Test 2 Flashcards
Match the term to the definition:
A. orderly cell death without inflammation
B. leaky fluid from blood vessels
C. fragmentation of the nucleus of a dying cell causing irregular chromatin distribution
D. death of a body part (finger, foot, ear, etc)
E. cell death occurring in a granuloma
F. too much fluid in a body cavity
terms: caseous necrosis effusion apoptosis gangrenous necrosis karyorrhexis hyperremia
APOPTOSIS - A. orderly cell death without inflammation
HYPEREMIA - B. leaky fluid from blood vessels
KARYORRHEXIS - C. fragmentation of the nucleus of a dying cell causing irregular chromatin distribution
GANGRENOUS NECROSIS - D. death of a body part (finger, foot, ear, etc)
CASEOUS NECROSIS - E. cell death occurring in a granuloma
EFFUSION - F. too much fluid in a body cavity
Which of the following 3 symptoms are most likely experience by a patient with left-sided heart failure with the right side still functioning normally? A. ischemic heart disease B. pulmonary edema C. difficulty breathing when lying down D. brain hemorrhages E. pitted edema in the ankles F. hepatomegaly G. severe headaches
Answer:
A. ischemic heart disease (usually one of the causes of left-sided heart failure)
B. pulmonary edema
C. difficulty breathing when lying down
incorrect answers: D. brain hemorrhages -microhemorrhages in the lungs, not the brain E. pitted edema in the ankles - more of a right-sided heart failure symptom F. hepatomegaly - symptoms of right-sided heart failure G. severe headaches - not mentioned in study guide
Select the correct statement concerning myocardial infarction:
A. universally associated with extreme pain
B. most related deaths are associated with ventricular arrythmias
C. aortic thrombus is usually associated
D. blood levels of troponin T and creatinine phosphate are reduced
Answer: B. most related deaths are associated with ventricular arrhythmias
A. universally associated with extreme pain
- sometimes an MI can be asymptomatic
C. aortic thrombus is usually associated
- its a MURAL thrombus that forms 40% of the time
D. blood levels of troponin T and creatinine phosphate are reduced
- these cardiac enzymes are ELEVATED due to MI
Select the 2 correct statements:
A. Libman-Sacks is endocarditis not associated with autoimmune disease
B. splinter hemorrhages are cardiac miniature blood clots that can migrate to under the finger nails
C. cardiac tamponade is associated with fluid accumulation around the heart which causes excessive cardiac compression
D. bradycardia typically associated with ventricular fibrillations
E. a 1st degree heart block is associated with a lack of heart conduction
F. Atrial fibrillation is very rare, even in the elderly
Answers:
B. splinter hemorrhages are cardiac miniature blood clots that can migrate to under the finger nails
C. cardiac tamponade is associated with fluid accumulation around the heart which causes excessive cardiac compression
incorrect:
A. Libman-Sacks is endocarditis not associated with autoimmune disease
- this endocarditis is associated with autoimmune disease, such as Lupus Erythematosus
D. bradycardia typically associated with ventricular fibrillations
- tachycardia is associated with ventricular arrhythmias
E. a 1st degree heart block is associated with a lack of heart conduction
- a 1st degree heart block refers to a slowed impulse propagation and is usually asymptomatic; a 3rd degree heart block is the one associated with a lack of heart conduction
F. Atrial fibrillation is very rare, even in the elderly
- atrial fibrillation is the most common form of ectopic beats/arrhythmias and is common in elderly people
Which of the following are associated with primary hypertension (1) and which are associated with secondary hypertension (2)?
preeclampsia increased Na+ retention consequence of congestive heart failure 95% of all cases of hypertension associated with diabetes
2 - preeclampsia 1 - increased Na+ retention 2 - consequence of congestive heart failure 1 - 95% of all cases of hypertension 2 - associated with diabetes
Which of the following is least likely to be a compensation for congestive heart failure?
A. cardiomegaly
B. a reduction in cardiac stroke volume
C. increased catecholamine (sympathetic activity)
D. tachycardia
Answer: B. a reduction in cardiac stroke volume (an increase is cardiac stroke volume is a compensation for congestive heart failure)
the other answers are all ways the body will compensate for congestive heart failure.
An elderly, hypertensive man with type II diabetes has suddenly started to experience severe retrosternal chest pain every time he stands up but also often during periods when he is just sitting and there is no exertion. Select which of the following statements is most likely to apply to this condition:
A. this condition is easy to manage and is known as stable angina.
B. this type of pain is often associated with esophageal reflux
C. the use of sublingual nitroglycerin should be effective in rapidly relieving this discomfort
D. this condition could easily become associated with dyspnea and arrhythmias
Answer: D. this condition could easily become associated with dyspnea and arrhythmias
incorrect answers:
A. this condition is easy to manage and is known as stable angina.
- false. this condition is called unstable angina and is difficult to manage. Stable angina is caused by exertion, is the most common type, and the easiest to manage.
B. this type of pain is often associated with esophageal reflux
- reflux pain may be associated with MI, but probably not angina that occurs often and at rest.
C. the use of sublingual nitroglycerin should be effective in rapidly relieving this discomfort
- unstable angina is the most difficult to treat/manage
Select the incorrect statement:
A. endocarditis can cause fatal thromboemboli
B. bradycardia is defined as fewer than 60 bpm and can be caused by cardiac conduction blocks
C. a risk of atrial fibrillation is a stroke-causing embolus
D. lidocaine is an effective treatment for ventricular arrhythmias because of its Ca++ channel blocking action
Answer: D. lidocaine is an effective treatment for ventricular arrhythmias because of its Ca++ channel blocking action
- lidocaine blocks Na+ channels, not Ca++ channels.
Which of the following drugs is used to treat hypertension because of its ability to hyperpolarize vascular smooth muscles by opening K+ channels? A. metoprolol B. dobutamine C. captopril D. minoxidil E. digitalis
Answer: D. minoxidil
incorrect answers:
A. metoprolol
- selective beta 1 blocker that can reduce peripheral vascular resistance and reduce cardiac function
B. dobutamine
- selective beta 1 agonist used for treatment of heart failure; can cause arrhythmias
C. captopril
- ACE inhibitor that reduces peripheral resistance by reducing salt and water
E. digitalis
- positive ionotropic drug that increases intracellular Ca++ and cardiac contractility which increases blood ejection; used to treat heart failure; can cause arrhythmias
Select the two incorrect statements concerning the following antihypertensive drugs:
A. hydrochlorthiazide is a K+ sparing diuretic
B. phenoxybenzamine is an alpha 1 and alpha 2 blocker
C. clonidine is an alpha 2 antagonist
D. captopril is an ACE inhibitor
E. verapamil is a calcium channel blocker
Answers:
A. hydrochlorthiazide is a K+ sparing diuretic
- this is a diuretic that works in the distal convoluted tubule; its main side effect is an electrolyte imbalance, especially with K+, thus it is not K+ sparing.
C. clonidine is an alpha 2 antagonist
- this drug is a centrally-acting alpha 2 agonist, NOT antagonist.
A women in her 22nd week of pregnancy presents positive for diabetes. Abruptly, her normal blood pressure jumps up to a persistent reading of 144/95. Which of the following complications would most likely explain this clinical presentation? A. cardiac tamponade B. left heart failure C. preeclampsia D. cor pulmonale
Answer: C. preeclampsia
incorrect answers:
A. cardiac tamponade
- includes compression of the heart from fluid accumulation which can reduce cardiac output and cause death.
B. left heart failure
- symptoms include increased peripheral edema, reduced blood perfusion to organs, microhemorrhages in the lungs, pulmonary edema and breathing problems, and dyspnea when lying down.
D. cor pulmonale
- abnormal enlargement of the right side of the heart usually because of a heart valve problem; associated with right sided heart failure
What type of thrombus usually forms after a myocardial infarct or from atrial fibrillation? A. mural B. agonal C. red D. white E. fibrin
Answer:
A. mural
incorrect answers: B. agonal C. red D. white E. fibrin - not sure we even learned about these other types of thrombi...
Which of the following is the most likely drug to treat a patient's cholesterol and lipid condition (cholesterol is 270 mg/dL and triglycerides are 200 mg/dL; patient has family history of MI and stroke) A. niacin B. cholesteramine C. fenobrate D. simvastatin
Answer: D. simvastatin
- inhibitor of HMG-CoA reductase (an enzyme necessary for cholesterol synthesis; it is the most common cholesterol medication prescribed; it has been shown to reduce coronary events like stroke and MI)
incorrect answers:
A. niacin
- nicotinic acid; decreases triglycerides and LDLs
B. cholesteramine
- bile-acid binding agent that reduces the reabsorption of bile acids and metabolites
C. fenobrate
- increases lipolysis in the liver and muscles which reduces VLDLs and has a modest effect on LDLs; also increases HDLs and reduces triglycerides.
A 10-year-old female patient has dry mouth and inflamed gingiva and you witness a sneezing/coughing episode with chest tightening and difficulty breathing. What's the most likely diagnosis? A. "blue bloater" B. bronchiectasis C. acute respiratory distress syndrome D. asthma E. sarcoidosis
Answer: D. asthma
incorrect answers:
A. “blue bloater”
- chronic bronchitis (persistent cough for more than 3 months in 2 consecutive years); usually caused by smoking and air pollution
B. bronchiectasis
- obstruction of the bronchi and persistent necrotizing infections (Tb or staph); hypersecretion mucous in the airways.
C. acute respiratory distress syndrome
- progression of acute injury and damage from activated neutrophils and fluid accumulation
E. sarcoidosis
- type of restrictive lung disease (difficult to inhale); abnormal connective tissue and reduced elastic properties; immune-related disease
Select the incorrect statement about bronchitis:
A. you would expect to see a decreased PO2
B. there is a decreased Reid index
C. it is caused by mucous hypersecretion in the smaller airways and bronchi
D. they are referred to as “blue bloaters”
Answer:
B. there is a decreased Reid index
- the Reid index is actually increased in bronchitis. The Reid index is the ratio of mucus glands to bronchial wall. In bronchitis there is excessive mucus production.
Select the incorrect statement concerning pulmonary tumors:
A. the vast majority of lung cancers are carcinomas
B. the most aggressive carcinomas are the small cell (oat cell) type
C. these cancers rarely metastasize to the brain
D. pulmonary carcinomas are the leading cause of cancer deaths worldwide
Answer:
C. these cancers rarely metastasize to the brain
- they frequently spread to the brain
