UNDERSTANDING PATHOPHYSIOLOGY
CHAPTER 40 CERTIFICATION EVALUATION
TEST COMPLETE QUESTIONS AND CORRECT
ANSWERS
◉ Causes of varicosities.
Answer: Damaged valves from trauma to the valve, OR chronic
venous distention (involving gravity and venous constriction).
◉ Risk factors for varicose veins.
Answer: Age, female sex, family history, obesity, pregnancy, DVT, and
prior leg injury.
◉ Chronic venous insufficiency.
Answer: Inadequate venous return over a long period of time (from
varicose veins or valvular incompetence) that causes pathologic
ischemic changes in the vasculature, skin, and supporting tissues.
◉ Venous stasis ulcers.
Answer: Ulcers that follow chronic venous insufficiency; develop
from the borderline metabolic state of cells in the affected
extremities.
,◉ Deep venous thrombosis (DVT) — cause.
Answer: Results from stasis of blood flow, endothelial damage, or
hypercoagulability.
◉ Triad of Virchow.
Answer: The three factors in venous thrombus formation: venous
stasis, venous endothelial damage, and a hypercoagulable state.
◉ Conditions associated with thrombus formation (Virchow triad).
Answer: Cancer, orthopedic surgery, trauma, heart failure, and
immobility.
◉ Most serious complication of DVT.
Answer: Pulmonary embolism.
◉ Superior vena cava (SVC) syndrome.
Answer: Progressive occlusion of the superior vena cava leading to
venous distention of the upper extremities and head.
◉ Most common cause of SVC syndrome.
Answer: Bronchogenic cancer — making it an oncologic emergency
rather than a vascular emergency.
,◉ Signs of SVC syndrome.
Answer: Edematous head/neck with naso-oropharyngeal edema,
swelling of the upper arms/torso, collateralized chest wall veins, and
cyanotic skin.
◉ Hypertension.
Answer: Consistent elevation of systemic arterial BP resulting from
increases in cardiac output (blood volume), total peripheral
resistance, or both.
◉ Two categories of hypertension.
Answer: Primary (essential/idiopathic, no known cause) and
secondary (caused by an underlying disease).
◉ Risk factors for hypertension.
Answer: Family history, male gender, advancing age, Black race,
obesity, high sodium intake, low magnesium/potassium/calcium
intake, DM, smoking, and heavy alcohol use.
◉ Primary (essential) hypertension.
Answer: Essential or idiopathic HTN from genetic or environmental
factors; accounts for 92-95% of people with HTN.
◉ Proposed causes of primary hypertension.
, Answer: SNS overactivity, RAAS overactivity, Na and H2O retention
by the kidneys, hormonal inhibition of Na-K transport across cell
walls, and complex interactions involving insulin resistance,
inflammation, and endothelial function.
◉ Risk factors specific to primary hypertension.
Answer: High sodium intake, natriuretic peptide abnormalities,
inflammation, obesity, and insulin resistance.
◉ Secondary hypertension.
Answer: HTN from a systemic disease process that increases
peripheral vascular resistance or cardiac output; seen in renal
vascular/parenchymal disease, adrenocortical/adrenomedullary
tumors, and drugs.
◉ Clinical manifestations of hypertension.
Answer: Damage to organs/tissues outside the vascular system:
retinal changes, heart disease, renal disease, and CNS disorders
(stroke, dementia).
◉ Treatment goal for hypertension.
Answer: Lower the blood volume and the total peripheral resistance
(pharmacologic and nonpharmacologic methods).
CHAPTER 40 CERTIFICATION EVALUATION
TEST COMPLETE QUESTIONS AND CORRECT
ANSWERS
◉ Causes of varicosities.
Answer: Damaged valves from trauma to the valve, OR chronic
venous distention (involving gravity and venous constriction).
◉ Risk factors for varicose veins.
Answer: Age, female sex, family history, obesity, pregnancy, DVT, and
prior leg injury.
◉ Chronic venous insufficiency.
Answer: Inadequate venous return over a long period of time (from
varicose veins or valvular incompetence) that causes pathologic
ischemic changes in the vasculature, skin, and supporting tissues.
◉ Venous stasis ulcers.
Answer: Ulcers that follow chronic venous insufficiency; develop
from the borderline metabolic state of cells in the affected
extremities.
,◉ Deep venous thrombosis (DVT) — cause.
Answer: Results from stasis of blood flow, endothelial damage, or
hypercoagulability.
◉ Triad of Virchow.
Answer: The three factors in venous thrombus formation: venous
stasis, venous endothelial damage, and a hypercoagulable state.
◉ Conditions associated with thrombus formation (Virchow triad).
Answer: Cancer, orthopedic surgery, trauma, heart failure, and
immobility.
◉ Most serious complication of DVT.
Answer: Pulmonary embolism.
◉ Superior vena cava (SVC) syndrome.
Answer: Progressive occlusion of the superior vena cava leading to
venous distention of the upper extremities and head.
◉ Most common cause of SVC syndrome.
Answer: Bronchogenic cancer — making it an oncologic emergency
rather than a vascular emergency.
,◉ Signs of SVC syndrome.
Answer: Edematous head/neck with naso-oropharyngeal edema,
swelling of the upper arms/torso, collateralized chest wall veins, and
cyanotic skin.
◉ Hypertension.
Answer: Consistent elevation of systemic arterial BP resulting from
increases in cardiac output (blood volume), total peripheral
resistance, or both.
◉ Two categories of hypertension.
Answer: Primary (essential/idiopathic, no known cause) and
secondary (caused by an underlying disease).
◉ Risk factors for hypertension.
Answer: Family history, male gender, advancing age, Black race,
obesity, high sodium intake, low magnesium/potassium/calcium
intake, DM, smoking, and heavy alcohol use.
◉ Primary (essential) hypertension.
Answer: Essential or idiopathic HTN from genetic or environmental
factors; accounts for 92-95% of people with HTN.
◉ Proposed causes of primary hypertension.
, Answer: SNS overactivity, RAAS overactivity, Na and H2O retention
by the kidneys, hormonal inhibition of Na-K transport across cell
walls, and complex interactions involving insulin resistance,
inflammation, and endothelial function.
◉ Risk factors specific to primary hypertension.
Answer: High sodium intake, natriuretic peptide abnormalities,
inflammation, obesity, and insulin resistance.
◉ Secondary hypertension.
Answer: HTN from a systemic disease process that increases
peripheral vascular resistance or cardiac output; seen in renal
vascular/parenchymal disease, adrenocortical/adrenomedullary
tumors, and drugs.
◉ Clinical manifestations of hypertension.
Answer: Damage to organs/tissues outside the vascular system:
retinal changes, heart disease, renal disease, and CNS disorders
(stroke, dementia).
◉ Treatment goal for hypertension.
Answer: Lower the blood volume and the total peripheral resistance
(pharmacologic and nonpharmacologic methods).
