Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drug Action I > Block 2 - CHF Physiology > Flashcards

Block 2 - CHF Physiology Flashcards

(83 cards)

Start Studying
1
Q

What is HF?

A

Inability of heart to pump adequate amount of blood to meet metabolic needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the primary HFs?

A
  1. Muscular contraction problem (decreased ejection)
  2. Muscular relaxation problem (inadequate filling)
  3. Combination of contraction and relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is CO?

A

Amount of blood pumped out of the heart in L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the systems affected by HF?

A

RAAS and SNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes volume overload and fatigue?

A

Response to compensatory mechanism triggered by decreased CO for long term maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What mechanisms can exacerbate HF?

A
  1. Fluid retention
  2. Vasoconstriction
  3. Myocardial stimulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the symptoms of HF?

A
  1. Fatigue
  2. SOB
  3. Inability to exercise
  4. Swelling in extremities (edema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is HF diagnosed?

A

Increased BNP levels with HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is BNP?

A

Secreted cardiomyocytes in response to excess stretching from increased ventricular blood volume

PreproBNP → ProBNP → BNP + NT-proBNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does BNP do?

A
  1. Vasodilation → decrease resistance
  2. Naturesis and diuresis → reduced BV
  3. Decrease CO and pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the concepts of HF that reinforce it being a progressive disorder?

A
  1. Initial cardiac injury
  2. Compensatory mechanisms
  3. Secondary damage
  4. Cardiac decompensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kind of cardiac injury leads to HF?

A
  1. Damages of heart
  2. Impairs heart ability to contract
  3. Reduce pumping capacity of heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the compensatory mechanisms used to control HF?

A
  1. Activate with reduction in pumping capacity
  2. Maintaining near-normal left ventricle functions (SNS, RAAS, Inflammatory mediators)
  3. Maladaptive over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are secondary damages that caused by HF?

A
  1. End organ damage (ventricle)
  2. Left venatricular remodeling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are classifications of HF?

A
  1. Chamber affected
  2. Type of HF
  3. Clinical sequelae
  4. Type and timing of symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is left-sided HF? Outcomes?

A

Causes volume overload and venous congestion in lungs → Na+ and H2O retention → pulmonary venous congestion → Fatigue and SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between forward and backward failure LHF?

A

F: Fails to put enough out (decreased urine, palpitations, fatigue)
B: Fails to relieve enough in (congestion, fluid buildup)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Right sided HF? Pathophys?

A
  1. Caused by LVF
  2. More vulnerable to volume overload than LV
  3. When LV fails, pulmonary venous congestion increases RV work → Generating more force → venous congestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the results in RHF?

A
  1. Elevated jugular pressure
  2. Liver congestion
  3. Peripheral edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the results of isolated RV failure?

A
  1. Incomplete LV filling
  2. Decreased CO
  3. Contributes to HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T or F: Reduced CO is always caused by reduced contractility

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is SV?

A

Amount of blood pumped out of the heart with each beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is EF?

A

Percentage of blood ejected from the ventricles with each contraction

EF = SV/EDV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the difference between systolic and diastolic HF?

A

S: HF with reduced EF
D: HF with preserved EF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What kind of HF is a majority of cases?
low output HF
26
What is low-output HF?
Heart can't pump a sufficient amount of blood CO is reduced Tissue perfusion decreases Cells don't receive sufficient O and nutrients
27
**T or F:** HF is chronic
True
28
How can patients manage their HF?
1. Meds 2. Low sodium 3. Symptom monitoring 4. Weight and vital sign monitoring 5. Health status decision making
29
Individuals with chronic HF may develop ______ requiring ______
Acute decompensated HF; hospitalization
30
What are the causes of ADHF?
1. Stress 2. Infection 3. Diet and med nonadherence 4. Poor health 5. High BP 6. MI 7. Alcohol and endocrine disorders
31
ADHF can range from ___ to ___
Volume overload to cariogenic shock
32
**T or F:** Acute HF can NOT be isolated.
False Patients can recover from event but must take inotropic meds or have mechanical support
33
Classifications of heart disease are based on _____ according to the _____
Functional capacity; NY Heart Association
34
Describe the classes for staging HF according to NYHA?
Class I: Heart disease does **not affect** daily activities. Class II: Heart disease causes **slight activity limitations** but does not cause problems at rest. Class III: Heart disease causes **marked activity limitations** but does not cause problems at rest. Class IV: Heart disease causes **symptoms with any level of activity and sometimes at rest.**
35
What are the pros and cons of having the system based on NYHA?
1. Subjective and prone to bias 2. Difficult to define what constitutes normal activity 3. Effective in predicting mortality
36
How do ACC/AHA differ from NYHA classification of HF?
Based on evolution of disease Staging can only advance and patient can't move back
37
Describe the classes for staging HF according to ACC/AHA? How is it treated?
**A:** At high risk for HF but without structural heart diseaseor symptoms of HF. Lifestyle modifications. **Treatment of underlying disorder.** **B:** Structural heart disease but without signs or symptoms of HF. **ACE inhibitors, ARBs, beta blockers, blood pressure control.** **C:** Structural heart disease with prior or current symptoms of HF. **Diuretics, aldosterone blockers, vasodilators.** **D:** Refractory HF requiring specialized interventions. **Heart transplantation, LV assist devices, continuous IV inotropes.**
38
NYHA is based on ____ ACC/AHA is based on ____ Killip classificaction is based on ____
1. Functional capacity 2. Evolution of disease 3. Hemodynamic ability
39
How does Killip differ from other stagings?
1. Severity of MI in the presence of HF 2. Based on seerity of HF symptoms that occur as a result of depression of heart muscle function
40
Describe the classes for staging HF according to Killip? How is it treated?
I: **No HF.** II: **HF.** III: **Severe HF.** IV: **Cardiogenic shock.**
41
The higher the Killip class, the ___ severe ______
More: burden of HF
42
What is used by Killip to determine the risk of death after MI?
1. TIMI-RS 2. GRACE-RS 3. CADILLAC-RS
43
What impariments does systolic HF cause? What does it effect?
1. Decreased CO and BP 2. Triggers compensatory mechanisms 3. HF with reduced EF Right, left, or both sides
44
What are some of the causes of dilated cardiomyopathy for Systolic HF?
1. Idiopathic 2. Ischemic 3. Familial
45
What are the principles of normal heart function that are affected by systolic HF?
1. CO 2. Cardiac index 3. Preload 4. Afterlead 5. Contractility 6. Systemic vascular resistance
46
How do you calculate CO?
HRxCV
47
What is cardiac index? Normal value?
Obtained when CO is divided by body surface area 2.5-4.3 L/min/m^2
48
What is preload?
The amount of blood in the ventricle before contraction Influenced by BFV, venous return, and EF
49
What is afterload?
The amount of pressure the heart must generate to pump blood out of the ventricle
50
Right ventricle is to ____ circulation as the left ventricle is to ____ circulation
Pulmonary; Aortic and systemic
51
What is contractility?
The strength of muscular contraction in the heart muscle
52
**T or F:** Decreased contractility decreases SV.
True
53
What is systemic vascular resistance? Normal value?
The resistance to forward flow of blood 800-1200 dynes/sec/cm^3
54
DIfference between low and high SVR?
Lower: Lower pressure needed for forward flow of blood Higher: More difficult for heart to provide forward flow
55
What is a pulmonary artery catheter used to measure?
1. Preload 2. Afterload 3. CO
56
As CO decreases ___ ___ and ____ response occurs
EF decreases; neurohumoral
57
EF decrease → ___
1. Ventricular preload increases 2. Cardiac muscle stretches 3. Increase contractility when heart in normal (no increase if abnormal)
58
What occurs in neurohumoral response?
1. SNS release NE and E for BP and CO 2. SNS activation of RAAS
59
Natural responses can ____ HF by decreasing ____ ____ Neurohumoral responses lead to ____ ____ in the heart with chronic HF
Worsen; myocardial contractility Physical changes
60
Systolic HF doesnt affect the ____ but ____ ventricle
Circulation to ventricle; back up blood behind ventricle
61
What are the general symptoms of systolic HF?
1. Fatigue 2. Sleep disturbances 3. Weight loss 4. Anorexia 5. Dyspnea
62
What are the clinical signs of SHF?
1. Peripheral edema 2. Diminished distal pulses 3. Hypotension 4. Tachycardia
63
Pulmonary edema and hepatic congestion may develop ___
Cough Frothy sputum Right upper quad pain
64
How do you diagnose Systolic HF?
1. Transthoracic echocardiography 2. Chest X-ray 3. PRemature artial contraction 4. Biopsy of heart muscle 5. Coronary arteriography
65
What are the goals of systolic HF?
Decrease fluid retention and counteract neuorhumoral effects to reduce symptoms
66
What is the first line for Systolic HF?
ACEI ARB for those who can't use ACEIs
67
What are the treatments for systolic HF
1. Beta blockers 2. Vasodilator 3. Diuretic 4. Aldosterone antagonists
68
What are non pharms for Systolic HF?
1. Self care 2. Education 3. Ca
69
What is diastolic heart failure?
Abnormal relaxation of the heart with normal contractility HFpEF (presevered EF)
70
What are the characteristics of HFpEF?
1. SIgns and symptoms of HF 2. Normal left ventricular EF 3. Difficulty with ventricular relaxation that decreases diastolic ventricular filling
71
What are some of the outcomes of HFpEF?
Failure in relaxation caused by stiffness of muscle cells Decreased ventricle filling → Decreased CO → HF
72
What are soem risk factors that lead to HFpEF?
1. Obesity 2. HTN 3. Metabolic syndrome 4. DM
73
What are clinical manifestations of diastolic HF?
1. Decreased CO activates RAA 2. Renal insufficiency
74
How is Diastolic HF diagnosed?
None Diagnosis by exclusion
75
What are treatment with HFpEF?
No therapy to improves Cautions use of diuretics
76
What are the causes of LVHF?
1. Cardiomyopathy 2. CAD 3. ALcohol 4. HTN 5. HFpEF 6. Systolic HF and HFpEF
77
What are the clinical manifestations of LVHF?
1. Decreased BP 2. Enlarged cardiac muscle 3. Decreased CO 4. Preload increase and pressure in lungs 5. COugh 6. Extra heart sounds 7. Pulmonary edema 8. Decreased tissue perfusion and hypotenstion
78
How do you diagnos LVHF?
1. ECG 2. Pulmonary artery catheterization (PAC) 3. Lab exams
79
Treatment for LVHF?
1. Diuretic 2. ACEI 3. ARB 4. Aldosterone antagonists 5. Beta blockers 6. Self care 7. Surgery
80
What are the causes of RVHF?
1. increased RV afterload due to left-sided HF Pulmonary HTN → increased afterload → RV failure Ischemia or MI
81
What are the clinical manifestations of RVHF?
1. Reduced CO → SNS and RAAS 2. Mesentery edema 3. Liver enlargement 4. Neck vien distend and jugular pressure increase 5. Ascites and peripheral edema
82
How do you diagnose RVHF?
1. MRI 2. Transthoracic echocardiography 3. PAC
83
Treatment for RVHF?
1. Treatment of RV failure 2. Low sodium diet 3. Diuretics 4. Direct acting pulmonary vasodialtors 5. Inotrope support 6. IV inotropes 7. Surgery

Drug Action I (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions