Pathophysiology

What is secondary hypertension

Most common in infant and childrens

What is systolic blood pressure

Peak pressure during cardiac systole

Hypertension with a specific, identifiable cause is known as _____ hypertension. a.secondary b.orthostatic c.malignant d.primary

a.secondary

What is primary hypertension?

-aka essential or idiopathic hypertension -rare before age 10

An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure? a.High-pressure workload leads to left ventricular atrophy. b.High blood pressure enhances left ventricular perfusion during systole. c.Left ventricular workload is increased with high afterload. d.This is an expected blood pressure in the elderly and has little effect on left ventricular function.

.Left ventricular workload is increased with high afterload.

The prevalence of high blood pressure is higher in a.Asian children .b.non-Hispanic black adults .c.non-Hispanic white adults .d.Mexican-American adults.

.b.non-Hispanic black adults

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time? a.Continue lifestyle modifications plus ACE inhibitor therapy .b.Continue lifestyle modifications plus diuretic therapy .c.Continue lifestyle modifications only. d.Continue lifestyle modifications plus b-blocker therapy

.c.Continue lifestyle modifications only.

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of a.arterial obstruction .b.isolated left-sided heart failure .c.right-sided heart failure. d.peripheral vascular disease.

.c.right-sided heart failure

Changes in BP are mediated through the activation of what system and what gets released as a result?

Activation of the sympathetic nervous system and results in release of epinephrine and norepinephrine

What does cardiac output formula

CO=SV( stroke volume) x HR (heart rate).

What is diastolic blood pressure?

Lowest pressure during cardiac diastole

What is the most common primary diagnosis in the US

Hypertension

What does a increase in extracellular fluid volume result in?

Increase in CO and SVR (systemic vascular resistance) which leads to elevated BP

What is arterial blood pressure?

Pressure difference between the left and right side of the heart

What is prehypertension?

Range of pressure between normal and stage 1 hypertension.

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? a.Aortic regurgitation b.Bradycardia c.Tachycardia d.Hypotension

Tachycardia

What is SVR systemic vascular resistance determined by?

The radius of arterys and degree of vessel compliance

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? a.Elevated CK-MB, troponin I, and troponin T b.Prolonged coagulation time c.Elevated LDL d.Markedly decreased CK-MB and troponin I

a.Elevated CK-MB, troponin I, and troponin T

Chronic elevation of myocardial wall tension results in atrophy. a.False b.True

a.False

The most commonly recognized outcome of hypertension is pulmonary disease. a.False b.True

a.False

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? a.Septic b.Anaphylacticc. Cardiogenic d.Hypovolemic

a.Septic

Mitral stenosis is associated with a.a pressure gradient across the mitral valve .b.left ventricular hypertrophy. c.a muffled second heart sound (S2) .d.a prominent S4 heart sound.

a.a pressure gradient across the mitral valve

Sepsis has been recently redefined as a.a systemic inflammatory response to infection. b.severe hypotension in an infected patient. c.a systemic infection with viable organisms in the bloodstream. d.a systemic inflammatory response to ischemia.

a.a systemic inflammatory response to infection

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a.elderly woman without a previous history of MI .b.young sedentary male with a high-stress job. c.middle-aged man with a previous history of MI. d.young female athlete with cardiomegaly

a.elderly woman without a previous history of MI

Hypotension associated with neurogenic and anaphylactic shock is because of a.peripheral pooling of blood .b.poor cardiac contractility. c.high afterload. d.hypovolemia.

a.peripheral pooling of blood

In which dysrhythmias should treatment be instituted immediately? a.Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute b.Atrial fibrillation with a ventricular rate of 220 beats/minute c.Fever-induced tachycardia at 122 beats/minute d.Premature atrial complexes occurring every 20 seconds

b.Atrial fibrillation with a ventricular rate of 220 beats/minute

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time? a.Encourage smoking cessation. b.Begin antihypertensive drug therapy .c.Begin lifestyle modifications. d.Recheck blood pressure in 4 to 6 weeks.

b.Begin antihypertensive drug therapy

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis. a.True b.False

b.False

What results when systemic blood pressure is increased? a.Decreased cardiac output b.Vasoconstriction c.Hypovolemiad. Decreased vascular resistance

b.Vasoconstriction

Myocarditis should be suspected in a patient who presents with a.chest pain and ST elevation .b.acute onset of left ventricular dysfunction. c.family history of cardiomyopathy .d.murmur and abnormal valves on echocardiogram.

b.acute onset of left ventricular dysfunction.

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock. a.hypovolemic b.obstructive c.cardiogenic d.distributive

b.obstructive

Hypertension is closely linked to a.spinal stenosis.b.obstructive sleep apnea. c.de Quervain syndrome. d.urinary tract infection

b.obstructive sleep apnea

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is a.unstable angina. b.stable angina. c.myocardial infarction. d.coronary vasospasm.

b.stable angina

The effect of nitric oxide on systemic arterioles is a.vasoconstriction. b.vasodilation. c.not significant. d.opposed by nitrate drugs.

b.vasodilation

The majority of cardiac cells that die after myocardial infarction do so because of a.thrombus. b.insufficient glucose. c.apoptosis .d.cell rupture

c.apoptosis.

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of a.congestive heart failure (CHF) .b.myocardial infarction. c.cardiac tamponade .d.cardiomyopathy.

c.cardiac tamponade

patient with heart failure who reports intermittent shortness of breath during the night is experiencing a.sleep apnea .b.paroxysmal atrial tachycardia. c.paroxysmal nocturnal dyspnea. d.orthopnea.

c.paroxysmal nocturnal dyspnea.

The majority of tachydysrhythmias are believed to occur because of a.enhanced automaticity. b.triggered activity. c.reentry mechanisms .d.defective gap junctions.

c.reentry mechanisms

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock. a.obstructive b.cardiogenic c.septic d.hypovolemic

c.septic

An example of an acyanotic heart defect is a.transposition of the great arteries .b.all right-to-left shunt defects. c.ventricular septal defect. d.tetralogy of Fallot.

c.ventricular septal defect

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is a.dysrhythmias. b.severe, crushing chest pain. c.pain radiating to the lower legs. d.ST-segment elevation.

d.ST-segment elevation.

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of a.vasopressin .b.nitric oxide. c.clotting factors .d.catecholamines.

d.catecholamines.

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of a.myocardial infarction. b.arthrosclerosis. c.angina. d.hypertensive crisis.

d.hypertensive crisis.

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to a.angina .b.deep vein thrombosis .c.hypertension .d.hypotension.

d.hypotension.

Constrictive pericarditis is associated with a.elevated myocardial oxygen consumption .b.cardiac hypertrophy. c.increased cardiac preload. d.impaired cardiac filling.

d.impaired cardiac filling.

Lusitropic impairment refers to a.poor contractile force .b.altered action potential conduction rate. c.altered automaticity. d.impaired diastolic relaxation.

d.impaired diastolic relaxation.

Atherosclerotic plaques with large lipid cores are prone to a.dislodgement .b.attachment .c.binding. d.rupture.

d.rupture

What is outcome of primary hypertension

end organ damage