Patho exam 2 book questions
The mitral valve
is located between the right atrium and right ventricle.
Which of the following blood pressure readings is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
Diabetic patients with hypertension have a blood pressure goal of less than
130/80
Which of the following is an accurate description of patent ductus arteriosus?
A communication between the aorta and the pulmonary artery
Mitral stenosis is associated with
A pressure gradient across the mitral valve
Drug of choice for treating hypertensive diabetic patients is
ACE inhibitors
Cardiac hypertrophy is stimulated by all of the following except
ANP
Elevation of an extremity suffering from arterial insufficiency will
Decrease perfusion
Adrenergic antagonist (beta blocker) drug therapy may be indicated in the management of
Decrease the effect of prolonged SNS stimulation
A hypertensive patient is reluctant to adhere to the prescribed plan because he feels fine and doesn't like his new diet. It can be explained to him that high blood pressure increases the risk of all of the following except
Diabetes
Aortic regurgitation is associated with
Diastolic murmur
Which of the following statements regarding myocardial cell regeneration is correct?
Differentiated myocytes cannot divide, but stem cells present in the heart can.
A laboratory test that would be helpful in confirming the diagnosis of iron-deficiency anemia is
Elevatated TIBC
Right-sided heart failure usually is a consequence of
Elevated rv afterload
Acidemia increases the affinity of hemoglobin for oxygen.
False
Although smoking has been linked to heart disease, it is no longer considered a major risk factor.
False
Angiotensin-converting enzyme (ACE) inhibitor therapy is avoided in heart failure because a drop in preload may reduce cardiac output.
False
Red blood cell production in the bone marrow is inhibited by hypoxemia.
False
True or false: Stable angina pectoris may produce significantly elevated serum cardiac enzymes.
False
Vasopressin, angiotensin II, and atrial natriuretic peptide all increase blood volume and pressure.
False
beta Adrenergic blocking drugs are contraindicated in heart failure.
False
Myocardial cells are connected by gap junctions enabling them to
Function as a coordinated synctium
Red blood cells differ from other cell types in the body because they
Have no cytoplasmic organelles
Anemia associated with elevated reticulocytes
Hemolytic anemia
Rheumatic heart disease is most often a consequence of
Hemolytic streptococcal infection
Restrictive pericarditis is associated with
Impaired cardiac filling
The compensatory mechanisms that are triggered following myocardial infarction
Increase myocardial oxygen demands
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?
Increased LDL levels are associated with increased risk of coronary artery dis-ease.
Which of the following physiologic changes would increase cardiac work but not enhance cardiac output?
Increased afterload
A patient receives an ACE-inhibiting agent to manage his cardiovascular disease. Which of the following is not an expected result of ACE inhibitor therapy?
Increased cardiac preload
Pernicious anemia caused by lack of
Instrinsic factor
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?
Iron deficiency
Most common cause of anemia
Iron deficiency
Primary source of epo
Kidney
A 48-year-old man was noted to have elevated blood pressure at a health fair and is in the office for follow-up. He states that 3 weeks ago his blood pressure was recorded at 162/96. He has no significant past medical history and takes no medications. He smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. He is about 40 pounds overweight and admits to a high-fat, high-calorie diet. At his visit today, his blood pressure is 150/92. What is the least appropriate intervention at this time?
Begin antihypertensive drug therapy.
Excessive red cell lysis can be detected by measuring serum
Bilirubin
An elderly patient's blood pressure is measured at 160/98. How would his left ventricular function be affected by this level of blood pressure?
LV workload increased with high afterload
Lab finding usually related with aplastic anemia
Thrombocytopenia
Not considered risk for thrombus formation
Thrombocytopenia
Which of the following proteins is not associated with the thin filament in the cardiac muscle?
Titin
A patient with a blood pressure consistently measured at 109/92 is correctly diagnosed as having stage 1 hypertension.
True
A person who experiences signs and symptoms consistent with acute coronary syndrome should immediately take an aspirin
True
Acute myocardial infarction and unstable angina are both acute coronary syndromes.
True
Blood pressure is the product of blood flow and vascular resistance.
True
Digitalis therapy may improve symptoms of CHF, but it doesn't alter survival.
True
If blood pressure drops, the baroreceptors stimulate the sympathetic nervous system and inhibit the parasympathetic nervous system.
True
Loss of functional myocardial cells is the principal cause of heart failure.
True
Most blood flow through the coronary arteries occurs during ventricular diastole.
True
Most cases of heart failure are a consequence of coronary heart disease or systemic hypertension.
True
Most myocardial infarctions occur when an atherosclerotic plaque stimulates thrombus formation at the site.
True
Stroke volume is reduced when afterload is increased
True
Systolic blood pressure is defined as the highest pressure detected in the arteries.
True
Systolic failure is associated with a low cardiac output and low ejection fraction.
True
The overall 5-year survival rate after onset of heart failure is about 50%.
True
The principal determinant of heart rate is the baroreceptor reflex.
True
The principal difference between systolic failure and diastolic failure is the ejection fraction.
True
Tissues can autoregulate rate of blood flow by controlling
Vascular resistance
Decreased cardiac output, muffled heart sounds, and equalized intracardiac pressures are manifestations of
Caradiac tamponade
Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?
Class I
Which of the following would result in an increase in systemic BP?
Vasoconstriction
After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later and reports "moderate" adherence to the recommended lifestyle changes. His blood pressure is 148/90. What is the most appropriate intervention at this time?
Continue lifestyle modifications only
Myocarditis should be suspected in a patient who presents with
Acute onset of biventricular failure
High bp increases workload of the the LV because it increases
Afterload
The majority of cardiac cells that die after myocardial infarction do so because of
Apoptosis
In which of the following dysrhythmias should treatment be instituted immediately?
Atrial fibrillation with a ventricular rate of 220 beats/min
Phase of cardiac cycle when mitral valve is open
Atrial systole
Angiotensin-converting enzyme (ACE) inhibitors block the
Conversion of angiotensin I to angiotensin II
Most appropriate treatment for secondary polycythemia
Measures to improve oxygenation
Thalassemia may be confused with iron-deficiency anemia because they are both
Microcytic
patient who presents with a loud pansystolic murmur that radiates to the axilla most likely has
Mitral regurgitation
Which of the following would cause vasoconstricition
Norepinephrine
Parasympathetic stimulation of the heart generally leads to a decrease in heart rate because acetylcholine
Opens potassium channels
The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by
P=QR
An abnormally wide (more than 1.0 msec) QRS complex is characteristic of
Premature ventricular complexes
Angina due to coronary artery spasm is called _____ angina.
Prinzmetal variant
Blood is transported from the right ventricle to the lungs by the
Pulmonary artery
Left-sided heart failure is characterized by
Pulmonary congestion
A patient with pure left-sided heart failure is likely to exhibit
Pulmonary congestion with dyspnea
Hypertrophy of rv is compensatory response to
Pulmonary stenosis
Which of the following is not a manifestation of acute arterial obstruction?
Purapura
Morphine and nitrates may be used in the management of acute pulmonary edema to
Reduce cardiac preload
Common denominator in most forms of heart failure is
Reduced cardiac output
Activation of barorecpetors by increased BP results in
Reduced heart rate
The majority of dysrhythmias are believed to occur because of
Reentry mechanisms
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells
Renin
What is the effect on resistance if the radius of a vessel is halved?
Resistance increases by facotr of 16
Blood pressure is lowest in the
Right atrium
After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of
Right-sided heart failure
The most reliable indicator that a person is experiencing acute myocardial ischemia is
ST-segment elevation
All of the following dysrhythmias are thought to be associated with reentrant mechanisms except
Second-degree AV block
Because of his high blood pressure, smoking history, obesity, and sedentary lifestyle, a patient is at significant risk for developing atherosclerosis. What laboratory evaluation would be most helpful in further assessing risk for atherosclerosis?
Serum lipid profile
Which of the following findings is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?
Sitting BP 110/72, HR 118
Restriction of which of the following electrolytes is recommended in the management of high blood pressure?
Sodium
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
Stable angina
Vessel with most rapid blood flow
Vena cava
An example of an acyanotic heart defect is
Ventricular septal defect
An increase in intracellular calcium ion results in myocardial contraction because calcium
binds troponin, causing actin-binding sites to be exposed.