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NYCC Visceral Pathology > Heart Failure & Shock > Flashcards

Heart Failure & Shock Flashcards

(53 cards)

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1
Q

What is the most common cause of cardiac failure?

A

Ischemic heart disease

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2
Q

_____ is seen in virtually all conditions associated with chronic heart failure?

A

Ventricular hypertrophy

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3
Q

What unique histological finding is present in the nuclei of a heart with hypertrophy?

A

Boxcar nuclei with hyperchromatic nuclei and thick, enlarged myocardial cells

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4
Q

What are the three classifications of heart failure?

A

Left-heart failure
Right-heart failure
Biventricular failure

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5
Q

What are the potential causes of left-sided heart failure?

A

Ischemic heart disease
Hypertension
Valvular disease

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6
Q

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

A

Ischemic heart disease

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7
Q

What are the clinical features of left heart failure?

A

Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Hemoptysis
Heart-Failure cells

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8
Q

What form of heart failure causes pulmonary edema in the lungs?

A

Left-heart failure

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9
Q

What cell is commonly seen in the lungs in a patient with left-sided heart failure?

A

Heart-failure cells

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10
Q

What is a heart failure cell and what pathology will it be present in?

A

Hemosiderin-laden macrophages in the alveolar air spaces of the lungs present in left-sided heart failure

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11
Q

What is orthopnea? What is it a clinical feature of?

A

Discomfort breathing while laying flat indicative of left-sided heart failure

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12
Q

What is paroxysmal nocturnal dyspnea? What is it a clinical feature of?

A

Short attacks of short breath occurring at night indicative of left-sided heart failure

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13
Q

With left heart failure, the lungs experience ____ failure?

A

Backward

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14
Q

With left heart failure, the kidneys, brain, and skeletal muscle all experience ____ failure?

A

Forward

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15
Q

What signs and symptoms will be present in a brain experiencing forward left heart failure?

A

Altered states of consciousness or personality changes

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16
Q

What signs and symptoms will be present in skeletal muscle experiencing left heart failure?

A

Atrophy, fatigue, weakness, and exercise intolerance

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17
Q

What signs and symptoms will be present related to the kidney in a patient with left heart failure?

A

Increased BUN and creatinine, decreased pH (acidic), increased renal pressure

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18
Q

What type of overload and myocardial hypertrophy causes pulmonary edema?

A

Pressure overload and concentric hypertrophy

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19
Q

Aortic stenosis can cause (Pressure/Volume) overload leading to (Concentric/Eccentric) hypertrophy and pulmonary edema?

A

Pressure, concentric

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20
Q

Aortic stenosis can cause (Right/Left) heart failure and pressure overload?

A

Left

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21
Q

Pulmonary stenosis can cause (Right/Left) heart failure?

A

Right

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22
Q

What is the most common etiology of right heart failure?

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A

Left-heart failure

23
Q

What are common etiologies of right heart failure?

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A

Left-heart failure
Pulmonary hypertension/Cor pulmonale
Intrinsic diseases

24
Q

Pulmonary hypertension results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?

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A

Pressure, concentric, right

25
Late stage cor pulmonale results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?
Volume, eccentric, right
26
What does COPD stand for? What cardiac pathology can it cause?
Chronic obstructive pulmonary disease causing pulmonary hypertension and right-sided heart failure
27
COPD results in (Pressure/Volume) overload and (Concentric/Eccentric) hypertrophy as well as (Right/Left) heart failure?
Pressure, concentric, right
28
What are the clinical features of right-sided heart failure?
Neck vein distension Elevated jugular venous pressure (EJV) Hepato-abdomino-jugular reflex Hepatomegaly Splenomegaly Ascites Bilateral pitting edema in the lower extremities
29
Neck vein distension and elevated jugular venous pressure are clinical signs of (Right/Left) sided heart failure?
Right
30
The hepato-abdomino-jugular reflex, hepatomegaly, and/or splenomegaly are clinical signs of (Right/Left) sided heart failure?
Right
31
Ascites is a clinical sign indicative of (Right/Left) sided heart failure?
Right
32
Bilateral pitting edema in the lower extremities is most likely caused by (Right/Left) sided heart failure?
Right
33
Nutmeg liver is most commonly caused by (Right/Left) sided heart failure?
Right
34
What is the criteria for determining the severity of pitting edema?
Depth of pit and time that pit lasts
35
What is shock?
Global hypoperfusion of tissues
36
What is hypovolemic shock?
Shock resulting from loss of blood volume and plasma
37
What is septic shock?
Shock caused by a gram negative bacterial infection and lipid A endotoxins
38
What is cardiogenic shock?
Shock that results when the heart is unable to meet the demands placed on it by the body
39
What is anaphylactic shock?
Shock due to an allergic or hypersensitivity reaction resulting in increased IgE, histamine, eosinophils, and basophils
40
What is neurogenic shock?
Shock caused by a brain or spinal cord injury
41
What are the three sequential stages of shock?
Non-progressive Progressive Irreversible
42
What systems are active in the non-progressive stage of shock?
RAAS, sympathetic nervous system, autoregulation
43
What signs occur during the progressive stage of shock?
Metabolic acidosis and hypotension
44
What signs occur during irreversible stage of shock?
Multi-system organ failure, increased LDH, CK, BUN, creatinine, amylase, and lipase
45
What effect does shock have on the heart?
Decreased cardiac output, clotting, and possible MI
46
What effect does shock have on the kidney?
Oliguria and increased BUN
47
What is oliguria and what can cause it?
Decreased urine output by the kidney caused by shock
48
What effect does shock have on the lungs?
Foamy cough, dyspnea, "deathrattle" sound
49
What effect does shock have on the GI tract?
Ischemic infarct, gangrenous necrosis, melena, and hematochezia
50
What is hematochezia and what can cause it?
Bright red blood in the stool indicative of a lower GI bleed caused by shock, hemorrhoids, or neoplasias
51
What is melena and what can cause it?
Black, tarry stool indicative of an upper GI bleed caused by shock or neoplasias
52
What effect does shock have on the brain?
Loss of consciousness, dizziness, comatose state
53
What effect does shock have on the skin?
Cold cyanosis

NYCC Visceral Pathology (40 decks)

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