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Flashcards in Final Deck (65):

Name some anticoagulant substances:

- Aspirin, ASA: Acetylsalicylic acid.

- Heparin

- Warfarin


What are some common signs/symptoms of Hodgkin's disease?

First indicator: painless, enlarged cervical lymph node.

Later: Splenomegaly and/or a mediastinal mass as well as enlarged lymph nodes at other locations.

General signs of cancer: weight loss, anemia, low grade fever, night sweats

Maybe some general puritis and recurrent infections.


What actions cause the atrioventricular valves to close?

As the ventricles start to contract, the ventricular pressure soon exceeds the atrial pressure, causing the AV valves to close. As the ventricles continue to contract, the ventricular pressure exceeds the arterial pressures causing the semilunar valves open.


What is the QRS wave on an ECG?

The QRS complex corresponds to the depolarization of the left and right ventricles.


What does cardiac reserve refer to?

Refers to the difference between the rate at which the heart pumps blood and its maximum capacity for pumping blood at any given time. A measurement of the cardiac reserve may be a health indicator for some medical condition.


What does the term "preload" refer to?

Preload is the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions under variable physiologic demand.


What effects does smoking have on CAD?

Coronary Artery Disease: Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.


What are some predisposing factors to thrombus formation in the circulation?

1) Hypercoagulable state: malignancy, pregnancy and peri-partum period, nephrotic syndrome, and sepsis...

2) Circulatory stasis: atrial fibrillation, left ventricular dysfunction, immobility/paralysis, or venous insufficiency.

3) Vascular wall injury: Trauma, heart valve injury/surgery, chemical injury, indwelling catheters, or atherosclerosis.


What is arteriosclerosis?

The build-up of fats, cholesterol, and other substances in and on the artery walls.


What does an atheroma develop from?

Development of deposits of fibrous tissue and lipids on arterial walls.



Low Density Lipoprotein

Promote atheroma development.


Comparison between MI and angina:

MI: Angina does not usually cause lasting damage to the heart. Heart attacks can happen if the flow of oxygen-rich blood to heart muscle suddenly becomes blocked. Chest pain is usually more severe, lasts longer and does not go away with rest or nitroglycerin.

Angina: Angina is chest pain, tightness, or discomfort that comes and goes. It gets worse with activity or stress. It gets better with rest, medicine called nitroglycerin, or both. Angina does not damage the heart muscle, like an MI does.


Basic pathophysiology of MI:

A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle


Early signs of MI include:

- Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back.

- Nausea, indigestion, heartburn or abdominal pain.

- Shortness of breath.

- Cold sweat.

- Fatigue.

- Lightheadedness or sudden dizziness.


Calcium channel blocking drugs are effective in:

Calcium channel blockers prevent calcium from entering cells of the heart and blood vessel walls, resulting in lower blood pressure. Calcium channel blockers, also called calcium antagonists, relax and widen blood vessels by affecting the muscle cells in the arterial walls.


How is a MI best confirmed?

The diagnosis of myocardial infarction requires two out of three components (history, ECG, and enzymes). When damage to the heart occurs, levels of cardiac markers rise over time, which is why blood tests for them are taken over a 24-hour period.


What is the most common cause of death immediately following a MI?

Cardiac rupture. After arrhythmias and cardiogenic shock, the commonest cause of death after acute MI is rupture. Cardiac rupture complicates 10 per cent of acute MIs and occurs in the healing stages at around five to nine days.


Ventricular fibrillation will result in cardiac arrest because:

The lower chambers quiver and the heart can't pump any blood, causing cardiac arrest. The heart's electrical activity becomes disordered.


What is the most likely cause of left-sided heart failure?

Insufficient left ventricular contraction caused by:

- Left ventricular MI
- Aortic or mitral valve stenosis


Which drug improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions?

Digoxin, a cardiac glycoside, from the foxglove flower.


What effect may be expected from a "beta-blocking" drug?

Decreased SNS stimulation of heart.

Beta-adrenergic blockers:
- Reduce myocardial oxygen demand ( by slowing the heart rate and increasing the force of myocardial contractions)

- Antiarrythmic.

Ex: atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal).


What would an incompetent mitral valve cause?

Left sided HF, Pulmonary edema


Why does pericarditis cause a reduction in cardiac output?

Cardiac tamponade can develop if the effusion builds too rapidly.

This constricts the normal size of the heart and its movements leading to reduced stroke volume and output.


What could be the source of an embolus causing an obstruction in the brain?

An embolism is usually a pathological event, i.e., accompanying illness or injury.

The heart (atherosclerosis is common cause).


The basic pathophysiologic change in essential hypertension is considered to be:

Idiopathic. Increased systemic vasoconstriction.

HTN is a major cause of stroke, cardiac disease, and renal failure.

Causes of essential:
- Complex abnormalities in the mechanisms that control cardiac output, systemic vascular resistance, and blood volume.

- Genetic factors such as insulin resistance.

- Increased SNS activity.

- Risk factors: Obesity, stress, sedentary lifestyle, and high salt intake.


Uncontrolled hypertension is most likely to cause ischemia and loss of function in the:

Kidneys, brain, and retinas of the eye.


A Dx of HTN is considered when:

BP is consistently above 140/90.


The term, intermittent claudication refers to:

Claudication is pain caused by too little blood flow, usually during exercise. Sometimes called intermittent claudication, this condition generally affects the blood vessels in the legs, but claudication can affect the arms, too.


A dissecting aortic aneurysm develops when:

Chronic high blood pressure may stress the aortic tissue, making it more susceptible to tearing.


The outcome for many aortic aneurysms is:

Rupture and hemorrhage.

Prognosis. About 20% of patients with aortic dissection die before reaching the hospital. Without treatment, mortality rate is 1 to 3%/h during the first 24 h, 30% at 1 wk, 80% at 2 wk, and 90% at 1 yr. Hospital mortality rate for treated patients is about 30% for proximal dissection and 10% for distal.


Shock is defined as:

A critical condition that is brought on by a sudden drop in blood flow through the body. The circulatory system fails to maintain adequate blood flow, sharply curtailing the delivery of oxygen and nutrients to vital organs. It also compromises the kidneys and so restricts the removal of wastes from the body.


Shock may follow MI when:

A large portion of the myocardium is damaged.


Early signs of circulatory shock include:

1. Pale, moist skin.

2. Anxiety and restlessness.


Compensation for shock is indicated by:

Increased heart rate and oliguria.


Anaphylactic shock causes severe hypoxia very quickly because:

Bronchoconstriction and bronchial edema reduce airflow.


Decompensated acidosis related to shock would be indicated by:

Serum pH below normal range.


With shock, anaerobic cell metabolism and decreased renal blood flow causes:

Metabolic acidosis.


Shock develops in patients with severe burns because of:

Pain and loss of plasma.


When the diaphragm relaxes:

We exhale.


Cor pulmonale may develop with chronic pulmonary disease because:

Lung conditions that cause a low blood oxygen level in the blood over a long time can also lead to cor pulmonale.

Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to cor pulmonale.


The maximum volume of air a person can exhale after a maximum inspiration is called the:

Vital capacity


The basic pathophysiology of cystic fibrosis is considered to be:

An abnormality of the exocrine glands


Compensation mechanisms for individuals with anemias include:

Tachycardia and peripheral vasoconstriction.


Significant signs of right-sided heart failure include:

Edematous feet and legs with hepatomegaly.


The changes resulting from total heart block include:

Spontaneous slow ventricular contractions, not coordinated with atrial contraction


What are compensation mechanisms for decreased cardiac output?

Sympathetic nervous system stimulation (inc. catecholemines)
--RAAS activation: Increased renin and aldosterone secretion. This helps build up blood volume.


Pernicious anemia usually develops slowly, over the course of 20-30 years

Pernicious anemia aka Megaloblastic anemia.

This is true. Many have B-12 stores that can last 5-10 years. And symptoms develop slowly in that the patient is gradually sensitized to feeling crummy.


In posthemorrhagic anemia the number of circulating reticulocytes is:


Body is trying to replace the loss.
(Reticulocytes are immature RBCs)


What's hypochlorhydria?

Low stomach acid


Folate is essential for DNA synthesis:

True. It's necessary for the production and maintenance of new cells, for DNA and RNA synthesis...


Is bone marrow involvement more common in Hodgkin or non-Hodgkin's lymphoma?

Both have bone penetration in the fourth stage.


In some anemias the erythrocytes are present in various sizes, this is called:



Which anemia is classified as macrocyclic normochromic anemia?

Pernicious anemia.


Erythrocytes that are ? contain abnormally low concentration of hemoglobin:



Normocytic-normochromic anemias include:

These types of anemias are caused by RBC hemolysis, acute bleeding, malignancies such as leukemia and lymphoma, chronic disease states, infections and renal and liver diseases to name a few.


Respiratory system compensation for tissue hypoxia includes:



The cause of macrocyctic anemia is usually related to:



Why do vitamin B12 and folate deficiencies cause anemia?

These are needed for RBC synthesis


Individuals with highest risk for developing a vitamin B12 deficiency anemia:



A population group for high risk for folate deficiency is:



The Schilling test for pernicious anemia involves:

Radioactive B12 to measure absorption


Which anemia show signs of extreme fatigue, shortness of breath, and skin/sclera appear to have a yellowish hue:



Complaints of fatigue, weight loss, and tingling in fingers. Labs show low hemoglobin and hematocrit, a high mean corpuscular volume, a normal plasma iron... these findings are consistent with which anemia?



Eosinophilia can result from?

Parasitic diseases and allergic reactions to medication as well as some cancers (bone).


A hereditary abnormality associated with a high rate of leukemia:

Down syndrome in children, Philadelphia chromosome for adults.