HCR 240 EXAM 3 2026/2027 | STUDY GUIDE, PRACTICE QUESTIONS, ANSWERS &
EXAM REVIEW
Triad of Virchow (S.H.E.) - ANS ✔✔promotes venous thrombosis
Stasis of Venous Circulation (inactive blood movement): associated with immobility, obesity, late
pregnancy, age, congestive heart failure, and prolonged leg dependency
Hypercoagulability: inherited disorders, smoking malignancy, liver disease, pregnancy, oral
contraceptives, hormone replacement (birth control), antiphospholipid syndrome,
hyperhomocysteinemia
Endothelial (Venous) Damage: trauma, venipuncture, IV medications
Hypertension Risk Factors - ANS ✔✔Non-Modifiable:
Positive family history
Advancing age
Gender: female >70 years of age; male <55 years of age
Race: black
Modifiable:
Sodium (Na+) intake
Glucose intolerance (diabetes mellitus)/insulin resistance
Heavy alcohol use
Obesity
Cigarettes
Decreased Potassium (K+), magnesium (Mg++), calcium (Ca++)
Orthostatic Hypotension - ANS ✔✔Decrease in blood pressure related to positional or postural changes
from lying to sitting or standing positions
may cause dizziness
Types of Embolisms (Blockage in the arterial or venous blood flow) - ANS ✔✔Thromboembolism:
Vascular obstruction from dislodged thrombus
Air embolism: Room air that enters the circulation
Amniotic fluid embolism: Amniotic fluid that is forced into the mother's bloodstream
Bacterial embolism: Infectious endocarditis
Fat embolism: Trauma to long bones causes globules of fat to form in the blood
Coronary Artery Disease (CAD) -- think risks - ANS ✔✔CAD: A condition where the major blood vessels
supplying the heart are narrowed
,Most common cause: atherosclerosis
Non-Modifiable Risks:
Advanced age
Family history
Women after menopause
Modifiable Risks:
Cigarette smoking
Diabetes and Insulin resistance
Obesity
Valvular Stenosis - ANS ✔✔Narrowing, stiffening, thickening, or blockage of one or more valves of the
heart impeding blood flow and increasing workload
Atrial pressure increases to overcome resistance flow through the valve
Myocardial hypertrophy is caused by myocardium work overload due to increased pressure
Ex - Aortic, Mitral
Valvular Regurgitation - ANS ✔✔One or more of the heart's valves does not close properly causing blood
to leak in the wrong direction (can cause a murmur)
Valvular regurgitation increases the volume of blood the heart must pump and increases the workload of
the affected heart chamber
Increased volume leads to chamber dilation
Increased workload leads to hypertrophy
Ex - Aortic, Mitral, Tricuspid
Left Sided (Congestive) Heart Failure - ANS ✔✔Left ventricle does not empty, blood flows back into the
lungs, causing difficulty breathing (pulmonary congestion), anxiety, cyanosis, and cerebral hypoxia.
"DROWNING"
Systolic heart failure - the inability of the heart to generate an adequate cardiac output to perfuse vital
tissues
Cardiac output depends on heart rate and stroke volume
Diastolic heart failure - pulmonary congestion despite a normal stroke volume and cardiac output
Can occur alone or in combination with systolic heart failure
Causes 50% of left heart failure cases
More common in women
, Right Sided Heart Failure - ANS ✔✔Is the inability of the right ventricle to provide adequate blood flow
into the pulmonary circulation at a normal central venous pressure
Can cause anorexia, GI distress, weight changes, Edema, Impaired liver function "SWELLING"
Can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary
circulation
Can result from diffuse hypoxic pulmonary disease
Tetralogy of Fallot (R.A.P.S) - ANS ✔✔Right ventricular hypertrophy
Aorta displacement
Pulmonary stenosis
Septal (ventricle) defect
Manifestations: Cyanosis, Hypoxia, Restlessness
Pressures are equal in right and left ventricles due to large VSD size
Shut direction through VSD is determined through the difference between PVR and SVR
Pulmonary stenosis decreases blood flow to the lungs and the amount of oxygenated blood that returns
to the left heart
If blood shunts from right to left via VSD, deoxygenated blood mixes with the oxygenated blood
returning from the lungs
Results in hypoxemia in the systemic circulation...
Body produces more RBC to compensate for hypoxemia and increasing blood flow to the lungs
Treatment: Surgery
Patent Ductus Arteriosus (PDA) - ANS ✔✔Failure of the ductus arteriosus to close
Normally closes within the first few hours of birth.
PDA allows blood to shunt from the pulmonary artery to the aorta before birth.
Clinical manifestations:
Continuous, machinery-type murmur
Bounding pulses, active precordium, thrill upon palpation, and signs and symptoms of pulmonary
overcirculation
Abnormal Breathing Patterns - ANS ✔✔Abnormal breathing: rate, depth, regularity, and effort of
breathing undergo characteristic alterations in response to physiologic and pathophysiologic conditions
patterns of breathing automatically adjust to minimize the work of the respiratory muscles
Kussmaul respirations (hyperpnea): strenuous exercise or metabolic acidosis (fast, deep breath)
EXAM REVIEW
Triad of Virchow (S.H.E.) - ANS ✔✔promotes venous thrombosis
Stasis of Venous Circulation (inactive blood movement): associated with immobility, obesity, late
pregnancy, age, congestive heart failure, and prolonged leg dependency
Hypercoagulability: inherited disorders, smoking malignancy, liver disease, pregnancy, oral
contraceptives, hormone replacement (birth control), antiphospholipid syndrome,
hyperhomocysteinemia
Endothelial (Venous) Damage: trauma, venipuncture, IV medications
Hypertension Risk Factors - ANS ✔✔Non-Modifiable:
Positive family history
Advancing age
Gender: female >70 years of age; male <55 years of age
Race: black
Modifiable:
Sodium (Na+) intake
Glucose intolerance (diabetes mellitus)/insulin resistance
Heavy alcohol use
Obesity
Cigarettes
Decreased Potassium (K+), magnesium (Mg++), calcium (Ca++)
Orthostatic Hypotension - ANS ✔✔Decrease in blood pressure related to positional or postural changes
from lying to sitting or standing positions
may cause dizziness
Types of Embolisms (Blockage in the arterial or venous blood flow) - ANS ✔✔Thromboembolism:
Vascular obstruction from dislodged thrombus
Air embolism: Room air that enters the circulation
Amniotic fluid embolism: Amniotic fluid that is forced into the mother's bloodstream
Bacterial embolism: Infectious endocarditis
Fat embolism: Trauma to long bones causes globules of fat to form in the blood
Coronary Artery Disease (CAD) -- think risks - ANS ✔✔CAD: A condition where the major blood vessels
supplying the heart are narrowed
,Most common cause: atherosclerosis
Non-Modifiable Risks:
Advanced age
Family history
Women after menopause
Modifiable Risks:
Cigarette smoking
Diabetes and Insulin resistance
Obesity
Valvular Stenosis - ANS ✔✔Narrowing, stiffening, thickening, or blockage of one or more valves of the
heart impeding blood flow and increasing workload
Atrial pressure increases to overcome resistance flow through the valve
Myocardial hypertrophy is caused by myocardium work overload due to increased pressure
Ex - Aortic, Mitral
Valvular Regurgitation - ANS ✔✔One or more of the heart's valves does not close properly causing blood
to leak in the wrong direction (can cause a murmur)
Valvular regurgitation increases the volume of blood the heart must pump and increases the workload of
the affected heart chamber
Increased volume leads to chamber dilation
Increased workload leads to hypertrophy
Ex - Aortic, Mitral, Tricuspid
Left Sided (Congestive) Heart Failure - ANS ✔✔Left ventricle does not empty, blood flows back into the
lungs, causing difficulty breathing (pulmonary congestion), anxiety, cyanosis, and cerebral hypoxia.
"DROWNING"
Systolic heart failure - the inability of the heart to generate an adequate cardiac output to perfuse vital
tissues
Cardiac output depends on heart rate and stroke volume
Diastolic heart failure - pulmonary congestion despite a normal stroke volume and cardiac output
Can occur alone or in combination with systolic heart failure
Causes 50% of left heart failure cases
More common in women
, Right Sided Heart Failure - ANS ✔✔Is the inability of the right ventricle to provide adequate blood flow
into the pulmonary circulation at a normal central venous pressure
Can cause anorexia, GI distress, weight changes, Edema, Impaired liver function "SWELLING"
Can result from an increase in left ventricular filling pressure that is reflected back into the pulmonary
circulation
Can result from diffuse hypoxic pulmonary disease
Tetralogy of Fallot (R.A.P.S) - ANS ✔✔Right ventricular hypertrophy
Aorta displacement
Pulmonary stenosis
Septal (ventricle) defect
Manifestations: Cyanosis, Hypoxia, Restlessness
Pressures are equal in right and left ventricles due to large VSD size
Shut direction through VSD is determined through the difference between PVR and SVR
Pulmonary stenosis decreases blood flow to the lungs and the amount of oxygenated blood that returns
to the left heart
If blood shunts from right to left via VSD, deoxygenated blood mixes with the oxygenated blood
returning from the lungs
Results in hypoxemia in the systemic circulation...
Body produces more RBC to compensate for hypoxemia and increasing blood flow to the lungs
Treatment: Surgery
Patent Ductus Arteriosus (PDA) - ANS ✔✔Failure of the ductus arteriosus to close
Normally closes within the first few hours of birth.
PDA allows blood to shunt from the pulmonary artery to the aorta before birth.
Clinical manifestations:
Continuous, machinery-type murmur
Bounding pulses, active precordium, thrill upon palpation, and signs and symptoms of pulmonary
overcirculation
Abnormal Breathing Patterns - ANS ✔✔Abnormal breathing: rate, depth, regularity, and effort of
breathing undergo characteristic alterations in response to physiologic and pathophysiologic conditions
patterns of breathing automatically adjust to minimize the work of the respiratory muscles
Kussmaul respirations (hyperpnea): strenuous exercise or metabolic acidosis (fast, deep breath)
