Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Coronary heart disease - ansCharacterized by insufficient delivery of oxygenated blood to the
myocardium due to atherosclerotic coronary arteries (CADs)
Sequelae of CHD - ans-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 - ansSmoking, hyperlipidemia (high Triglyceride and high LDL
cholestrol), diabetes mellitus, and hypertension are all...
Angina Pectoris - ans1. 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 - ans1. 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 - ans1. 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 - ansFailure of the valve to open completely results in extra pressure work for the
heart
Regurgitation - ansInability of a valve to close completely results in extra volume work for
the heart
Mitral (bicuspid) Stenosis - ans-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 - ans-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
,Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Mitral (bicuspid) Valve Prolapse - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ansAccumulation of noninflammatory fluid in the pericardial sac
Cardiac Tamponade - ans1. 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
,Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Hint: last word is similar to tapenade
Pericarditis - ansAcute or chronic inflammation of the pericardium. Categories include:
idiopathic, infectious, immune-inflammatory, neoplastic, or radiation induced
Hint: inflammation of the pericardium
Acute Pericarditis - ansForm of pericarditis
-Most cases idiopathic and presumed viral
-Typically presents as chest pain
Chronic Pericarditis - ansForm 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 - ansCPK (creatine phosphokinase), CK (creatine kinase), and troponin are
examples of...
Stable or typical angina - ansForm of angina brought up by exercise
Prinzmetal or variant angina - ansAngina due to coronary artery spasm—problem with
muscle contraction in tunica media. HAS NOTHING TO DO WITH FAT DEPOSITS
Unstable or crescendo angina - ansAngina that is not relieved by rest
Low density lipoprotein (LDL) - ans15-20 nm, 5% triglyceride, 55% cholesterol, 20% protein
High density lipoprotein (HDL) - ans5-10 nm, 5% triglyceride, 20% cholesterol, 50% protein
Pathogenesis of atherosclerosis - ans1. 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 - ansRepresents atrial depolarization/atrial systole (contraction) on an ECG
QRS Complex - ansRepresents ventricular depolarization/ventricular systole (contraction) on
an ECG
T-wave - ansRepresents ventricular repolarization/ventricular diastole (relaxation) on an ECG
Heart Failure - ansInability 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 - ansForm 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 - ans-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 - ans-The two main causes of this are ischemic heart disease and
hypertension
, Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
-Most likely to develop in elderly women
-Disorder of myocardial relaxation, the ventricle is excessively noncompliant and doesn't fill
effectively
-LOW CARDIAC OUTPUT, congestion, and edema formation with normal ejection fraction
[hint: comes after systole]
Forward heart failure - ans1. Insufficient cardiac pumping manifested by poor cardiac output
(hint: clinical manifestation of heart failure)
2. Reduced CO leads to renin release from the kidney which leads to fluid retention which
leads to backward failure
[hint: not backwards but...]
Backward heart failure - ansCongestion of blood behind the pumping chamber (hint: clinical
manifestation of heart failure)
[hint: not forward but...]
Left-sided heart failure - ans1. Most often associated with backward effects, which result in
accumulation of blood within pulmonary circulation, pulmonary congestion with dyspnea,
edema, and paroxysmal nocturnal dyspnea (intermittent SOB during night)
2. Hint: ASSOCIATED WITH LUNG CONGESTION
Backward effects of left-sided heart failure - ansDyspnea on exertion, orthopnea, cough,
paroxysmal nocturnal dyspnea, cyanosis, and basilar crackles are all...
Right-sided heart failure - ans1. Associated with pulmonary disorders or stenosis, increased
pulmonary vascular resistance, high afterload, right ventricular hypertrophy, right ventricular
failure
2. Backward effects due to congestion in the systemic venous system
3. Forward effects cause low output to left ventricle, leading to low CO
4. Usually a consequence of elevated right ventricular overload
Forward effects of left/right-sided heart failure - ansFatigue, oliguria (urine output <30
mL/hr), increased HR, faint pulses, restlessness, confusion, and anxiety are all...
Backward effects of right-sided heart failure - ansHepatomegaly, ascites, splenomegaly,
anorexia, subcutaneous edema, and jugular vein distention are all...
Biventricular heart failure - ans1. Most often the result of primary left-sided HF progressing
to right-sided HF
2. Reduced cardiac output
3. Pulmonary congestion due to left-sided HF
4. Systemic venous congestion due to right-sided HF
[hint: affects both sides]
FACES - ansFatigue
Activity limitation
Congestion
Edema
Shortness of breath
[Hint: acronym]
Treatment of heart failure - ansAimed at improving cardiac output while minimizing
congestive symptoms and cardiac workload; obtained by manipulating
preload/afterload/contractility
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Coronary heart disease - ansCharacterized by insufficient delivery of oxygenated blood to the
myocardium due to atherosclerotic coronary arteries (CADs)
Sequelae of CHD - ans-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 - ansSmoking, hyperlipidemia (high Triglyceride and high LDL
cholestrol), diabetes mellitus, and hypertension are all...
Angina Pectoris - ans1. 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 - ans1. 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 - ans1. 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 - ansFailure of the valve to open completely results in extra pressure work for the
heart
Regurgitation - ansInability of a valve to close completely results in extra volume work for
the heart
Mitral (bicuspid) Stenosis - ans-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 - ans-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
,Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Mitral (bicuspid) Valve Prolapse - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ans-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 - ansAccumulation of noninflammatory fluid in the pericardial sac
Cardiac Tamponade - ans1. 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
,Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
Hint: last word is similar to tapenade
Pericarditis - ansAcute or chronic inflammation of the pericardium. Categories include:
idiopathic, infectious, immune-inflammatory, neoplastic, or radiation induced
Hint: inflammation of the pericardium
Acute Pericarditis - ansForm of pericarditis
-Most cases idiopathic and presumed viral
-Typically presents as chest pain
Chronic Pericarditis - ansForm 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 - ansCPK (creatine phosphokinase), CK (creatine kinase), and troponin are
examples of...
Stable or typical angina - ansForm of angina brought up by exercise
Prinzmetal or variant angina - ansAngina due to coronary artery spasm—problem with
muscle contraction in tunica media. HAS NOTHING TO DO WITH FAT DEPOSITS
Unstable or crescendo angina - ansAngina that is not relieved by rest
Low density lipoprotein (LDL) - ans15-20 nm, 5% triglyceride, 55% cholesterol, 20% protein
High density lipoprotein (HDL) - ans5-10 nm, 5% triglyceride, 20% cholesterol, 50% protein
Pathogenesis of atherosclerosis - ans1. 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 - ansRepresents atrial depolarization/atrial systole (contraction) on an ECG
QRS Complex - ansRepresents ventricular depolarization/ventricular systole (contraction) on
an ECG
T-wave - ansRepresents ventricular repolarization/ventricular diastole (relaxation) on an ECG
Heart Failure - ansInability 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 - ansForm 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 - ans-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 - ans-The two main causes of this are ischemic heart disease and
hypertension
, Pathophysiology II Final Exam Mastering the Complexities: Your
Comprehensive Guide to the Pathophysiology II Final Exam Review with CNM
Fildes.
Top Rated Ultimate Exam Study Guide Current Updated Edition 2025/2026
-Most likely to develop in elderly women
-Disorder of myocardial relaxation, the ventricle is excessively noncompliant and doesn't fill
effectively
-LOW CARDIAC OUTPUT, congestion, and edema formation with normal ejection fraction
[hint: comes after systole]
Forward heart failure - ans1. Insufficient cardiac pumping manifested by poor cardiac output
(hint: clinical manifestation of heart failure)
2. Reduced CO leads to renin release from the kidney which leads to fluid retention which
leads to backward failure
[hint: not backwards but...]
Backward heart failure - ansCongestion of blood behind the pumping chamber (hint: clinical
manifestation of heart failure)
[hint: not forward but...]
Left-sided heart failure - ans1. Most often associated with backward effects, which result in
accumulation of blood within pulmonary circulation, pulmonary congestion with dyspnea,
edema, and paroxysmal nocturnal dyspnea (intermittent SOB during night)
2. Hint: ASSOCIATED WITH LUNG CONGESTION
Backward effects of left-sided heart failure - ansDyspnea on exertion, orthopnea, cough,
paroxysmal nocturnal dyspnea, cyanosis, and basilar crackles are all...
Right-sided heart failure - ans1. Associated with pulmonary disorders or stenosis, increased
pulmonary vascular resistance, high afterload, right ventricular hypertrophy, right ventricular
failure
2. Backward effects due to congestion in the systemic venous system
3. Forward effects cause low output to left ventricle, leading to low CO
4. Usually a consequence of elevated right ventricular overload
Forward effects of left/right-sided heart failure - ansFatigue, oliguria (urine output <30
mL/hr), increased HR, faint pulses, restlessness, confusion, and anxiety are all...
Backward effects of right-sided heart failure - ansHepatomegaly, ascites, splenomegaly,
anorexia, subcutaneous edema, and jugular vein distention are all...
Biventricular heart failure - ans1. Most often the result of primary left-sided HF progressing
to right-sided HF
2. Reduced cardiac output
3. Pulmonary congestion due to left-sided HF
4. Systemic venous congestion due to right-sided HF
[hint: affects both sides]
FACES - ansFatigue
Activity limitation
Congestion
Edema
Shortness of breath
[Hint: acronym]
Treatment of heart failure - ansAimed at improving cardiac output while minimizing
congestive symptoms and cardiac workload; obtained by manipulating
preload/afterload/contractility
