes - Right side pumps blood from the body back to the body - Left side pumps blood from lungs back to lungs - Without septal defects to allow some mixing of blood, this would be incompatible with life

Patho Unit 6 Flashcards

Understand: - Alterations of Hormonal Regulation (Ch 18) - Stress and Disease (Ch 8) - Alterations of Cardiovascular Function (Ch 23) - Alterations of Cardiovascular Function in Children (Ch 24)