Patho - Exam 3| study guide verified A+

Patho - Exam 3| study guide verified A+Patho - Exam 3| study guide verified A+ acute pericarditis - correct answer-chest pain that is usually relieved by sitting upright and leaning forward, aggravated by coughing, swallowing and positional changes and lasting less than 2 weeks constrictive pericarditis - correct answer-development of scar tissue between visceral and parietal layers resulting in fixed CO, ascites, LE edema, dyspnea on exertion pericardial effusion - correct answer-accumulation of fluid in the pericardial cavity that can be infectious or inflammatory and can lead to compression of the heart cardiac tamponade - correct answer-compression of the heart due to accumulation of fluid/blood in pericardial sac which can be life threatening; decreases SV and CO pulsus paradoxus - correct answer-= / 10mmHg drop in SBP during inspiration chemicals that control coronary artery diameter - correct answer-adenosine and nitric oxide both cause vasodilation infectious endocarditis - correct answer-infection (staph aureus) of inner surface of the heart including the heart valves which results in destruction of cardiac tissue; patients with prosthetic valves are at increased risk acute - rapid onset; normal heart valve sub-acute - evolves slowly over months; underlying valve abnormalities coronary artery disease (CAD) - correct answer-disorder that narrows/occludes the coronary arteries as a result of imbalances in myocardial supply and demand of O2 and nutrients; most common cause is atherosclerosis myocardial ischemia - correct answer-decreased blood flow to the heart as a result of metabolic needs not being met myocardial infarction - correct answer-death of myocardial tissue d/t ischemia and deprivation of O2/nutrients fixed/stable plaque - correct answer-thick fibrous cap that narrows or partially occludes a vessel and is less likely to rupture; usually associated with stable angina myocardial remodeling - correct answer-prolonged ischemia resulting in irreversible damage stable angina - correct answer-predictable chest pain that is often alleviated with rest and/or nitroglycerin therapy; usually exacerbated by exertion unstable/vulnerable plaque - correct answer-thin fibrous cap that can rupture causing sudden coronary obstruction d/t thrombus formation over rupture plaque; usually associated with unstable angina or MI unstable angina - correct answer-chest pain that is unrelieved with rest and/or nitroglycerin with transient episodes of thrombotic vessel occlusion and vasoconstriction; usually a sign of impending infarction Non-STEMI - correct answer-type of infarction where ST elevation cannot be seen on an EKG; Review Troponin levels to confirm diagnosis STEMI - correct answer-type of infarction where ST elevation can be observed on EKG; emergent situation that can cause dysrhythmias, CHF, or sudden death if not treated in a timely manner (ideally 90 minutes) acute coronary syndrome (ACS) - correct answer-A blanket term used to represent any symptoms related to lack of oxygen (ischemia) in the heart muscle; usually associated with unstable angina and/or MI T wave inversion - correct answer-ischemia T wave elevation - correct answer-infarction Troponin I - correct answer-specific cardiac marker for MI; elevation can be seen 2-12 hours after damage and remains elevated for 2-4 weeks creatinine phosphokinase-MB - correct answer-non-specific cardiac marker that is elevated 4-8 hours after MI and peaks at 24 hours; not commonly used hypertrophic (obstructive) cardiomyopathy - correct answer-inherited heart defect (autosomal dominant) characterized by thickening of septal wall causing outflow obstruction to L ventricle; results in sudden cardiac death in young athletes hypertensive (valvular) hypertrophic cardiomyopathy - correct answer-heart defect that is characterized by increased resistance to ventricular ejection (afterload); results in diastolic dysfunction and/or systolic dysfunction of ventricle dilated (congestive) cardiomyopathy - correct answer-enlarged heart due to dilation of ventricle and decreased ability to pump blood (impaired systolic function -- systolic HF); can be a result of MI, diabetes, excessive alcohol, hyperthyroidism stenosis - correct answer-narrowing or failure of valves to open normally causing increased resistance to blood flow through the valves and cardiac workload incompetent/regurgitant valve - correct answer-A valve that does not close properly and permits backflow of blood into the vessel/chamber that it just left mitral valve stenosis - correct answer-incomplete opening of MV during diastole that leads to pulmonary edema mitral valve regurgitation - correct answer-incomplete closure of MV that leads to L ventricular HF aortic valve stenosis - correct answer-narrowing of the aortic valve opening with increased resistant to ejection of blood from LV into aorta causing heart failure aortic valve regurgitation - correct answer-incompetent aortic valve that leads to increased preload, size/dilation of LV and eventually heart failure d/t pressure overload cardiac output - correct answer-amount of blood ejected from the ventricle in 1 minute (5-6 L/min) CO = SV x HR heart rate - correct answer-the number of ventricular contractions per minute stroke volume - correct answer-amount of blood ejected from ventricles during each systole/heartbeat preload - correct answer-degree of stretch that results from volume of blood remaining in ventricle at the end of diastole just before contraction (Think 'rubber band') afterload - correct answer-resistance that ventricles must overcome to push blood through SL valves into pulmonary and systemic circulation; inversely proportional to SV diastole - correct answer-relaxation of the heart that allows blood to fill the ventricles systole - correct answer-contraction of the heart chambers ejection fraction - correct answer-percentage of blood emptied from the ventricle during systole venous return - correct answer-amount of blood returning from peripheral circulation to the RA End-diastolic volume - correct answer-volume of blood in the ventricles before the heart contracts and volume remaining at the end of ventricular filling myocardial contractility/inotropy - correct answer-force with which the LV ejection occurs; force of muscular contraction heart failure - correct answer-condition characterized by the inability to maintain adequate perfusion to tissues as a result of inadequate pumping of the heart/increased workload Frank-Starling Law - correct answer-compensatory mechanism of HF in which CO increases in proportion to diastolic stretch of muscle fibers -- more forceful contraction (inotropy) -- improved SV sympathetic nervous system activity - correct answer-compensatory mechanism of HF in which HR increases in order to improve perfusion renin-angiotensin-aldosterone mechanism - correct answer-compensatory mechanism of HF in which the kidneys increase renin secretion and elevation of angiotensin II causing vasoconstriction Natriuretic peptides - correct answer-include BNP and ANP and are elevated in patients with HF to promote vasodilation and diuresis due to increased stretching of the mycoardium ANP - released in response to volume overload BNP - associated with HF systolic heart failure - correct answer-condition characterized by impaired contraction of heart muscles leading to decreased EF and CO (fluid backup -- increased preload) Heart is not able to pump blood into circulation; L ventricle is dilated -- reduced EF 40% diastolic heart failure - correct answer-condition characterized by stiffness of ventricle/impaired L ventricular relaxation causing decrease in ventricular filling -- decreased preload, SV and CO; caused by pericardial effusion, constrictive pericarditis EF is preserved 45% R Ventricular Dysfunction - correct answer-blood isn't moving to the lungs to become oxygenated leading to decreased CO and backup of blood into systemic venous system (peripheral edema, fluid accumulation/weight gain, JVD) L Ventricular Dysfunction - correct answer-decreased CO to systemic circulation causing backup of blood in LV/LA/pulmonary circulation (pulmonary edema) L Ventricular Assistive Device (LVAD) - correct answer-mechanical pump that decreases the workload of the myocardium to maintain CO and systemic arterial pressure congenital heart defects - correct answer-results in abnormal shunting of blood, cyanosis, and disruption of pulmonary blood flow patent ductus arteriosus - correct answer-high-pressure blood of the aorta is shunted back to the pulmonary artery ventricular septal defects - correct answer-abnormal opening in the septum between the ventricles that causes blood to be shunted from L to R pulmonary stenosis - correct answer-obstruction of blood flow from R ventricle to pulmonary circulation causing decreased pulmonary blood flow and R ventricular hypertrophy tetralogy of Fallot - correct answer-ventricular septal defect, R ventricular outflow obstruction and R ventricular hypertrophy transposition of the great arteries - correct answer-pulmonary artery is attached to the L side of the heart and the aorta to the R side coarctation of the aorta - correct answer-congenital cardiac condition characterized by a localized narrowing of the aorta Kawasaki disease - correct answer-acute febrile disease in young children causing vasculitis that affects small vessels and progresses to larger arteries; characterized by patchy peeling of skin on palms and feet that is progressive shock - correct answer-inability of circulatory system to supply periphery/organs with adequate blood supply leading to cellular hypoxia cardiogenic = ineffective cardiac pumping hypovolemic = decreased blood volume widespread vasodilation = septic, neurogenic, anaphylactic sepsis vs septic shock - correct answer-sepsis = systemic infection and inflammatory response (fever, tachycardia/tachypnea, elevated WBCs, AMS, hyperglycemia) shock = inadequate perfusion to organs as a result of systemic infection Complications of shock - correct answer-ALI/ARDS AKI DIC - increased risk for bleeding MODS - life-threatening multiple organ dysfunction syndrome normal hemostasis - correct answer-- fibrin wraps around platelet plug - blood becomes gel-like and traps RBCs - clot and fibrous tissue grow together to seal hole in vessel wall 3 processes involved in platelet plug formation - correct answer-activation - platelets move to damaged vessel wall adhesion - platelet receptors bind to vessel wall aggregation - mediators released to attract additional platelets intrinsic pathway - correct answer-- activated inside the vessel wall by tissue factor XII; slower to respond (1-6 minutes) - PTT extrinsic pathway - correct answer-- activated outside the vessel wall by tissue factor III; faster response. - PT and INR