Responses to Pathological Situations

Question 1

systemic hypoxemia is

Answer 1

Subnormal partial pressure of O2 in the arterial blood

Question 2

Causes of hypoxemia

Answer 2

1) high altitude
2) asphyxiation
3) lung pathology (chronic emphysema, pulmonary edema)
4) right-to-left shunts cong. heart defects

Question 3

Humans respond to arterial hypoxemia w/ 3 primary compensatory changes

Answer 3

1) resting hyperventilation
2) increased cardiac output
3) peripheral vasodilation

Question 4

Clinical shock (definition)

Answer 4

potentially fatal, pathophysiological disorder characterized by acute failure of the cardiovascular system to perfuse the tissues of the body adequately.

Question 5

Clinical signs of Shock

Answer 5

1) pale, cold, sweaty skin; venoconstricted
2) weak & rapid pulse
3) reduced pulse pressure
4) rapid & shallow breathing
5) reduced urine output
6) reduced mental awareness/confusion, muscle weakness, collapse

Question 6

4 Categories of clinical shock

Answer 6

1) hypovolemic shock
2) cardiogenic shock
3) septic shock
4) anaphylactic shock

Question 7

Causes of hypovolemic shock

Answer 7

fall in circulating blood or plasma volume.

• hemorrhage
• diarrhea
• vomiting
• dehydration
• extensive burns
• crush injuries
• pancreatitis

Question 8

Signs of hypovolemic shock

Answer 8

• increases systemic vascular resistance
• poor skin turgor
• thirst
• oliguria
• low systemic & pulmonary preloads
• rapid heart rate

Question 9

Cardiogenic shock

Answer 9

acute impairment of cardiac function by myocardial infarction, myocarditis, or arrhythmia

Question 10

signs of cardiogenic shock

Answer 10

• ekg changes
• cool,clammy skin
• hypotension
• decrease in urinary output
• need for O2 supplementation

Question 11

Septic shock

Answer 11

cardiovascular toxins, such as endotoxin from bacterial infection.

Question 12

signs & symptoms of septic shock

Answer 12

• warm and cold phase
• altered mental status
• high fever
• tachycardia
• increased respiration
• elevated WBC
• hypotension
• decreased urinary output

Question 13

anaphylactic shock

Answer 13

intense allergic reaction to antigens to which the patient has become sensitized, such as foodstuffs, insect bites, antibiotics.

Question 14

Fainting (syncope)

Answer 14

sudden, transient loss of consciousness. Abrupt fall in arterial blood pressure.

Question 15

Fainting can be caused by:

Answer 15

1) hemodynamic stress such as hypovolemia
2) postural hypotension
3) paroxysmal coughing
4) exercise w/ aortic valve stenosis
5) emotional stress such as fear or horror

Question 16

clinical hypertension

Answer 16

most common chronic disease; progressive, raised arterial blood pressure.

Question 17

essential hypertension

Answer 17

hypertension without an obvious predisposing organic cause

Question 18

benign essential hypertension

Answer 18

almost symptomless, found during routine check-ups, predisposing factors: dietary salt intake, obesity, excessive alcohol consumption, stress, lack of exercise

Question 19

malignant hypertension

Answer 19

rapid increase in blood pressure leading to cardiac failure, peripheral edema, renal damage w/ proteinuria, hypertensive encephalopathy, retinopathy

Question 20

secondary hypertension

Answer 20

has an identifiable pathological cause and is uncommon

Question 21

Treatment for hypertension

Answer 21

1) ACE inhibitors/angiotensin receptor blockers
2) Calcium-channel blockers
3) Diuretics
4) Beta-adrenoceptor blockers

Question 22

Congestive heart failure

Answer 22

chronic inability of the heart to maintain adequate tissue perfusion at a normal filling pressure.

Question 23

Causes of Left Heart Failure

Answer 23

1) diffuse coronary artery disease
2) reduce myocardial mass due to infarct
3) excessive work (afterload) due to clinical hypertension
4) cardiomyopathy
5) cardiac failure in elderly, idiopathic myopathy arising from myocytes

Question 24

signs/symptoms of Left Heart Failure

Answer 24

1) shortness of breath
2) orthopnea (dyspnea on lying down)
3) paroxysmal nocturnal dyspnea
4) pulmonary congestion and edema (crackles)
5) exercise intolerance

Question 25

Causes of chronic Right Ventricular Failure

Answer 25

1) chronic hypertension due to chronic lung disease

2) left ventricular failure

Question 26

Signs/symptoms of Right Ventricular Failure

Answer 26

1) edematous swelling of feet, ankles, legs
2) hepatomegaly
3) ascites (fluid in abdominal cavity)
4) raised jugular venous pressure
5) exercise intolerance

Question 27

True/False - Arterial PO2 is almost the same as alveolar PO2 because oxygen equilibrates across the pulmonary capillary wall.

Answer 27

True

Question 28

What is the third component of the alveolar capillary membrane?

Answer 28

Interstitial space

Question 29

List TWO causes of systemic hypoxemia. There are 4 listed in the readings

Answer 29

(double check)

1) altitude
2) asphyxiation

Question 30

List THREE clinical signs of SHOCK. There are six given in the readings.

Answer 30

(double check)

1) hypotension
2) cool, clammy skin
3) decreased urine output

Question 31

Describe hypovolemic shock

Answer 31

Shock due to loss of blood and/or plasma volume which compromises the body’s ability to perfuse the tissues adequately.

Question 32

True/False - Tachycardia is a psychogenic response

Answer 32

True

Question 33

Define secondary hypertension

Answer 33

Secondary hypertension is from a known cause; it is a rare type of hypertension.

Question 34

True/False - Peripheral edema is a compensatory mechanism that supports a failing heart

Answer 34

True

Question 35

What type of hypertension presents as symptom-less and is the result of high dietary salt intake, obesity, stress, and lack of exercise.

Answer 35

Benign essential hypertension

Question 36

List THREE signs and symptoms of LEFT ventricular failure

Answer 36

(double check)

1) difficulty breathing when lying flat
2) pulmonary edema
3) reduced exercise tolerance

Question 37

List THREE signs and symptoms of RIGHT ventricular failure

Answer 37

(double check)

1) peripheral edema
2) reduced exercise tolerance
3) increased jugular vein distention/pressure