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