PATHO: Chapter 16,18,19,20

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

b. ST-segment elevation

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

b. a pressure gradient across the mitral valve

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. acute onset of left ventricular dysfunction

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. antiplatelet drugs

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

b. cardiac tamponade

In which stage of shock is a patient who has lost 1200 ml of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing a. class I, initial stage b. class II, compensated stage c. class III, progressive stage d. class iv, refractory stage

b. class II, compensated stage

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. conversion of angiotensin I to angiotensin II

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. decreasing myocardial oxygen demands

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

b. hypotension

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

b. impaired diastolic relaxation

An elderly patients blood pressure is measured at 160/98. How would the patients 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. left ventricular workload is increase with high afterload

Second-degree heart block type I (Wenckebach) is characterized by a. absent P waves b. lengthening PR intervals and dropped P wave c. constant PR interval and dropped QRS complexes d. no correlation between P waves and QRS complexes

b. lengthening PR intervals and dropped P wave

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. obstructive

A patient with pure left-sided hear failure is likely to exhibit a. jugular vein distention b. pulmonary congestion with dyspnea c. peripheral edema d. hepatomegaly

b. pulmonary congestion with dyspnea

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. reduce cardiac output

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. septic

Tachycardia is an early sign of low cardiac output that occurs because of a. tissue hypoxia b. anxiety c. baroreceptor activity d. acidosis

c. baroreceptor activity

Patent. ductus ateriosus is accurately described as a(n) a. opening between the atria b. structure of the aorta that impedes blood flow c. communication between the aorta and the pulmonary artery d. cyanotic heart defect associated with right-to-left-shunt

c. communication between the aorta and the pulmonary artery

Administration of a vasodilator to a patient in shock would be expected to a. decrease vascular resistance b. increase contractility c. decrease left ventricular afterload d. increase tissue perfusion

c. decrease left ventricular afterload

Increased preload of the cardiac chambers may lead to which patient symptoms? a. decreased heart rate b. decreased respiratory rate c. edema d. excitability

c. edema

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. high cardiac output

a loud pansystolic murmur that radiated to the axilla is most likely a result of a. aotric regurgitation b. aortic stenosis c. mitral regurgitation d. mitral stenosis

c. mitral regurgitation

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

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

c. secondary

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

c. systemic inflammatory response to infection

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 x systemic resistance

c. systolic pressure - diastolic pressure

What results when systemic blood pressure is increased? a. hypovolemia b. decreased cardiac output c. vasoconstriction d. decreased vascular resistance

c. vasoconstriction

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm? a. third-degree heart block b. junctional tachycardia c. ventricular escape rhythm d. sinus bradycardia

c. ventricular escape rhythm

Patient with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Hear Association heart failure class? a. class I b. class II c. class III d. class IV

a. class I

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. diastolic murmur

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

a. elderly-women without a previous history of MI

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. elevated CK-MB, troponin I, and troponin T

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. positioning the arm above the heart level

hypertophy of the right ventricle is a compensatory response to a. aortic stenosis b. aortic regurgitation c. tricuspid stenosis d. pulmonary stenosis

d. pulmonary stenosis

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

d. septic

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. septic

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis true false

false

New-organ damage is a function of both the stage of hypertension and its duration true false

false

The most commonly recognized outcome of hypertension is pulmonary disease true false

false

a type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic true false

false