Test 3 Review sheet Flashcards
- Normal heartbeats originate with a signal from what location?
a. Sinoatrial node in the right atrium
- Why are Arrhythmias mechanically inefficient?
a. Arrhythmias are mechanically inefficient because they interrupt the normal pattern of filling and emptying of the chambers
- How is Atrial fibrillation characterized?
a. Atrial fibrillation is a disorganized, irregular atrial rhythm that causes an irregular, rapid ventricular rate near 200 bpm
- Define forward heart failure
a. Forward heart failure = low ventricular output
- Define compensated heart failure
a. the heart compensates for muscle weakness or valve inefficiency in two ways
- What are the two way that the body compensates for heart failure
i. Sympathetic nervous stimulation and release of adrenal hormone (epinephrine) to increase heart rate and the force of contraction
ii. Cardiac muscle hypertrophy
- The increased secretion of renin in heart failure is caused by?
a. Left-heart failure since it results in low cardiac output, which causes low blood pressure and low blood flow to the kidneys. Thus, the kidneys release renin
- What has an effect on cardiac valves?
a. inflammation and infection
- Left heart failure is also known as?
a. uncompensated left ventricular failure
- Young atherosclerotic plaques are unstable
a. Young atheroma’s are soft and prone to fissure and rupture
- What is the most common cause of myocarditis
a. usually caused by viral infections, especially Coxsackie A or B viruses
- Tetralogy of Fallot
a. a right-to-left cardiac shunt consisting of 4 defects
What are the 4 defects of Tetralogy of fallout?
i. misplacement (rightward shift) of the aortic valve- aortic orifice catches unoxygenated blood coming through
ii. ventricular septal defect in a right-to-left shunt
iii. Pulmonary artery stenosis obstructs pulmonary blood flow- increases right ventricular pressure
iv. right ventricular hypertrophy
- Atrial defect
a. occurs when there is incomplete closure of the embryonic atrial septum
i. presents as a congenital hole in the septum that separates the atria
- Ductus arteriosus
a. conveys oxygenated blood from the pulmonary artery into the aorta for distribution to the body
i. patent ductus arteriosus- If it fails to close at birth and blood is shunted in the opposite direction from normal
- What is most pericarditis caused by?
a. most often caused by viral infection, and uremia (high level of waste in blood) associated with renal failure
- Penetrating branches of the coronary arteries
a. Right coronary artery, left circumflex branch, left anterior descending branch
- Define stable and unstable angina pectoris
a. Stable angina- rises and falls smoothly over a period of a few minutes and is relieved by rest or medication
b. Unstable angina- caused by aggregates of platelets accumulating on an atherosclerotic plaque, and is a very serious condition that may indicate an impending MI
- Enterohepatic circulation
a. excretion of bile acids (made from cholesterol) from the liver into the intestine
b. the reabsorption of most of the bile acids (and their cholesterol) by the intestine for recirculation through the portal system and reuse by the live
- Describe unconjugated bilirubin
a. not water soluble and is attached to albumin for transport to the liver where it is conjugated (joined) to glucuronide and becomes water soluble and can be excreted in bile
- Describe prehepatic jaundice
a. causes an increase in blood of water in-soluble unconjugated bilirubin
- Describe hepatic failure
a. The loss of hepatic metabolic function is severe enough to cause clinical symptoms
- What is the most common type of liver cirrhosis?
a. Portal cirrhosis
- What is a consequence of portal hypertension?
a. occurs when there is obstruction of portal blood flow caused by the choking action of the dense fibrous bands of cirrhosis, which scar and shrink the liver.
b. hemorrhoids, esophageal varices, splenomegaly, and caput medusa veins radiating from the umbilicus, and contributes to the formation of ascites.
- Describe carrier state of hepatitis infection
a. Asymptomatic patients harbor virus and are capable of transmitting virus.
b. Type A isn’t capable of being a carrier state, Types B and C are.
- Hepatitis B surface antigen (HBsAg) in blood?
a. Usually used to indicate if the virus is in the blood
- Risk factors for hepatitis C infection?
a. Half of the cases are a consequence of drug abuse – a great majority of IV users are infected
- Define Alcoholic liver disease
a. damage of the liver due to excessive drinking, can develop into fatty live.
b. Alcoholic Hepatitis- subacute or chronic form of alcoholic injury characterized by inflammation, hepatocyte necrosis, and early fibrosis.
c. Alcoholic Cirrhosis- The final and irreversible stage
- Define Hemochromatosis
a. A toxic accumulation of excessive iron in cells, especially the liver, heart, and pancreas
- Define Primary biliary cirrhosis
a. an autoimmune disease of intrahepatic bile ducts
- Characteristics of cholesterol gallstones?
a. Most common gallstone
- Cholestasis, Cholelithiasis and Cholecystitis
a. Cholestasis-An accumulation of bile acids and cholesterol in blood when there is obstruction.
b. Cholelithiasis- caused a bright yellow coloration, microscopic study of the gallbladder wall revealed chronic inflammation.
c. Cholecystitis- Gallbladder contains mucus and numerous pigment stones. Note thick gallbladder wall, caused by chronic inflammation and fibrosis.
- In cirrhosis what is caused by accumulations of estrogen?
a. In men accounts for thinning scalp and genital hair, female-like breasts, red palms atrophic testes, and spider angiomas. Women may have abnormal menstrual bleeding
- Carrier state in chronic hepatitis infection
a. Hepatitis B and C are both positive carrier states
- The enterohepatic circulation refers to?
a. the reabsorption of most of the bile acids (and their cholesterol) by the intestine for recirculation through the portal system and reuse by the live
- Laboratory Evaluation of Liver Function
a. Enzymes- In liver disease enzymes are washed into the blood.
b. Bilirubin- increased levels of blood bilirubin usually indicates at least moderate liver disease.
c. Proteins- Low levels of plasma albumin and blood coagulation factors are characteristic of moderate to serous liver disease.
d. Coagulation tests- liver disease can cause abnormal (prolonged) prothrombin time (PT) and partial thromboplastin time (PTT).
e. Hepatitis virus markers- hepatitis virus is distinguished by characteristic patterns of virus antigens and antibodies in blood.
f. Autoimmune antibodies- anti smooth muscle antibodies are characteristic of chronic autoimmune hepatitis.
- Azotemia
a. renal failure detectable only by laboratory tests
- Uremia
a. renal failure with clinical signs and symptoms. caused by any other underlying kidney disease
- Oliguria
a. less than normal urine output, caused by low glomerular filtration rate
- Normal daily urine output
a. 1,000 to 1,500 ml per day
- Nitrate produced in urine, indicative of?
a. Evidence of bacterial infection
- Casts – cylinders formed by compaction of protein; what kinds of casts are there?
Hyaline cast
Fatty cast
Hyaline to finely granular cast
Cellular cast
Cellular to coarsely granular cast
coarsely granular cast
Finely granular cast
Granular to waxy cast
Waxy cast
- triple phosphate crystals
a. look like rectangles
- calcium oxalate crystals
a. tetrahedrons, 50% derived from ascorbic acid.
- Trichomonas Vaginalis
a. Most frequently encountered gynecological parasite
- Urine specific gravity normal range
a. 1.016 -1.022
- Patients with uremia will usually have
a. Hypertension – retention of salt and water
b. Anemia – low erythropoietin output
c. Oliguria – caused by low glomerular filtration rate.
d. Pericarditis & gastroenteritis
e. Bleeding/coagulation defects, platelet malfunction
f. Peripheral nerve disease (neuropathy)
- Horseshoe kidney
a. a single fused kidney, joined inferiorly by a thick bridge of normal, functioning renal tissue as a result of abnormal embryogenesis
- Renal dysplasia
a. occurs when there is in utero obstruction of urinary flow, usually caused by obstruction of the ureter
- Glomerulonephritis
a. inflammation of the glomerulus
i. Poststreptococcal Glomerulonephritis
caused by an autoimmune injury
ii. Rapidly Progressive Glomerulonephritis
may arise from unknown causes
iii. Membranous Glomerulonephritis
autoimmune disease characterized by thickening of the glomerular basement membrane
iv. Minimal Change Glomerulonephritis
affects glomerular epithelial cells with very subtle changes that are not visible with conventional microscopy
v. IGA Glomerulonephritis
autoimmune glomerular disease associated with IgA deposits in mesangial cells (Bergers disease). the most common type of glomerulonephritis
- Pyelonephritis
a. Tract Infection – a bacterial infection of the kidney and is one of the most important diseases of the kidney, Gram negative fecal bacteria are the usual culprits, Escherichia coli
