patho check your understanding week 3

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with A. perfumes. B. incompatible blood products. C. animal proteins or dander. D. antibiotics

D

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body. True False

True

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. True False

True

Cardiogenic shock is characterized by A. hypovolemia. B. reduced systemic vascular resistance. C. reduced cardiac output. D. elevated SvO2.

C

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with A. high afterload. B. low cardiac output. C. High cardiac output D. reduced contractility.

C

Rheumatic heart disease is most often a consequence of A. chronic intravenous drug abuse. B. viral infection with herpesvirus. C. β-hemolytic streptococcal infection. D. cardiomyopathy.

C

Tachycardia is an early sign of low cardiac output that occurs because of A. tissue hypoxia. B. anxiety. C. baroreceptor activity. D. acidosis.

C

The prevalence of high blood pressure is higher in A. non-Hispanic white adults. B. Mexican-American adults. C. non-Hispanic black adults. D. Asian children.

C

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of A. catecholamines. B. clotting factors. C. nitric oxide. D. vasopressin.

C

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing A. orthopnea. B. paroxysmal atrial tachycardia. C. sleep apnea. D. paroxysmal nocturnal dyspnea.

D

Angina caused by coronary artery spasm is called _____ angina. A. stable B. classic C. unstable D. Prinzmetal variant

D

Hypertrophy of the right ventricle is a compensatory response to A. aortic stenosis. B. aortic regurgitation. C. tricuspid stenosis. D. pulmonary stenosis.

D

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

D

Pulse pressure is defined as A. two thirds of systolic pressure + diastolic pressure. B. systolic pressure + diastolic pressure. C. systolic pressure - diastolic pressure. D. systolic pressure × systemic resistance.

c

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class? A. class 1 B. class 2 C. class 3 D. class 4

A

The progressive stage of hypovolemic shock is characterized by A. tachycardia. B. hypertension. C. lactic acidosis. D. cardiac failure.

A

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100? A. Sitting BP 88/60, HR 118 B.Sitting BP 108/68, HR 102 C.Sitting BP 110/78, HR 98 D.Sitting BP 120/80, HR 100

A

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? A.Elevated CK-MB, troponin I, and troponin T B. Markedly decreased CK-MB and troponin I C. Elevated LDL D. Prolonged coagulation time

A

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding? A.Increased LDL levels are associated with increased risk of coronary artery disease. B. Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease. C. Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. D. Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant.

A

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

B

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? A. Cardiogenic B. Septic C. Anaphylactic D. Neurogenic

B

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. cardiogenic B. obstructive C. hypovolemic D. distributive

B

A patient with pure left-sided heart failure is likely to exhibit A. jugular vein distention. B. pulmonary congestion with dyspnea. C. peripheral edema. D. hepatomegaly.

B

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is A. serum sodium. B. albumin level. C. serum potassium. D. serum calcium.

C

A loud pansystolic murmur that radiates to the axilla is most likely a result of A.aortic regurgitation. B.aortic stenosis. C. mitral regurgitation. D.mitral stenosis.

C

Atherosclerotic plaques with large lipid cores are prone to A. dislodgement. B. binding. C. rupture D. attachment

C

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. True False

False

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. True False

False

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

False

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

False

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.stable angina. B.myocardial infarction. C.coronary vasospasm. D.unstable angina.

A

A patient with significant aortic stenosis is likely to experience A. syncope. B.hypertension. C. Increased pulse pressure. D. peripheral edema.

A

Administration of which therapy is most appropriate for hypovolemic shock? A. Crystalloids B. Vasoconstrictor agents C. Inotropic agents D. 5% dextrose in water

A

An erroneously low blood pressure measurement may be caused by A. positioning the arm above the heart level. B.using a cuff that is too small. C. positioning the arm at heart level. D. measuring blood pressure after exercise.

A

Aortic regurgitation is associated with A. diastolic murmur. B. elevated left ventricular/aortic systolic pressure gradient. C. elevated systemic diastolic blood pressure. D. shortened ventricular ejection phase.

A

Constrictive pericarditis is associated with A. impaired cardiac filling. B. cardiac hypertrophy. C. increased cardiac preload. D. elevated myocardial oxygen consumption.

A

First-degree heart block is characterized by A. prolonged PR interval. B. absent P waves. C. widened QRS complex. D. variable PR interval.

A

Hypertension is closely linked to A.obstructive sleep apnea. B.urinary tract infection. C.de Quervain syndrome. D.spinal stenosis.

A

Left-sided heart failure is characterized by A. pulmonary congestion. B. decreased systemic vascular resistance. C. jugular vein distention. D. peripheral edema.

A

Hypertension with a specific, identifiable cause is known as _____ hypertension. A. primary B. orthostatic C. secondary D. malignant

C

Improvement in a patient with septic shock is indicated by an increase in A. cardiac output. B. SvO2. C. systemic vascular resistance. D. serum lactate level.

C

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.This is an expected blood pressure in the elderly and has little effect on left ventricular function. B. Left ventricular workload is increased with high afterload. C.High blood pressure enhances left ventricular perfusion during systole. D.High-pressure workload leads to left ventricular atrophy.

B

Angiotensin-converting enzyme (ACE) inhibitors block the A. release of rennin. B. conversion of angiotensin I to angiotensin II. C. conversion of angiotensinogen to angiotensin I. D. effect of aldosterone on the kidney.

B

Beta-blockers are advocated in the management of heart failure because they A. increase cardiac output. B. reduce cardiac output. C. enhance sodium absorption. D. reduce blood flow to the kidneys.

B

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. A.systolic B. mean arterial C.diastolic D. pulse

B

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of A. myocardial infarction. B. cardiac tamponade. C. congestive heart failure (CHF). D. cardiomyopathy.

B

Lusitropic impairment refers to A. poor contractile force. B. impaired diastolic relaxation. C. altered action potential conduction rate. D. altered automaticity.

B

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

B

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with A. cardiac catheterization. B. antiplatelet drugs. C. acute reperfusion therapy. D. cardiac biomarkers only.

B

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with A. cardiac catheterization. B.antiplatelet drugs. C. acute reperfusion therapy. D. cardiac biomarkers only.

B

Primary treatment for myocardial infarction (MI) is directed at A. protecting the heart from further ischemia. B. decreasing myocardial oxygen demands. C. reducing heart rate and blood pressure. D. activating the parasympathetic system.

B

Primary treatment for myocardial infarction (MI) is directed at A.. protecting the heart from further ischemia. B.decreasing myocardial oxygen demands. C.reducing heart rate and blood pressure. D.activating the parasympathetic system.

B

The common denominator in all forms of heart failure is A. poor diastolic filling. B. reduced cardiac output. C. pulmonary edema. D. tissue ischemia.

B

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

B

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

An example of an acyanotic heart defect is A. tetralogy of Fallot. B.transposition of the great arteries. C. ventricular septal defect. D. all right-to-left shunt defects.

C

Cor pulmonale refers to A. biventricular failure. B. left ventricular hypertrophy secondary to lung disease. C. right ventricular hypertrophy secondary to pulmonary hypertension. D. right ventricular failure secondary to right ventricular infarction.

C

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. A. aldosterone B. norepinephrine C. angiotensinogen D. renin

D

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? A. Cardiogenic B. Hypovolemic C. Anaphylactic D. Septic

D

The majority of tachydysrhythmias are believed to occur because of A. triggered activity. B. enhanced automaticity. C. defective gap junctions. D. reentry mechanisms.

D

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is A. afterload reduction. B. β-antagonist agents. C. preload reduction. D. digitalis.

D

Which dysrhythmia is thought to be associated with reentrant mechanisms? A. Second-degree AV block B. Sinus bradycardia C. Junctional escape D. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

D