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.