Patho Exam 3 Heart Failure

Question 1

signs of acute cardiogenic pulmonary edema (deadly)

Answer 1

impaired gas exchange
severe dyspnea and anxiety
bolt upright posture
bubbly crackles and pink frothy sputum
cyanosis

Question 2

three types of dysrhythmias

Answer 2

abnormal rates of sinus rhythm
abnormal sites of impulse initiation
disturbances in conduction pathways

Question 3

NYHA class C

Answer 3

Objective evidence of moderately severe cardiovascular disease. Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.

Question 4

FACES tool for diagnosing HF

Answer 4

fatigue
activity limitation
congestion
edema
shortness of breath

Question 5

normal QRS interval

Answer 5

.06-.1 sec

Question 6

signs of pulmonary congestion

Answer 6

cough, rales/crackles, hypoxemia, S3 gallop, and high left atrial pressure

Question 7

normal PR interval

Answer 7

.12-.2 sec

Question 8

NYHA class 2

Answer 8

Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).

Question 9

cor pulmonale

Answer 9

right ventricular hypertrophy

Question 10

Commonly used criteria for determining heart failure

Answer 10

dyspnea, pulmonary rales, cardiomegaly, pulmonary edema, S3 heart sounds, and tachycardia.

Question 11

NYHA class 4

Answer 11

Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

Question 12

Diastolic dysfunction happens mostly in

Answer 12

the elderly, women, and those without history of MI.

Question 13

NYHA class 3

Answer 13

Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.

Question 14

How does sympathetic activation affect the heart?

Answer 14

Increased HR, contractility, and preload (from fluid retention)

Question 15

ventricular tachycardia

Answer 15

sustained for 30 seconds, with or without a pulse, 100-220 bpm

Question 16

What causes reentry?

Answer 16

continued depolarization after the main impulse has ceased due to slow or long pathway of the electrical conduction in the heart. Caused by gap junction issues, myocardial ischemia, excessive Epi/NE, and electrolyte imbalances.

Question 17

Which cells are stimulated by the SNS to start the RAAS system?

Answer 17

juxtaglomerular cells release renin

Question 18

How does SNS become problematic in HF?

Answer 18

Increased afterload due to HTN decreased stroke volume and increases cardiac workload. Causes cardiac remodeling which is less functional

Question 19

ventricular fibrillation

Answer 19

low electrical activity of the heart, no effective heart contraction or pulse. rapid uncoordinated cardiac rhythm.

Question 20

What causes triggered activity?

Answer 20

digoxin toxicity, excessive Epi/NE, and increased intracellular free calcium (genetic issues)

Question 21

NYHA class B

Answer 21

Objective evidence of minimal cardiovascular disease. Mild symptoms and slight limitation during ordinary activity. Comfortable at rest.

Question 22

causes of impaired contractility

Answer 22

loss of cardiac muscle cells, B1-receptor down regulation, reduced ATP production (due to ischemia), and altered CA2+ regulation.

Question 23

treatment for sinus bradycardia

Answer 23

if due to low CO, sympathomimetic or parasympatholytic drugs

Question 24

signs of left-sided heart failure

Answer 24

dyspnea, orthopnea, crackles, cough, pulmonary edema, and hypoxemia

Question 25

How does SNS become problematic in HF?

Answer 25

Increased afterload due to HTN decreased stroke volume and increases cardiac workload

Question 26

cause of eccentric hypertrophy (elongated muscle fibers)

Answer 26

excessive preload

Question 27

what causes abnormal automaticity

Answer 27

failure to repolarize to resting membrane potential or abnormal plasma membrane leakiness to sodium or calcium ions at rest. Action potentials are set off too frequently. Hypokalemia is a cause.

Question 28

What causes cardiac hypertrophy?

Answer 28

chronic elavation of myocardial wall tension from increased diastolic blood volume (high preload) or high systolic pressures needed to overcome high afterload

Question 29

treatment for sinus tachycardia

Answer 29

sympatholytic agents or calcium channel blockers

Question 30

signs of right-sided heart failure

Answer 30

systemic venous congestion, jugular vein distension, hepatomegaly, splenomegaly, and peripheral edmea

Question 31

sick sinus syndrome

Answer 31

alternating periods of tachy and brady sinus rhythms

Question 32

normal HR

Answer 32

60-100 bpm

Question 33

What are the three main compensatory mechanisms activated in heart failure?

Answer 33

SNS activation, increased preload, and myocardial hypertrophy.

Question 34

NYHA class A

Answer 34

No objective evidence of cardiovascular disease. No symptoms and no limitation in ordinary physical activity.

Question 35

lack of abdomen sounds

Answer 35

ileus

Question 36

HEAD right sided heart failure

Answer 36

hepatomegaly
edema
ascites
distended jugular vein

Question 37

How is the sympathetic nervous system activated?

Answer 37

when baroreceptors detect low blood pressure due to dimished stroke volume

Question 38

Heart failure risk factors

Answer 38

Coronary artery disease, hypertension, and cardiomyopathies.

Question 39

CHOP left sided heart failure

Answer 39

cough, hemoptysosis, orthopnea, pulmonary congestion

Question 40

cause of concentric hypertrophy (muscle fibers grow in diameter and thicken the ventricle wall)

Answer 40

high afterload

Question 41

NYHA class 1

Answer 41

No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).