CAT Topics 1

Question 1

CHF: impairment in cardiac output causes the body to compensate and results in an increase in

Answer 1

• blood volume
• cardiac filling pressure
• heart rate
• cardiac muscle mass

Question 2

A pt with CHF will initially show signs of _____

Answer 2

Tachycardia

Question 3

Left sided heart failure is generally associated with signs of _________ venous congestion

Answer 3

Pulmonary

Question 4

R sided heart failure is generally associated with signs of _______ venous congestion

Answer 4

Systemic

Question 5

CHF: Over time, fluid accumulation spreads and you get

Answer 5

• ankle edema
• congestive hepatomegaly
• ascites
• pleural effusion

Question 6

What medication issue do you have to watch out for with CHF?

Answer 6

Digitalis toxicity

Question 7

Medical mgmt for CHF: types of drugs used

Answer 7

• diuretics
• nitrates
• analgesics
• ACE inhibitors

Question 8

CHF: survival

Answer 8

3-5 years

Question 9

How is cor pulmonale different from CHF?

Answer 9

Form of R sided heart failure, but is normally seen as a consequence of COPD

Question 10

With CF, there is an underlying impermeability of epithelial cells to _______

Answer 10

Chloride

Question 11

The most consistent symptom to confirm CF is

Answer 11

The finding of high concentrations of sodium and chloride in the sweat

Question 12

Sodium and chloride amounts greater than ___ mEq/l is a positive dx for CF

Answer 12

60

Standard value is 40

Question 13

CF is (obstructive/restrictive)

Answer 13

Obstructive

Question 14

CF: Airway obstruction can lead to

Answer 14

• pulmonary HTN
• atelectasis
• pneumonia
• lung abscess

Question 15

CF median age of death

Answer 15

35 years

Question 16

Most common cause of death for CF pts

Answer 16

Respiratory failure

Question 17

3 Classifications of emphysema

Answer 17

• centrilobular
• panlobular
• paraseptal

Question 18

Emphysema results from non-reversible injury and destruction of this protein within the alveolar walls

Answer 18

Elastin

Question 19

Pockets of air that form between alveolar spaces

Answer 19

Blebs

Question 20

Pockets of air that form within the lung parenchyma

Answer 20

Bullae

Question 21

Centrilobular emphysema destroys _______, but _____ remain intact

Answer 21

• bronchioles of upper lungs

- alveoli

Question 22

Panlobular emphysema destroys _____ and is usually found here

Answer 22

• destroys air spaces of the acinus

- found in lower lungs

Question 23

Paraseptal emphysema destroys _______

Answer 23

Alveoli in lower lobes

Question 24

This type of emphysema results in blebs along the lung periphery

Answer 24

Paraseptal

Question 25

Characteristics of emphysema patients

Answer 25

- Barrel chest, rounded shoulders - Rosy - Pursed lip breathing

Question 26

Emphysema: formation and rupture of bullae and blebs can lead to

Answer 26

Pneumothorax

Question 27

This is a serious complication that can occur with advanced emphysema

Answer 27

Cor pulmonale

Question 28

Emphysema: pharmacological mgmt

Answer 28

- bronchodilators - mucolytics - anti-inflammatory agents - mast cell membrane stabilizers - antihistamines

Question 29

This type of MI involves the full thickness of the myocardium

Answer 29

Transmural

Question 30

This type of MI involves the subendocardial area (inner third of the myocardium)

Answer 30

Nontransmural

Question 31

3 zones that form concentric circles around the point of infarction

Answer 31

- zone of infarct - zone of hypoxic injury - zone of ischemia

Question 32

Approximately ⅔ of patients experience prodromal symptoms days to weeks before an MI, including:

Answer 32

- unstable angina - SOB - fatigue

Question 33

Primary tool to detect MI

Answer 33

12 lead ECT

Question 34

ECG: An inverted T wave indicates

Answer 34

Myocardial ischemia

Question 35

ECG: An elevated ST segment indicates

Answer 35

Acute infarction

Question 36

ECG: A depressed ST segment indicates

Answer 36

Pending subendocardial or transmural infarction

Question 37

Arrhythmias occur in 90% of pts post-MI and are caused by

Answer 37

- ischemia - ANS impairment - electrolyte imbalance - conduction deficits - chemical imbalances

Question 38

This accounts for 90% of all cases of angina

Answer 38

CAD

Question 39

PVD aka

Answer 39

Arteriosclerosis obliterans

Question 40

Primary risk factor for developing PVD

Answer 40

Atherosclerosis

Question 41

During the early stages of PVD, this may be the only manifestation

Answer 41

Intermittent claudication

Question 42

It is fairly common for a pt with PVD to also have these dx’s

Answer 42

- CAD | - DM

Question 43

PVD: these meds may be indicated due to increased risk for DVT

Answer 43

Anticoagulants Antiplatelet agents Thrombolytics

Question 44

Symptomatic PVD has a ____% risk of death within 5 years

Answer 44

30%

Question 45

Symptomatic PVD has a ____% risk of death within 10 years

Answer 45

50%

Question 46

Symptomatic PVD: death usually results from

Answer 46

MI or cerebrovascular disease

Question 47

Most likely clinical presentation for RLD

Answer 47

Decrease in lung volumes

Question 48

RLD: diagnostic testing for confirmation

Answer 48

- chest radiograph | - ABG

Question 49

As RLD progresses, respiratory muscle fatigue will lead to

Answer 49

- impaired alveolar ventilation | - CO2 retention

Question 50

What are complications and outcomes of advanced RLD?

Answer 50

- Cor pulmonale - Hypoxemia - Pulmonary HTN - Severe decrease in oxygenation - Ventilatory failure