Pathophysiology II Final Exam Review CNM
Fildes|Questions With Correct Answers|Verified
Coronary heart disease - ✔️Characterized by insufficient delivery of oxygenated blood
to the myocardium due to atherosclerotic coronary arteries (CADs)
Sequelae of CHD - ✔️-Angina pectoris
-Myocardial infarction—occurs when there's a blood clot & artery is completely blocked
(infarction = death)
-Dysrhythmias
-Heart failure
-Sudden cardiac death
Are all...
Risk factors for CHD - ✔️Smoking, hyperlipidemia (high Triglyceride and high LDL
cholestrol), diabetes mellitus, and hypertension are all...
Angina Pectoris - ✔️1. Chest pain associated with intermittent myocardial ischemia
2. May result in inefficient cardiac pumping with resultant pulmonary congestion and
shortness of breath
3. Three patterns
Hint: the general name for angina
Acute Coronary Syndrome - ✔️1. Sudden change in Angina Pectoris
2. Chest pain usually more severe and lasts longer than typical angina
3. Plaque rupture with acute thrombus development
4. Unstable angina—occlusion is partial
5. MI—occlusion is complete
6. ECG and biomarkers used for diagnosis
Hint: it's a syndrome
Sudden Cardiac Death - ✔️1. Unexpected death from cardiac causes within 1 hour of
symptom onset
2. Use of external defibrillators and CPR has increased survival
3. Lethal dysrhythmia (such as ventricular fibrillation) is usually the primary cause
Stenosis - ✔️Failure of the valve to open completely results in extra pressure work for
the heart
Regurgitation - ✔️Inability of a valve to close completely results in extra volume work
for the heart
Mitral (bicuspid) Stenosis - ✔️-Blood flow from the left atrium to the left ventricle is
impaired during ventricular diastole
,-Increased pressure of the left atrium leads to atrial chamber enlargement and
hypertrophy
-Can lead to chronic pulmonary hypertension, right ventricular hypertrophy, and right-
sided heart failure
-Low-pitched, rumbling diastolic murmur
Hint: form of stenosis
Mitral (bicuspid) Regurgitation - ✔️-Backflow of blood from the left ventricle to the left
atrium during ventricular systole
-Left atrium and ventricle dilate and hypertrophy due to extra volume
-May lead to left-sided heart failure
-High-pitched, pansystolic, blowing murmur
Hint: form of regurgitation
Mitral (bicuspid) Valve Prolapse - ✔️-Displacement of the mitral valve leaflets into the
left atrium during ventricular systole
-Typically asymptomatic
-Complications may include infective endocarditis, sudden cardiac death, cerebral
embolic events, and progression to mitral regurgitation
-Midsystolic click or systolic murmur
Hint: papal prolapse
Aortic Stenosis - ✔️-Predominant cause is age-related calcium deposits on the aortic
cusps
-Results in obstruction of aortic outflow from the left ventricle into the aorta during
systole
-May result in ischemia and left-sided HF
-A patient with significant aortic stenosis is likely to experience syncope.
-Crescendo-decrescendo murmur during ventricular systole
Hint: form of stenosis
Aortic Regurgitation - ✔️-Incompetent aortic valve allows blood to leak back from the
aorta into the left ventricle during diastole
-Leads to left ventricle hypertrophy and dilation with eventual left-sided HF
-High-pitched blowing murmur during ventricular diastole
Hint: form of regurgitation
Pulmonary valvular stenosis - ✔️-Results in obstruction of pulmonary outflow from the
right ventricle into the pulmonary trunk during systole
-May result in ischemia and right-sided HF
-Characterized by a low right atrial/right ventricular pressure gradient during diastole.
Hint: form of stenosis
Rheumatic heart disease - ✔️-Acute inflammatory disease that follows infection with
group A β-hemolytic streptococci
,-Antibodies against the streptococcal antigens damage connective tissue in joints,
heart, and skin
-Occurs mainly in children
Infective endocarditis - ✔️-Invasion and colonization of endocardial structures by
microorganisms with resulting inflammation—vegetations
-Most common bacteria: streptococcus and staphylococcus
-Predisposing risk factors typically present
Hint: inflammation of the endocardium
Myocarditis - ✔️-Inflammatory disorder of the heart muscle characterized by necrosis
and degeneration of myocytes
-Causes include microbial agents, immune-mediated diseases, physical agents
-Viral etiology most common
-Characterized by left ventricular dysfunction and general dilation of all four chambers
Hint: inflammation of the myocardium
Pericardial Effusion - ✔️Accumulation of noninflammatory fluid in the pericardial sac
Cardiac Tamponade - ✔️1. When fluid accumulation in the pericardial sac is
large/sudden it can lead to external compression of the heart chambers such that filling
is impaired
2. Symptoms include: reduced stroke volume, compensatory increases in heart rate,
muffled heart sound, equalized intracardiac pressures
Hint: last word is similar to tapenade
Pericarditis - ✔️Acute or chronic inflammation of the pericardium. Categories include:
idiopathic, infectious, immune-inflammatory, neoplastic, or radiation induced
Hint: inflammation of the pericardium
Acute Pericarditis - ✔️Form of pericarditis
-Most cases idiopathic and presumed viral
-Typically presents as chest pain
Chronic Pericarditis - ✔️Form of pericarditis, further categorized in to:
1. Adhesive mediastinopericarditis— pericardial sac is destroyed and the external
aspect of the heart adheres to surrounding mediastinal structures
2. Constrictive (Restrictive) pericarditis—pericardial sac becomes dense, nonelastic,
fibrous, and scarred
Restrictive pericarditis is associated with impaired cardiac filling.
Cardiac enzymes - ✔️CPK (creatine phosphokinase), CK (creatine kinase), and
troponin are examples of...
Stable or typical angina - ✔️Form of angina brought up by exercise
, Prinzmetal or variant angina - ✔️Angina due to coronary artery spasm—problem with
muscle contraction in tunica media. HAS NOTHING TO DO WITH FAT DEPOSITS
Unstable or crescendo angina - ✔️Angina that is not relieved by rest
Low density lipoprotein (LDL) - ✔️15-20 nm, 5% triglyceride, 55% cholesterol, 20%
protein
High density lipoprotein (HDL) - ✔️5-10 nm, 5% triglyceride, 20% cholesterol, 50%
protein
Pathogenesis of atherosclerosis - ✔️1. Chronic endothelial injury
2. Endothelial dysfunction
3. Smooth muscle emigration from media to intima/macrophage activation
4. Macrophages and smooth muscle cells engulf lipid
5. Smooth muscle proliferation, collagen and other ECM deposition, extracellular lipid
[Hint: pathogenesis of this disease]
P-wave - ✔️Represents atrial depolarization/atrial systole (contraction) on an ECG
QRS Complex - ✔️Represents ventricular depolarization/ventricular systole
(contraction) on an ECG
T-wave - ✔️Represents ventricular repolarization/ventricular diastole (relaxation) on an
ECG
Heart Failure - ✔️Inability of the heart to maintain sufficient cardiac output to meet
metabolic demands of tissues and organs. The most common denominator in all forms
of this disease is decreased cardiac output.
Etiology/pathogenesis of heart failure - ✔️Form of etiology/pathogenesis. This is a
potential consequence of most cardiac disorders (mainly systemic hypertension or
coronary heart disease). Results from impaired ability of myocardial fibers to contract,
relax, or both.
Systolic heart failure - ✔️-Most common etiology of this is due to myocardial infarction
-Associated with LOW CARDIAC OUTPUT and LOW EJECTION FRACTION
-Impaired contractility involved loss of cardiac muscle cells, beta receptor down-
regulation, and reduced ATP
[hint: comes before diastole]
Diastolic dysfunction - ✔️-The two main causes of this are ischemic heart disease and
hypertension
-Most likely to develop in elderly women
Fildes|Questions With Correct Answers|Verified
Coronary heart disease - ✔️Characterized by insufficient delivery of oxygenated blood
to the myocardium due to atherosclerotic coronary arteries (CADs)
Sequelae of CHD - ✔️-Angina pectoris
-Myocardial infarction—occurs when there's a blood clot & artery is completely blocked
(infarction = death)
-Dysrhythmias
-Heart failure
-Sudden cardiac death
Are all...
Risk factors for CHD - ✔️Smoking, hyperlipidemia (high Triglyceride and high LDL
cholestrol), diabetes mellitus, and hypertension are all...
Angina Pectoris - ✔️1. Chest pain associated with intermittent myocardial ischemia
2. May result in inefficient cardiac pumping with resultant pulmonary congestion and
shortness of breath
3. Three patterns
Hint: the general name for angina
Acute Coronary Syndrome - ✔️1. Sudden change in Angina Pectoris
2. Chest pain usually more severe and lasts longer than typical angina
3. Plaque rupture with acute thrombus development
4. Unstable angina—occlusion is partial
5. MI—occlusion is complete
6. ECG and biomarkers used for diagnosis
Hint: it's a syndrome
Sudden Cardiac Death - ✔️1. Unexpected death from cardiac causes within 1 hour of
symptom onset
2. Use of external defibrillators and CPR has increased survival
3. Lethal dysrhythmia (such as ventricular fibrillation) is usually the primary cause
Stenosis - ✔️Failure of the valve to open completely results in extra pressure work for
the heart
Regurgitation - ✔️Inability of a valve to close completely results in extra volume work
for the heart
Mitral (bicuspid) Stenosis - ✔️-Blood flow from the left atrium to the left ventricle is
impaired during ventricular diastole
,-Increased pressure of the left atrium leads to atrial chamber enlargement and
hypertrophy
-Can lead to chronic pulmonary hypertension, right ventricular hypertrophy, and right-
sided heart failure
-Low-pitched, rumbling diastolic murmur
Hint: form of stenosis
Mitral (bicuspid) Regurgitation - ✔️-Backflow of blood from the left ventricle to the left
atrium during ventricular systole
-Left atrium and ventricle dilate and hypertrophy due to extra volume
-May lead to left-sided heart failure
-High-pitched, pansystolic, blowing murmur
Hint: form of regurgitation
Mitral (bicuspid) Valve Prolapse - ✔️-Displacement of the mitral valve leaflets into the
left atrium during ventricular systole
-Typically asymptomatic
-Complications may include infective endocarditis, sudden cardiac death, cerebral
embolic events, and progression to mitral regurgitation
-Midsystolic click or systolic murmur
Hint: papal prolapse
Aortic Stenosis - ✔️-Predominant cause is age-related calcium deposits on the aortic
cusps
-Results in obstruction of aortic outflow from the left ventricle into the aorta during
systole
-May result in ischemia and left-sided HF
-A patient with significant aortic stenosis is likely to experience syncope.
-Crescendo-decrescendo murmur during ventricular systole
Hint: form of stenosis
Aortic Regurgitation - ✔️-Incompetent aortic valve allows blood to leak back from the
aorta into the left ventricle during diastole
-Leads to left ventricle hypertrophy and dilation with eventual left-sided HF
-High-pitched blowing murmur during ventricular diastole
Hint: form of regurgitation
Pulmonary valvular stenosis - ✔️-Results in obstruction of pulmonary outflow from the
right ventricle into the pulmonary trunk during systole
-May result in ischemia and right-sided HF
-Characterized by a low right atrial/right ventricular pressure gradient during diastole.
Hint: form of stenosis
Rheumatic heart disease - ✔️-Acute inflammatory disease that follows infection with
group A β-hemolytic streptococci
,-Antibodies against the streptococcal antigens damage connective tissue in joints,
heart, and skin
-Occurs mainly in children
Infective endocarditis - ✔️-Invasion and colonization of endocardial structures by
microorganisms with resulting inflammation—vegetations
-Most common bacteria: streptococcus and staphylococcus
-Predisposing risk factors typically present
Hint: inflammation of the endocardium
Myocarditis - ✔️-Inflammatory disorder of the heart muscle characterized by necrosis
and degeneration of myocytes
-Causes include microbial agents, immune-mediated diseases, physical agents
-Viral etiology most common
-Characterized by left ventricular dysfunction and general dilation of all four chambers
Hint: inflammation of the myocardium
Pericardial Effusion - ✔️Accumulation of noninflammatory fluid in the pericardial sac
Cardiac Tamponade - ✔️1. When fluid accumulation in the pericardial sac is
large/sudden it can lead to external compression of the heart chambers such that filling
is impaired
2. Symptoms include: reduced stroke volume, compensatory increases in heart rate,
muffled heart sound, equalized intracardiac pressures
Hint: last word is similar to tapenade
Pericarditis - ✔️Acute or chronic inflammation of the pericardium. Categories include:
idiopathic, infectious, immune-inflammatory, neoplastic, or radiation induced
Hint: inflammation of the pericardium
Acute Pericarditis - ✔️Form of pericarditis
-Most cases idiopathic and presumed viral
-Typically presents as chest pain
Chronic Pericarditis - ✔️Form of pericarditis, further categorized in to:
1. Adhesive mediastinopericarditis— pericardial sac is destroyed and the external
aspect of the heart adheres to surrounding mediastinal structures
2. Constrictive (Restrictive) pericarditis—pericardial sac becomes dense, nonelastic,
fibrous, and scarred
Restrictive pericarditis is associated with impaired cardiac filling.
Cardiac enzymes - ✔️CPK (creatine phosphokinase), CK (creatine kinase), and
troponin are examples of...
Stable or typical angina - ✔️Form of angina brought up by exercise
, Prinzmetal or variant angina - ✔️Angina due to coronary artery spasm—problem with
muscle contraction in tunica media. HAS NOTHING TO DO WITH FAT DEPOSITS
Unstable or crescendo angina - ✔️Angina that is not relieved by rest
Low density lipoprotein (LDL) - ✔️15-20 nm, 5% triglyceride, 55% cholesterol, 20%
protein
High density lipoprotein (HDL) - ✔️5-10 nm, 5% triglyceride, 20% cholesterol, 50%
protein
Pathogenesis of atherosclerosis - ✔️1. Chronic endothelial injury
2. Endothelial dysfunction
3. Smooth muscle emigration from media to intima/macrophage activation
4. Macrophages and smooth muscle cells engulf lipid
5. Smooth muscle proliferation, collagen and other ECM deposition, extracellular lipid
[Hint: pathogenesis of this disease]
P-wave - ✔️Represents atrial depolarization/atrial systole (contraction) on an ECG
QRS Complex - ✔️Represents ventricular depolarization/ventricular systole
(contraction) on an ECG
T-wave - ✔️Represents ventricular repolarization/ventricular diastole (relaxation) on an
ECG
Heart Failure - ✔️Inability of the heart to maintain sufficient cardiac output to meet
metabolic demands of tissues and organs. The most common denominator in all forms
of this disease is decreased cardiac output.
Etiology/pathogenesis of heart failure - ✔️Form of etiology/pathogenesis. This is a
potential consequence of most cardiac disorders (mainly systemic hypertension or
coronary heart disease). Results from impaired ability of myocardial fibers to contract,
relax, or both.
Systolic heart failure - ✔️-Most common etiology of this is due to myocardial infarction
-Associated with LOW CARDIAC OUTPUT and LOW EJECTION FRACTION
-Impaired contractility involved loss of cardiac muscle cells, beta receptor down-
regulation, and reduced ATP
[hint: comes before diastole]
Diastolic dysfunction - ✔️-The two main causes of this are ischemic heart disease and
hypertension
-Most likely to develop in elderly women
