Advanced Pathophysiology Summer UTA 5315 Test 3 UPDATED
ACTUAL Exam Questions and CORRECT Answers | Verified |
100% Accurate
Question 1.
Mitral Valve Regurgitation
Correct Answer: -Characterized by INCOMPLETE CLOSURE of mitral valve
-Caused by MITRAL VALVE PROLAPSE (flaps don't close together properly,
leaving valve ajar); more common in WOMEN; STICKING CHEST PAIN -Blood in
left ventricle backs up to left ventricle during systole (mitral valve should be
closed during systole/contraction of heart) -Leads to atrial
dilation/hypertrophy, increased pulmonary vascular pressure/volume,
PULMONARY EDEMA -S/sx: Dyspnea, rales, pansystolic murmur, S3 & S4 heart
sounds
Question 2.
Aortic Valve Stenosis
Correct Answer: -Most common valvular disease -Most common causes are
aortic valve CALCIFICATION (stiffening) in people over 60; congenital aortic
valve stenosis in people less than 30 -Normal valve 3 cm; symptoms seen
when valve less than 1 cm; severe when valve is less than 0.5 cm -Narrowed
valve prevents outflow from left ventricle to aorta. This backs up blood to the
left atrium and ultimately floods the lung causing PULMONARY EDEMA S/Sx:
Pulmonary hypertension/edema, poor outflow of aorta to body (aorta sends
out oxygenated blood to body), causing fainting or chest pain Simplified:
Aorta is stiff and can't send out oxygenated blood properly to the body,
depriving tissues of oxygen. Blood gets backed up into lungs, causing
pulmonary edema.
• Aortic Valve Regurgitation -✓✓-Valve is TOO WIDE or TOO NARROW, blood
doesn't pass through effectively, causing back flow of blood into the left
ventricle
-Marked by EARLY DIASTOLIC MURMUR (on systole, heart contracts and
pushes blood up the aorta, but on diastole, heart relaxes and ineffective
aortic valve is not able to hold blood up in aorta, so blood falls and makes a
swish sound, which is the murmur) -Most commonly caused by AORTIC ROOT
DILATION(starting point of aorta is too wide) -Other causes: infective
endocarditis, rheumatic fever, aortitis from syphilis, coarctation (congenital
narrowing of aorta), aortic dissection (tear), ankylosing spondylitis
(inflammatory arthritis)
-Acute: increases left ventricular end-diastolic pressure (LVEDP) (increased
blood back down in the left ventricle increases pressure), decreased stroke
volume (not much blood is being pushed from left ventricle because blood's
backed up and overwhelming left ventricle), normal or decreased pulse
pressure, decreased cardiac output (aorta is not effectively pumping blood
,from heart)
Chronic: Body adjusts; LVEDP normalizes, systolic bp increases
(compensation: harder contraction to push blood out of aorta before it falls
back down to left ventricle), diastolic bp decreases (compensation: decreased
relaxation of heart to stop blood from seeping back out of aorta), cardiac
output is normal, pulse pressure is increase. Blood ultimately is backed up
into the left atrium and pulmonary circulation.
Question 3.
Atherosclerosis Causes
Correct Answer: -Begins with tissue injury Sources of injury: CIGARETTES
(toxins) Hypertension (increased force of the blood hitting the blood vessel
can weaken it) Diabetes Hyperlipidemia (lipids take place of endothelial cells
lining the blood vessel, initiating an inflammatory response)
Question 4.
Patho of Atherosclerosis r/t Hyperlipidemia - Inflammatory Response
Correct Answer: 1. Tissue injury to endothelial cells lining the blood vessel.
2. Endothelial cells become inflammed and unable to produce sufficient
antithrombotic and vasodilating cytokines, increasing risk for clot formation
and creating a tighter space for plaques and clots to grow.
3. Macrophages and platelets are called to the area of injury, further
congesting the growing plaque area.
4. LDL replaces endothelial cells in the lining of the blood vessel.
5. Macrophages engulf the LDL particles.
6. Macrophages eat too much LDL, causing them to burst and become foam
cells (under a microscope they look like sea foam)
7. Accumulation of foam cells causes a fatty streak. Fatting streak further
triggers inflammatory responses, repeating the whole cycle, and growing the
fatty streak.
8. Smooth muscle hyperplasia from all the inflammation grows, produces
collagen, and covers the fatty streak to create a fibrous plaque.
9. The plaque may calcify, protrude into the vessel, and occlude blood flow,
resulting in ischemia or infarction.
Question 5.
Hyperlipidemia
Correct Answer: Leading cause of coronary artery disease
Most commonly affects promximal portions of coronary arteries, larger
branches of carotid arteries, circle of Willis (base of brain), large vessels of
lower extremities, renal arteries, mesenteric (intestinal) arteries
,Question 6.
Consequences of Atherosclerosis
Correct Answer: Reduced blood flow
Coronary artery disease, myocardial infarction, carotid artery disease,
cerebral vascular disease, stroke, mesenteric ischemia, peripheral vascular
disease, renal artery stenosis
• Congenital Heart Disease -✓✓-Most common heart disease affecting children
-Etiology is unknown in 90% of cases
Causes: Genetic/environmental factors (multifactorial factors) Primary genetic
factors (single gene disorders, chromosome disorders) Sole environmental
factors (Accutane/isotretinoin for acne, alcohol, maternal rubella infection)
Maternal Risk Factors: Age over 45, prior child with heart defect, poorly
controlled diabetes during pregnancy, alcohol, congenital infection during
pregnancy (rubella), aspirin, lupus, Dilantin/phenytoin/diphenylhydantoin for
seizures
Question 7.
LEFT to RIGHT shunt (Congenital heart defect)
Correct Answer: -Oxygenated blood from the left side of the heart mixes with
unoxygenated blood in the right side of the heart. -Oxygen saturation on left
side is usually 95%, whereas right side is 75% - As blood mixes, right side's
oxygen saturation increases to 80% or more -VOLUME OVERLOAD occurs on
RIGHT side of heart occurs, leading to PULMONARY HYPERTENSION, which
causes RIGHT VENTRICULAR HYPERTROPHY, (secondary to pulm. hptn.), and
LEFT VENTRICULAR HYPERTROPHY(secondary to blood being returned to left
ventricle) Eisenmenger Syndrome: Reversal of left to right shunt to a right to
left shunt.
Question 8.
Eisenmenger Syndrome
Correct Answer: 1. Increased blood flow returns to lungs rather than to the
rest of the body.
2. Blood vessels become stiff and narrow - permanent damage.
3. Increased pressure of the blood flow in the lung becomes so great that the
direction of blood flow through the shunt reverses.
4. Oxygen-poor (blue) blood from the right side of the heart flows into the left
ventricle and is pumped to the body and tissues do not receive enough
oxygen.
5. Results in late-onset cyanosis (as in, later in life) and clubbing of
fingernails.
, Question 9.
Ventricular Septal Defect (most common congenital heart defect)
Correct Answer: -Hole allowing blood to move from left ventricle to the right
ventricle -Sign: Harsh holosytolic murmur at the lower left sternal border
(high- pitched, begins at the first heart sound (S1) and continue to the second
heart sound (S2)) -Multiple VSDs are associated with Tetralogy of Fallot, Cri
du Chat Syndrome, and Fetal Alcohol Syndrome. -Associated with
development of atrial septal defects, patent ductus arteriosus, coarction
(congenital narrowing) of aorta, aortic valve stenosis, INCREASED RISK FOR
DEVELOPING ENDOCARDITIS at some point in life ( infection of the heart's
inner lining, usually involving the heart valves)
Question 10.
Atrial Septal Defect (most common congenital heart defect in adults)
Correct Answer: -Most common cause is a patent foramen ovale (hole) that
does not close -Associated with FETAL ALCOHOL SYNDROME and DOWN
SYNDROME -Sign: Midsystolic murmur at upper sternal border -Increases risk
for EMBOLUS
Question 11.
Patent Ductus Arteriosus
Correct Answer: Patent ductus arteriosus (PDA) is a persistent opening
between the two major blood vessels leading from the heart. The opening,
called the ductus arteriosus, is a normal part of a baby's circulatory system
before birth that usually closes shortly after birth. If it remains open,
however, it's called a patent ductus arteriosus.
Sign: Machine-like murmur heard continuously throughout systole and
diastole
Reversal may occur if pulmonary hptn occurs from increased blood flow
through the pulmonary artery. If this happens, unoxygenated blood will enter
the aorta below the level of the subclavian artery and the child will be
cyanotic in the lower body, but not in the upper body.
Associated with congenital rubella, Tetralogy of Fallot, respiratory distress
syndrome, and transposition of great vessels (unoxygenated blood does not
pick up oxygen in lungs and is pumped back to body)
Question 12.
Right to left shunt
Correct Answer: Tetralogy of Fallot is most common cyanotic congenital heart
defect. *Impaired gas exchanged r/t decreased pulmonary blood flow* Right
side of heart = Deoxygenated Left side = Oxygenated
1. Deoxygenated blood is mixed with oxygenated blood.
ACTUAL Exam Questions and CORRECT Answers | Verified |
100% Accurate
Question 1.
Mitral Valve Regurgitation
Correct Answer: -Characterized by INCOMPLETE CLOSURE of mitral valve
-Caused by MITRAL VALVE PROLAPSE (flaps don't close together properly,
leaving valve ajar); more common in WOMEN; STICKING CHEST PAIN -Blood in
left ventricle backs up to left ventricle during systole (mitral valve should be
closed during systole/contraction of heart) -Leads to atrial
dilation/hypertrophy, increased pulmonary vascular pressure/volume,
PULMONARY EDEMA -S/sx: Dyspnea, rales, pansystolic murmur, S3 & S4 heart
sounds
Question 2.
Aortic Valve Stenosis
Correct Answer: -Most common valvular disease -Most common causes are
aortic valve CALCIFICATION (stiffening) in people over 60; congenital aortic
valve stenosis in people less than 30 -Normal valve 3 cm; symptoms seen
when valve less than 1 cm; severe when valve is less than 0.5 cm -Narrowed
valve prevents outflow from left ventricle to aorta. This backs up blood to the
left atrium and ultimately floods the lung causing PULMONARY EDEMA S/Sx:
Pulmonary hypertension/edema, poor outflow of aorta to body (aorta sends
out oxygenated blood to body), causing fainting or chest pain Simplified:
Aorta is stiff and can't send out oxygenated blood properly to the body,
depriving tissues of oxygen. Blood gets backed up into lungs, causing
pulmonary edema.
• Aortic Valve Regurgitation -✓✓-Valve is TOO WIDE or TOO NARROW, blood
doesn't pass through effectively, causing back flow of blood into the left
ventricle
-Marked by EARLY DIASTOLIC MURMUR (on systole, heart contracts and
pushes blood up the aorta, but on diastole, heart relaxes and ineffective
aortic valve is not able to hold blood up in aorta, so blood falls and makes a
swish sound, which is the murmur) -Most commonly caused by AORTIC ROOT
DILATION(starting point of aorta is too wide) -Other causes: infective
endocarditis, rheumatic fever, aortitis from syphilis, coarctation (congenital
narrowing of aorta), aortic dissection (tear), ankylosing spondylitis
(inflammatory arthritis)
-Acute: increases left ventricular end-diastolic pressure (LVEDP) (increased
blood back down in the left ventricle increases pressure), decreased stroke
volume (not much blood is being pushed from left ventricle because blood's
backed up and overwhelming left ventricle), normal or decreased pulse
pressure, decreased cardiac output (aorta is not effectively pumping blood
,from heart)
Chronic: Body adjusts; LVEDP normalizes, systolic bp increases
(compensation: harder contraction to push blood out of aorta before it falls
back down to left ventricle), diastolic bp decreases (compensation: decreased
relaxation of heart to stop blood from seeping back out of aorta), cardiac
output is normal, pulse pressure is increase. Blood ultimately is backed up
into the left atrium and pulmonary circulation.
Question 3.
Atherosclerosis Causes
Correct Answer: -Begins with tissue injury Sources of injury: CIGARETTES
(toxins) Hypertension (increased force of the blood hitting the blood vessel
can weaken it) Diabetes Hyperlipidemia (lipids take place of endothelial cells
lining the blood vessel, initiating an inflammatory response)
Question 4.
Patho of Atherosclerosis r/t Hyperlipidemia - Inflammatory Response
Correct Answer: 1. Tissue injury to endothelial cells lining the blood vessel.
2. Endothelial cells become inflammed and unable to produce sufficient
antithrombotic and vasodilating cytokines, increasing risk for clot formation
and creating a tighter space for plaques and clots to grow.
3. Macrophages and platelets are called to the area of injury, further
congesting the growing plaque area.
4. LDL replaces endothelial cells in the lining of the blood vessel.
5. Macrophages engulf the LDL particles.
6. Macrophages eat too much LDL, causing them to burst and become foam
cells (under a microscope they look like sea foam)
7. Accumulation of foam cells causes a fatty streak. Fatting streak further
triggers inflammatory responses, repeating the whole cycle, and growing the
fatty streak.
8. Smooth muscle hyperplasia from all the inflammation grows, produces
collagen, and covers the fatty streak to create a fibrous plaque.
9. The plaque may calcify, protrude into the vessel, and occlude blood flow,
resulting in ischemia or infarction.
Question 5.
Hyperlipidemia
Correct Answer: Leading cause of coronary artery disease
Most commonly affects promximal portions of coronary arteries, larger
branches of carotid arteries, circle of Willis (base of brain), large vessels of
lower extremities, renal arteries, mesenteric (intestinal) arteries
,Question 6.
Consequences of Atherosclerosis
Correct Answer: Reduced blood flow
Coronary artery disease, myocardial infarction, carotid artery disease,
cerebral vascular disease, stroke, mesenteric ischemia, peripheral vascular
disease, renal artery stenosis
• Congenital Heart Disease -✓✓-Most common heart disease affecting children
-Etiology is unknown in 90% of cases
Causes: Genetic/environmental factors (multifactorial factors) Primary genetic
factors (single gene disorders, chromosome disorders) Sole environmental
factors (Accutane/isotretinoin for acne, alcohol, maternal rubella infection)
Maternal Risk Factors: Age over 45, prior child with heart defect, poorly
controlled diabetes during pregnancy, alcohol, congenital infection during
pregnancy (rubella), aspirin, lupus, Dilantin/phenytoin/diphenylhydantoin for
seizures
Question 7.
LEFT to RIGHT shunt (Congenital heart defect)
Correct Answer: -Oxygenated blood from the left side of the heart mixes with
unoxygenated blood in the right side of the heart. -Oxygen saturation on left
side is usually 95%, whereas right side is 75% - As blood mixes, right side's
oxygen saturation increases to 80% or more -VOLUME OVERLOAD occurs on
RIGHT side of heart occurs, leading to PULMONARY HYPERTENSION, which
causes RIGHT VENTRICULAR HYPERTROPHY, (secondary to pulm. hptn.), and
LEFT VENTRICULAR HYPERTROPHY(secondary to blood being returned to left
ventricle) Eisenmenger Syndrome: Reversal of left to right shunt to a right to
left shunt.
Question 8.
Eisenmenger Syndrome
Correct Answer: 1. Increased blood flow returns to lungs rather than to the
rest of the body.
2. Blood vessels become stiff and narrow - permanent damage.
3. Increased pressure of the blood flow in the lung becomes so great that the
direction of blood flow through the shunt reverses.
4. Oxygen-poor (blue) blood from the right side of the heart flows into the left
ventricle and is pumped to the body and tissues do not receive enough
oxygen.
5. Results in late-onset cyanosis (as in, later in life) and clubbing of
fingernails.
, Question 9.
Ventricular Septal Defect (most common congenital heart defect)
Correct Answer: -Hole allowing blood to move from left ventricle to the right
ventricle -Sign: Harsh holosytolic murmur at the lower left sternal border
(high- pitched, begins at the first heart sound (S1) and continue to the second
heart sound (S2)) -Multiple VSDs are associated with Tetralogy of Fallot, Cri
du Chat Syndrome, and Fetal Alcohol Syndrome. -Associated with
development of atrial septal defects, patent ductus arteriosus, coarction
(congenital narrowing) of aorta, aortic valve stenosis, INCREASED RISK FOR
DEVELOPING ENDOCARDITIS at some point in life ( infection of the heart's
inner lining, usually involving the heart valves)
Question 10.
Atrial Septal Defect (most common congenital heart defect in adults)
Correct Answer: -Most common cause is a patent foramen ovale (hole) that
does not close -Associated with FETAL ALCOHOL SYNDROME and DOWN
SYNDROME -Sign: Midsystolic murmur at upper sternal border -Increases risk
for EMBOLUS
Question 11.
Patent Ductus Arteriosus
Correct Answer: Patent ductus arteriosus (PDA) is a persistent opening
between the two major blood vessels leading from the heart. The opening,
called the ductus arteriosus, is a normal part of a baby's circulatory system
before birth that usually closes shortly after birth. If it remains open,
however, it's called a patent ductus arteriosus.
Sign: Machine-like murmur heard continuously throughout systole and
diastole
Reversal may occur if pulmonary hptn occurs from increased blood flow
through the pulmonary artery. If this happens, unoxygenated blood will enter
the aorta below the level of the subclavian artery and the child will be
cyanotic in the lower body, but not in the upper body.
Associated with congenital rubella, Tetralogy of Fallot, respiratory distress
syndrome, and transposition of great vessels (unoxygenated blood does not
pick up oxygen in lungs and is pumped back to body)
Question 12.
Right to left shunt
Correct Answer: Tetralogy of Fallot is most common cyanotic congenital heart
defect. *Impaired gas exchanged r/t decreased pulmonary blood flow* Right
side of heart = Deoxygenated Left side = Oxygenated
1. Deoxygenated blood is mixed with oxygenated blood.
