Unit 4: Cardiovascular

Question 1

Edema

Answer 1

Abnormal accumulation of interstitial fluid due to force imbalances.

Increased vascular permeability, change in oncotic pressure, or lymphatic obstruction

Question 2

Exudate

Answer 2

Fluid with higher protein and cell content. Usually results from increased vascular permeability

Inflammatory

Question 3

Transudate

Answer 3

Lower protein and cell content. Usually a result of changes in pressure.

Hypervolemic
Hydrostatic
Oncotic

Question 4

Right ventricular congestive heart failure

Answer 4

Congestion of peripheral organs and extremities
Increased hydrostatic pressure, fluid overload

Peripheral edema (pitting, painless)
Enlarged liver
Ascites

Question 5

Left ventricular congestive heart failure

Answer 5

Transudation into alveoli
Pulmonary congestion and edema
Pleural effusion (dyspnea)

Question 6

Renal edema

Answer 6

Often caused by nephrotic syndrome
Decreased plasma oncotic pressure

Diffuse generalized edema
Ascites
Periorbital

Question 7

Virchow’s Triad

Answer 7

Three broad categories of factors that lead to thrombosis:

1. hypercoagulability
2. hemodynamic changes (stasis, turbulence)
3. endothelial insult, injury

Question 8

Thrombi

Answer 8

solid mass of blood cells and fibrin attached to the vessel wall

Occur when there is an interaction of coagulation proteins, endothelial cells and platelets

Question 9

Fate of thrombi

Answer 9

1. lysis and repurfusion
2. organization
3. recanalization
4. embolism

Question 10

Infarct

Answer 10

Localized tissue death, often resulting from ischemia

Question 11

Thrombophlebitis

Answer 11

Blood clot in a vein with inflammation

Usually extremities
Sx: red and swollen limb

Question 12

Thrombophlebitis: risk factors

Answer 12

immobilization
trauma
congestive heart failure
respiratory failure
obesity
pregnancy
recent childbirh
CA, cancer therapy

Question 13

Embolism

Answer 13

Freely movable intravascular mass

Question 14

Embolism: categories

Answer 14

Classified by origin

Arterial
Pulmonary
Thrombo
Gas
Fat
Tumor

Question 15

Atrial Septal defects

Answer 15

Congenital
Often asymptomatic, but may lead to thrombosis/CVA

Usually failure of foramen ovale to close

Question 16

Ventricular Septal defect

Answer 16

Congenital
Most common congenital heart defect

Defect in septum between left and right ventricle

Pulmonary hypertension
Heart murmur
Cyanosis
Right sided heart failure

Question 17

VSD pathogenesis

Answer 17

Greater left ventricle pressure causes left-to-right shunt

Now right ventricle has to work harder –> right ventricle hypertrophy –> increased blood flow to pulmonary arteries–> pulmonary hypertension
Narrowing of pulmonary artery –> increased right side pressure —> right-to-left shunt

BUT the blood going to the left ventricle is deoxygenated –> cyanosis

Question 18

Teratology of Fallot

Answer 18

Congenital heart defects

Pulmonary valvular stenosis
Ventricular septal defect
Dextroposition of the aorta
Hypertrophy of right ventricle

Presents with heart murmurs and cyanosis shortly after birh

Question 19

Patent ductus arteriosis

Answer 19

Ductus arteriosis between pulmonary artery and aorta fails to close after birth

Question 20

Coarctation of the aorta

Answer 20

Congenital narrowing of the aorta

Can lead to hypertension

Question 21

Rheumatic fever

Answer 21

Systemic autoimmune disease which occurs a few weeks after strep throat; antibodies damage heart tissue in 10% of cases

Question 22

Rheumatic fever: Sx

Answer 22

Carditis
Acute migratory joint pain
Heart murmurs
Skin manifestations (erythema marginatum or subQ nodules)
Chorea

Question 23

Pancarditis

Answer 23

Inflammation of cardiac tissue; can result from rheumatic fever, TB

Includes: endo, myo, and pericarditis

Question 24

Pericarditis

Answer 24

Inflammation of peri and epicardium

Can result from rheumatic fever, TB, viral infection
Can become chronic/constrictive

Sx can include chest pain, fever, joint pain, dyspnea, dysphagia

Question 25

Endocarditis

Answer 25

Inflammation of the endocardium Can result from rheumatic fever, IV drug users, septicemia, damaged heart valves which invite bacterial infecton May lead to destruction of heart valves Variably (but usually poor) prognosis

Question 26

Myocarditis

Answer 26

Uncommon inflammation of muscular walls of the heart Usually viral, parasitic. May also result from SLE, drugs, sarcoidosis Usually results in dilated myopathy; may also cause ventricular arrhythmias

Question 27

Mitral regurgitation

Answer 27

Incompetency of the mitral (bicuspid) valve Backflow from left ventricle to left atrium Often a sign of left heart failure

Question 28

Mitral Stenosis

Answer 28

Narrowing of mitral valve Impeded blood flow from left atrium to left ventricle Often a sign of left heart failure

Question 29

Mitral Valve prolapse

Answer 29

Most common heart valve abnormality Thicker, weaker mitral valve Usually benign but can increase mortality 15-20% Palpations, chest pain, dypnea

Question 30

Aortic regurgitation

Answer 30

incompetency of aortic valve Backflow from aorta to left atrium Sign of left heart failure

Question 31

Aortic stenosis

Answer 31

Narrowing of aortic valve, obstructing blood flow from left ventricle to aorta Angina, dyspnea, heart failure, palpation a, heart murmur

Question 32

Symptoms of pulmonary and tricuspid valve pathology

Answer 32

Same as for right sided heart failure Peripheral Edema

Question 33

Ischemic heart disease

Answer 33

Inadequate O2 supply to the myocardium Can be asymptomatic, or cause angina, dyspnea, fatigue, palpitations, congestive heart failure

Question 34

Most common cause of ischemic heart disease

Answer 34

Atherosclerosis

Question 35

Ischemic heart disease: pathogenesis

Answer 35

Either slow progressive narrowing of the arteries or sudden occlusion

Question 36

Stable angina pectoris

Answer 36

Ischemia heart disease Discomfort with exertion, relieved with rest and/or nitroglycerin. Rarely associated with infarction

Question 37

Unstable angina

Answer 37

Occurs early in morning Unrelated to activity Rapid narrowing coronary artery Not associated with infarction