Lecture 26: Disease States - Diarrhea, Dehydration, and Heart Failure Flashcards Preview

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Flashcards in Lecture 26: Disease States - Diarrhea, Dehydration, and Heart Failure Deck (28):
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hypovolemia

decreased blood volume

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diarrhea

loss of electrolytes AND water

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diarrhea clinical signs

increased hematocrit, cold extremities (due to cutaneous vasoconstriction), reduced activity

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diarrhea causes decreased:

plasma volume, venous pressure, atrial pressure, venous return, ventricular end-diastolic volume, stroke volume, cardiac output, arterial pressure

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Angiotensin II triggers:

blood volume restoration

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arterial baroreceptor withdrawal in diarrhea triggers:

increase in sympathetic drive to non-essential beds

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dehydration

extreme loss of water with minimal loss of electrolytes

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results of dehydration

1) decreased plasma volume
2) renal vasoconstriction
3) decreased Na+ and H2O excretion, increased reabsorption
4) increased plasma osmolarity due to water loss

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increased plasma osmolarity --> vasopressin release?

increases

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2 main classes of heart failure:

1) systolic dysfunction
2) diastolic dysfunction

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systolic dysfunction

type of heart failure in which there is a problem with ventricular ejection

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diastolic dysfunction

type of heart failure in which there is a problem with ventricular filling

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most common cause of heart failure

impaired LV function

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decreased stroke volume --> sympathetic drive

increases (to help restore cardiac output)

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increased sympathetic drive --> water and Na retention

increases

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increased fluid retention --> venous return

increases

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increased fluid retention --> end-diastolic ventricular volume

increases

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*CHF is often characterized by increased edema resulting from increased capillary hydrostatic pressure*

.

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Causes of Left Heart Failure

systolic or diastolic dysfunction

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Causes of Right heart failure

increases in afterload: left-sided heart failure, increased pulmonary pressure

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Frank-Starling Compensatory Mechanism for heart failure

length-tension relationship. More stretch triggers a more forceful contraction.

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Ventricular hypertrophy compensatory mech. for heart failure

increase in cardiac mass to compensate for increased stress. Increases contractile force and reduces wall stress (however decreases compliance and increases diastolic ventricular pressures)

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Neurohumoral activation (compensatory mech. for heart failure)

Sympathoexcitation in response to decreased cardiac output. Elevates RAAS, vasopressin, intravascular volume, preload

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elevated vascular resistance --> CO

decreases

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CHF --> atrial pressure

increases

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inotropic drugs

increase ventricular contractility via increasing cytosolic calcium

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diuretic

decreases intravascular volume and fluid accumulation

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vasodilator drug

reduces total peripheral resistance and afterload

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