NSG5003 Week 4 Study
Guide: Cardiovascular &
Respiratory
Pathophysiology
1. Which process initiates the development of atherosclerosis?
A. Smooth muscle proliferation in the tunica media
B. Endothelial cell injury and inflammation
C. Deposition of calcium in the vessel wall
D. Formation of a thrombus on the intimal surface
Answer: B
Rationale: Atherosclerosis begins with endothelial injury (e.g.,
from hypertension, smoking, or hyperlipidemia), triggering an
inflammatory response. Inflammatory cytokines (TNF-α, IL-1)
recruit macrophages and oxidized LDL, leading to plaque
formation.
2. A patient with known atherosclerosis has an LDL level of
190 mg/dL. Which pathophysiologic effect of oxidized LDL
,contributes most to disease progression?
A. Decreased nitric oxide production
B. Direct toxicity to endothelial cells and promotion of smooth
muscle proliferation
C. Activation of the complement cascade
D. Inhibition of platelet aggregation
Answer: B
Rationale: Oxidized LDL is directly toxic to endothelial cells and
stimulates vascular smooth muscle cell proliferation, accelerating
plaque growth and instability.
3. According to JNC 8 guidelines, what is the target blood
pressure for an otherwise healthy 55-year-old adult?
A. <120/80 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
D. <150/90 mmHg
Answer: C
Rationale: JNC 8 recommends a target BP <140/90 mmHg for
adults younger than 60 years. Higher thresholds may apply to
older adults or those with specific comorbidities.
4. In hypertension, which hormone is primarily responsible for
myocardial hypertrophy and increased afterload?
,A. Atrial natriuretic peptide (ANP)
B. Aldosterone
C. Angiotensin II
D. Bradykinin
Answer: C
Rationale: Angiotensin II causes vasoconstriction (increasing
afterload) and has direct trophic effects on cardiac myocytes,
promoting left ventricular hypertrophy.
5. A patient with left-sided heart failure presents with
dyspnea and crackles on auscultation. This occurs because
blood backs up into the:
A. Systemic venous system
B. Pulmonary circulation
C. Hepatic portal system
D. Right ventricle
Answer: B
Rationale: Left-sided heart failure leads to increased left
ventricular end-diastolic pressure, which is transmitted backward
to the left atrium and pulmonary veins, causing pulmonary
congestion.
6. Which natriuretic peptide is released from the ventricles in
response to increased wall tension and inhibits
, renin-angiotensin-aldosterone system (RAAS)?
A. ANP (atrial natriuretic peptide)
B. BNP (brain natriuretic peptide)
C. CNP (C-type natriuretic peptide)
D. Endothelin
Answer: B
Rationale: BNP is synthesized primarily in the ventricles and is
released in response to volume overload. It counteracts RAAS,
promoting vasodilation and natriuresis.
7. A patient with an ejection fraction (EF) of 35% is diagnosed
with heart failure. This type of HF is best described as:
A. Diastolic heart failure
B. Right-sided heart failure
C. High-output heart failure
D. Systolic heart failure
Answer: D
Rationale: Systolic heart failure is defined by reduced EF (<40%
by most guidelines). Diastolic HF occurs with preserved EF (>50%)
but impaired filling.
8. Restrictive cardiomyopathy is associated with all of the
following systemic diseases EXCEPT:
A. Amyloidosis
Guide: Cardiovascular &
Respiratory
Pathophysiology
1. Which process initiates the development of atherosclerosis?
A. Smooth muscle proliferation in the tunica media
B. Endothelial cell injury and inflammation
C. Deposition of calcium in the vessel wall
D. Formation of a thrombus on the intimal surface
Answer: B
Rationale: Atherosclerosis begins with endothelial injury (e.g.,
from hypertension, smoking, or hyperlipidemia), triggering an
inflammatory response. Inflammatory cytokines (TNF-α, IL-1)
recruit macrophages and oxidized LDL, leading to plaque
formation.
2. A patient with known atherosclerosis has an LDL level of
190 mg/dL. Which pathophysiologic effect of oxidized LDL
,contributes most to disease progression?
A. Decreased nitric oxide production
B. Direct toxicity to endothelial cells and promotion of smooth
muscle proliferation
C. Activation of the complement cascade
D. Inhibition of platelet aggregation
Answer: B
Rationale: Oxidized LDL is directly toxic to endothelial cells and
stimulates vascular smooth muscle cell proliferation, accelerating
plaque growth and instability.
3. According to JNC 8 guidelines, what is the target blood
pressure for an otherwise healthy 55-year-old adult?
A. <120/80 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
D. <150/90 mmHg
Answer: C
Rationale: JNC 8 recommends a target BP <140/90 mmHg for
adults younger than 60 years. Higher thresholds may apply to
older adults or those with specific comorbidities.
4. In hypertension, which hormone is primarily responsible for
myocardial hypertrophy and increased afterload?
,A. Atrial natriuretic peptide (ANP)
B. Aldosterone
C. Angiotensin II
D. Bradykinin
Answer: C
Rationale: Angiotensin II causes vasoconstriction (increasing
afterload) and has direct trophic effects on cardiac myocytes,
promoting left ventricular hypertrophy.
5. A patient with left-sided heart failure presents with
dyspnea and crackles on auscultation. This occurs because
blood backs up into the:
A. Systemic venous system
B. Pulmonary circulation
C. Hepatic portal system
D. Right ventricle
Answer: B
Rationale: Left-sided heart failure leads to increased left
ventricular end-diastolic pressure, which is transmitted backward
to the left atrium and pulmonary veins, causing pulmonary
congestion.
6. Which natriuretic peptide is released from the ventricles in
response to increased wall tension and inhibits
, renin-angiotensin-aldosterone system (RAAS)?
A. ANP (atrial natriuretic peptide)
B. BNP (brain natriuretic peptide)
C. CNP (C-type natriuretic peptide)
D. Endothelin
Answer: B
Rationale: BNP is synthesized primarily in the ventricles and is
released in response to volume overload. It counteracts RAAS,
promoting vasodilation and natriuresis.
7. A patient with an ejection fraction (EF) of 35% is diagnosed
with heart failure. This type of HF is best described as:
A. Diastolic heart failure
B. Right-sided heart failure
C. High-output heart failure
D. Systolic heart failure
Answer: D
Rationale: Systolic heart failure is defined by reduced EF (<40%
by most guidelines). Diastolic HF occurs with preserved EF (>50%)
but impaired filling.
8. Restrictive cardiomyopathy is associated with all of the
following systemic diseases EXCEPT:
A. Amyloidosis
