Patho week 3
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?
Left ventricular workload is increased with high afterload
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?
Ventricular escape rhythm
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
Septic
What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?
Tachycardia
What results when systemic blood pressure is increased?
Vasoconstriction
Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?
Elevated CK-MB, troponin I and troponin T
A patient has a history of falls, syncope, dizziness, and blurred vision. The patients symptomology is most likely related to
Hypotension
A patient is exhibiting severe dyspnea and anxiety. The patient is also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing
acute cardiogenic pulmonary edema
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction.
High blood pressure increases the workload of the left ventricle, because it increases
afterload
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics
Low cardiac output in association with high preload is characteristic of
cardiogenic
Primary treatment for myocardial infraction (MI) is directed at
decreasing myocardial oxygen demands
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with
high cardiac output
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with
high cardiac output.
Hypotension associated with neurogenic and anaphylactic shock is because of
peripheral pooling of blood
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes
true
The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension
true
The effect of nitric oxide on systemic arterioles is
vasodilation
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock
Anaphylactic
In which dysrhythmias should treatment be instituted immediately?
Atrial fibrillation with a ventricular rate of 220 beats/minute
After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changed 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?
Continue lifestyle modifications only
Hypotension, distended neck veins and muffled heart sounds are classic manifestations of
Cardiac 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
In which stage of shock is a patient who lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?
Class II, compensated stage
Increased preload of the cardiac chambers may lead to which patient symptom?
Edema
Administration of which therapy is most appropriate for hypovolemic shock?
Crystalloids
Increased preload of cardiac chambers may lead to which patient symptom?
Edema
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
False
A patient is diagnosed with cardiogenic shock. the patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis
False
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic
False
Chronic elevation of myocardial wall tension results in atrophy
False
New-organ damage is a function of both the stage of hypertension and its duration.
False
The most commonly recognized outcome of hypertension is pulmonary disease
False
Which dysrhythmia is thought to be associated with reentrant mechanisms?
Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)
Angina caused by coronary artery spasm is called ____ angina
Prinzmetal variant
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 an acute myocardial infraction (MI) is
ST- segment elevation
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
Sitting BP 88/60, HR 118
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature through out the body
True
Mitral stenosis is associated with
a pressure gradient across the mitral valve
Sepsis has been recently redefined as
a systemic inflammatory response to infection
The majority of cardiac cells that die after myocardial infraction do so because of
apoptosis
Tachycardia is an early sign of low cardiac output that occurs because of
baroreceptor activity
Patent ductus arteriosus is accurately described as a(n)
communication between the aorta and the pulmonary artery
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload.
Aortic regurgitation is associated with
diastolic murmur
The therapy that most directly improve cardiac contractility in a patient with systolic heart failure is
digitalis
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
digitalis
A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)
elderly woman without a previous history of MI
Constrictive pericarditis is associated with
impaired cardiac filling
Lusitropic impairment refers to
impaired diastolic relaxation.
Second-degree heart block type I (Wenckebach) is characterized by
lengthening PR intervals and dropped P wave.
Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure
mean arterial
A loud pansystolic murmur that radiated to the axilla is most likely a result of
mitral regurgitation
Tumor necrosis factor a and interleukin-1 contribute to shock states because they induce production of
nitric oxide
The prevalence of high blood pressure is higher in
non-hispanic black adults
A patient with heart failure who reports intermittent shortness of breath during the nigh is experiencing
paroxysmal nocturnal dyspnea
An erroneously low blood pressure measurement may be caused by
positioning the arm above the heart level
An abnormally wide (more than 0.10 second) QRS complex is characteristic of
premature ventricular complexes
First-degree heart block is characterized by
prolonged PR interval
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 the right ventricle is a compensatory response to
pulmonary stenosis
Beta-blockers are advocated in the management of heart failure because they
reduce cardiac output
Cardiogenic shock is characterized by
reduced cardiac output
The common denominator in all forms of heart failure is
reduced cardiac output
The progressive stage of hypovolemic shock is characterized by
tachycardia
Atherosclerotic plaques with large lipid cores are prone to
rupture
Hypertension with a specific, identifiable cause is known as _____ hypertension
secondary
A patient presenting with fever, hypotension and lactic acidosis is most likely to be experiencing what type of shock
septic
A patient with a history of myocardial infraction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely causes of this pain is
stable angina
A patient with significant aortic stenosis is likely to experience
syncope
Pulse pressure is defined as
systolic pressure - diastolic pressure