ADVANCED PATHOPHYSIOLOGY EXAM 3
FINAL PAPER UPDATED QUESTIONS
VERIFIED COMPLETE ANSWERS 100
PERCENT CORRECT
◉ pharmacological treatment of stage B HF
Answer: ACEI (pril)
ARBs (sartan)
beta blockers (lol)
in selected patients ICD or revascularization/valuvular surgery
structural heart disease but without symptoms of HF
◉ pharmacological treatment of stage C HFpEF
Answer: diuresis to relieve symptoms of congestion
revascularization or valvular surgery as appropriate
◉ pharmacological treatment of stage C HFrEF
Answer: diuretics for fluid retention
ACEI or ARB
bbs
aldosterone antagonists
,hydralazine/isosorbide dinitrate
digoxin
◉ treatments for Stage D HF
Answer: advanced care measures
heart transplant
chronic inotropes
temporary or permanent MCS
experimental surgery or drugs
palliative care and hospice
ICD deactivation
◉ benefits of diuretic in HFrEF
Answer: decreased fluid volume, relieves dyspnea
◉ benefits of ace and ARB in HFrEF
Answer: vasodilate and decrease remodeling
◉ benefits of beta blockers in HFrEF
Answer: decreased heart rate, remodeling (block SNS)
◉ benefits of aldosterone antagonists in HFrEF
,Answer: decrease in fibrosis, Na retention, remodeling, aldosterone
release
◉ HFpEF
Answer: heart failure with preserved ejection fraction
-diastolic (problems with filling)
EF50%
hypertrophy
-abnormal diastolic function
-abnormal filling or relaxation due to the myocardium becoming stiff
and rigid
-promotes inflammatory response - promotes apoptosis,
hypertrophy, cell proliferation, cachexia
◉ HFrEF
Answer: heart failure with reduced ejection fraction
-systolic (problems with contractility) EF <40%
-inability of the heart to generate an adequate CO to perfuse vital
tissues
-inability of the LV to contract against a load and eject blood volume
into the aorta
-impaired contractility
-myocyte loss (apoptosis)
, ◉ other body systems involved in HF
Answer: nervous
renal
pulmonary
hepatic
◉ what is the action of natriuretic peptides
Answer: ANP and BNP
reduce arterial pressure by decreasing blood volume and systemic
vascular resistance
important response however usually insufficient in HF
◉ compensatory mechanisms in HF: hemodynamics
Answer: Frank-sterling mechanism: normally stroke volume
increases with end-diastolic pressure (or volume) but in HF patients
it increases minimally and insuffiiciently because there is not
enough forward blood flow
-as the heart contracts harder, there is no increase in SV
-poor SV results in pulmonary congestion
-people with advanced HF will have a difficult time laying down
because they will feel like they are drowning due to pulmonary
congestion
FINAL PAPER UPDATED QUESTIONS
VERIFIED COMPLETE ANSWERS 100
PERCENT CORRECT
◉ pharmacological treatment of stage B HF
Answer: ACEI (pril)
ARBs (sartan)
beta blockers (lol)
in selected patients ICD or revascularization/valuvular surgery
structural heart disease but without symptoms of HF
◉ pharmacological treatment of stage C HFpEF
Answer: diuresis to relieve symptoms of congestion
revascularization or valvular surgery as appropriate
◉ pharmacological treatment of stage C HFrEF
Answer: diuretics for fluid retention
ACEI or ARB
bbs
aldosterone antagonists
,hydralazine/isosorbide dinitrate
digoxin
◉ treatments for Stage D HF
Answer: advanced care measures
heart transplant
chronic inotropes
temporary or permanent MCS
experimental surgery or drugs
palliative care and hospice
ICD deactivation
◉ benefits of diuretic in HFrEF
Answer: decreased fluid volume, relieves dyspnea
◉ benefits of ace and ARB in HFrEF
Answer: vasodilate and decrease remodeling
◉ benefits of beta blockers in HFrEF
Answer: decreased heart rate, remodeling (block SNS)
◉ benefits of aldosterone antagonists in HFrEF
,Answer: decrease in fibrosis, Na retention, remodeling, aldosterone
release
◉ HFpEF
Answer: heart failure with preserved ejection fraction
-diastolic (problems with filling)
EF50%
hypertrophy
-abnormal diastolic function
-abnormal filling or relaxation due to the myocardium becoming stiff
and rigid
-promotes inflammatory response - promotes apoptosis,
hypertrophy, cell proliferation, cachexia
◉ HFrEF
Answer: heart failure with reduced ejection fraction
-systolic (problems with contractility) EF <40%
-inability of the heart to generate an adequate CO to perfuse vital
tissues
-inability of the LV to contract against a load and eject blood volume
into the aorta
-impaired contractility
-myocyte loss (apoptosis)
, ◉ other body systems involved in HF
Answer: nervous
renal
pulmonary
hepatic
◉ what is the action of natriuretic peptides
Answer: ANP and BNP
reduce arterial pressure by decreasing blood volume and systemic
vascular resistance
important response however usually insufficient in HF
◉ compensatory mechanisms in HF: hemodynamics
Answer: Frank-sterling mechanism: normally stroke volume
increases with end-diastolic pressure (or volume) but in HF patients
it increases minimally and insuffiiciently because there is not
enough forward blood flow
-as the heart contracts harder, there is no increase in SV
-poor SV results in pulmonary congestion
-people with advanced HF will have a difficult time laying down
because they will feel like they are drowning due to pulmonary
congestion
