2025 Advanced Pathophysiology FINAL EXAM
GRADED A
A prolonged ischemia causing irreversible damage to heart muscle and subsequent
myocyte necrosis is? - CORRECT ANSWER Myocardial Infarction
What structure changes occur during an MI? - CORRECT ANSWER Myocardial
stunning
Hibernating myocardium
Myocardial remodling
The temporary loss of contractility that persists for hours to days after perfusion has
been restored to the heart is? - CORRECT ANSWER myocardial stunning
A myocardial tissue that persistently undergoes metabolic adaptation to prolong
myocyte survival is consistent with? - CORRECT ANSWER Hibernating
myocardium
Myocardial remodeling is a process that occurs in the myocardium after ? - CORRECT
ANSWER MI
In most cases, repair and remodeling of the myocardium causes? - CORRECT
ANSWER more problems ~ renal failure
Stable plaques are associated with? - CORRECT ANSWER stable angina
Unstable plaques are associated with? - CORRECT ANSWER acute coronary
syndromes
During a MI, angiotensin II plays a major role in/ - CORRECT ANSWER peripheral
vasoconstriction and fluid retention ~ increasing myocardial work load~ exacerbating a
decrease in contractility
hypersecretion of GH ~ promotion of catecholamine release ~ causing acute coronary
spasms
causes myocyte hypertrophy, scarring, and loss of contractile function int eh scarred
areas distal to the infarction
,What are the two major types of MI - CORRECT ANSWER Subendocardial and
transmural
What are the clinical manifestations of MI - CORRECT ANSWER Sudden, severe
chest pain, nausea, vomitting, severe indigestion, diaphoresis, peripheral
vasoconstriction, and inflammation.
When does remodeling of myocardium occur? - CORRECT ANSWER During
troponin elevation, CPK_MB elevation and hyperglycemic states
Compare and contrast the zones of ischemia with ECG changes - CORRECT
ANSWER ischemia~ inverted T-wave
injury ~ ST elevation
infarction/necrosis: prolonged QRS with depressed Q
What are common complications of MI - CORRECT ANSWER dysrhythmias
heart failure
cardiogenic shock
pericarditis
ventricular aneurysm
A person with an MI is releasing angiotensin II. How should the nurse interpret these
findings? - CORRECT ANSWER counterproductive. It causes the heart to work
harder
What is an inflammation of the endocardium from infectious agents? - CORRECT
ANSWER Infective endocarditis
What are the most common culprits of infective endocarditis? - CORRECT ANSWER
Bacteria (strept, staph, and entero)
What is the pathogenesis of infective endocarditis? - CORRECT ANSWER
endocardial damage
blood borne microorganism adherence
formation of infective endocardial vegetations
What are clinical manifestations of infective endocarditis? - CORRECT ANSWER
Fever
new or changed murmur
petechial lesions of the skin, conjunctiva and oral mucosa
osler nodes ~ pads of fingers and toes PAINFUL
Laneway lesions ~ non painful hemorrhagic lesions on the palms and soles
,weight loss
back pain
night sweats
heart failure
emboli
What is the condition in which the heart is unable to adequately produce sufficient
cardiac output, resulting in inadequate perfusion of tissues or an increased diastolic
filling pressure of the left ventricle or both? - CORRECT ANSWER Heart Failure
What is heart failure? - CORRECT ANSWER the inability of the heart to pump
sufficient blood to meet the needs of the tissues for oxygen and nutrients
ischemic heart disease and hypertension are risk factors for? - CORRECT ANSWER
heart failure
Describe left (congestive) heart failure - CORRECT ANSWER HFrEF or HFpEF
ventricular remodeling
What is the most common cause of decreased cardiac contractility? - CORRECT
ANSWER MI
When is preload increased? - CORRECT ANSWER decreased contractility
excess plama volume
An increase in peripheral vascular resistance correlates to? - CORRECT ANSWER
Increased Afterload
An inability of the heart to generate adequate cardiac output to perfuse tissues is which
type of heart failure? - CORRECT ANSWER systolic
Systolic heart failure sees an increase in? - CORRECT ANSWER Catecholamines
RAAS
ADH
Naturiuetic peptides
Inflammatory cytokines
myocyte calcium transport
Insulin resistance
DOE, orthopnea, cough with frothy sputum, fatigue, edema and decrease urine output
are characteristically seen in? - CORRECT ANSWER Systolic heart failure
HFrEF correlates to? - CORRECT ANSWER systolic heart failure
, HFpEF correlates to? - CORRECT ANSWER Diastolic heart failure
A decreased compliancy of the left ventricle and abnormal diastolic relaxation occurs
in? - CORRECT ANSWER Diastolic heart failure
Define lusitropy - CORRECT ANSWER abnormal diastolic relaxation
DOE and fatigue are characteristically seen in? - CORRECT ANSWER Diastolic
heart failure
Right Side heart failure is the inability of the right ventricle to provide? - CORRECT
ANSWER adequate blood flow in the pulmonary circulation
Increased left ventricular filling pressure may be a precursor to? - CORRECT
ANSWER right heart failure
diffuse hypoxic pulmonary disease - CORRECT ANSWER What usually causes
right heart failure
What are the clinical manifestations of right heart failure? - CORRECT ANSWER
JVD, peripheral edema, hepatosplenomegaly
What is high output heart failure? - CORRECT ANSWER uncommon; body needs
excessive CO; causes include severe anemia and thyrotoxicosis and beriberi
Systolic heart failure is associated with the activation of the ? - CORRECT ANSWER
RAAS
A disturbance in heart rhythm and rate. - CORRECT ANSWER dysrhythmia
An acute inflammation of the pericardium is? - CORRECT ANSWER Acute
pericarditis
A 34 y/o male presents with fever, myalgias, and malaise for four days but recently
reports sudden server chest pain. What do you suspect to be the cause? - CORRECT
ANSWER Acute pericarditis
An accumulation of fluid in the pericardial cavity is? - CORRECT ANSWER
Pericardial effusion
GRADED A
A prolonged ischemia causing irreversible damage to heart muscle and subsequent
myocyte necrosis is? - CORRECT ANSWER Myocardial Infarction
What structure changes occur during an MI? - CORRECT ANSWER Myocardial
stunning
Hibernating myocardium
Myocardial remodling
The temporary loss of contractility that persists for hours to days after perfusion has
been restored to the heart is? - CORRECT ANSWER myocardial stunning
A myocardial tissue that persistently undergoes metabolic adaptation to prolong
myocyte survival is consistent with? - CORRECT ANSWER Hibernating
myocardium
Myocardial remodeling is a process that occurs in the myocardium after ? - CORRECT
ANSWER MI
In most cases, repair and remodeling of the myocardium causes? - CORRECT
ANSWER more problems ~ renal failure
Stable plaques are associated with? - CORRECT ANSWER stable angina
Unstable plaques are associated with? - CORRECT ANSWER acute coronary
syndromes
During a MI, angiotensin II plays a major role in/ - CORRECT ANSWER peripheral
vasoconstriction and fluid retention ~ increasing myocardial work load~ exacerbating a
decrease in contractility
hypersecretion of GH ~ promotion of catecholamine release ~ causing acute coronary
spasms
causes myocyte hypertrophy, scarring, and loss of contractile function int eh scarred
areas distal to the infarction
,What are the two major types of MI - CORRECT ANSWER Subendocardial and
transmural
What are the clinical manifestations of MI - CORRECT ANSWER Sudden, severe
chest pain, nausea, vomitting, severe indigestion, diaphoresis, peripheral
vasoconstriction, and inflammation.
When does remodeling of myocardium occur? - CORRECT ANSWER During
troponin elevation, CPK_MB elevation and hyperglycemic states
Compare and contrast the zones of ischemia with ECG changes - CORRECT
ANSWER ischemia~ inverted T-wave
injury ~ ST elevation
infarction/necrosis: prolonged QRS with depressed Q
What are common complications of MI - CORRECT ANSWER dysrhythmias
heart failure
cardiogenic shock
pericarditis
ventricular aneurysm
A person with an MI is releasing angiotensin II. How should the nurse interpret these
findings? - CORRECT ANSWER counterproductive. It causes the heart to work
harder
What is an inflammation of the endocardium from infectious agents? - CORRECT
ANSWER Infective endocarditis
What are the most common culprits of infective endocarditis? - CORRECT ANSWER
Bacteria (strept, staph, and entero)
What is the pathogenesis of infective endocarditis? - CORRECT ANSWER
endocardial damage
blood borne microorganism adherence
formation of infective endocardial vegetations
What are clinical manifestations of infective endocarditis? - CORRECT ANSWER
Fever
new or changed murmur
petechial lesions of the skin, conjunctiva and oral mucosa
osler nodes ~ pads of fingers and toes PAINFUL
Laneway lesions ~ non painful hemorrhagic lesions on the palms and soles
,weight loss
back pain
night sweats
heart failure
emboli
What is the condition in which the heart is unable to adequately produce sufficient
cardiac output, resulting in inadequate perfusion of tissues or an increased diastolic
filling pressure of the left ventricle or both? - CORRECT ANSWER Heart Failure
What is heart failure? - CORRECT ANSWER the inability of the heart to pump
sufficient blood to meet the needs of the tissues for oxygen and nutrients
ischemic heart disease and hypertension are risk factors for? - CORRECT ANSWER
heart failure
Describe left (congestive) heart failure - CORRECT ANSWER HFrEF or HFpEF
ventricular remodeling
What is the most common cause of decreased cardiac contractility? - CORRECT
ANSWER MI
When is preload increased? - CORRECT ANSWER decreased contractility
excess plama volume
An increase in peripheral vascular resistance correlates to? - CORRECT ANSWER
Increased Afterload
An inability of the heart to generate adequate cardiac output to perfuse tissues is which
type of heart failure? - CORRECT ANSWER systolic
Systolic heart failure sees an increase in? - CORRECT ANSWER Catecholamines
RAAS
ADH
Naturiuetic peptides
Inflammatory cytokines
myocyte calcium transport
Insulin resistance
DOE, orthopnea, cough with frothy sputum, fatigue, edema and decrease urine output
are characteristically seen in? - CORRECT ANSWER Systolic heart failure
HFrEF correlates to? - CORRECT ANSWER systolic heart failure
, HFpEF correlates to? - CORRECT ANSWER Diastolic heart failure
A decreased compliancy of the left ventricle and abnormal diastolic relaxation occurs
in? - CORRECT ANSWER Diastolic heart failure
Define lusitropy - CORRECT ANSWER abnormal diastolic relaxation
DOE and fatigue are characteristically seen in? - CORRECT ANSWER Diastolic
heart failure
Right Side heart failure is the inability of the right ventricle to provide? - CORRECT
ANSWER adequate blood flow in the pulmonary circulation
Increased left ventricular filling pressure may be a precursor to? - CORRECT
ANSWER right heart failure
diffuse hypoxic pulmonary disease - CORRECT ANSWER What usually causes
right heart failure
What are the clinical manifestations of right heart failure? - CORRECT ANSWER
JVD, peripheral edema, hepatosplenomegaly
What is high output heart failure? - CORRECT ANSWER uncommon; body needs
excessive CO; causes include severe anemia and thyrotoxicosis and beriberi
Systolic heart failure is associated with the activation of the ? - CORRECT ANSWER
RAAS
A disturbance in heart rhythm and rate. - CORRECT ANSWER dysrhythmia
An acute inflammation of the pericardium is? - CORRECT ANSWER Acute
pericarditis
A 34 y/o male presents with fever, myalgias, and malaise for four days but recently
reports sudden server chest pain. What do you suspect to be the cause? - CORRECT
ANSWER Acute pericarditis
An accumulation of fluid in the pericardial cavity is? - CORRECT ANSWER
Pericardial effusion
