TEST 3 - Advanced Pathophysiology
Summer 2018 UTA 5315 Exam 2026
Questions and Answers
Mitral Valve Stenosis - Correct answer-- Characterized by NARROWING of mitral
valve
- Normal is 4-6 cm
-Narrowed is less than 2.5 cm
- Caused by RHEUMATIC FEVER
-More common in WOMEN
-Oxygenated blood comes back into heart into the left atrium and down through the
mitral valve to the left ventricle
- Complex: Stenosis leads to volume/pressure in left atrium, which results in atrial
hypertrophy/dilation, which increases pressure/volume in the pulmonary
circulation & causes PULMONARY EDEMA
©COPYRIGHT 2025, ALL RIGHTS RESERVE 1
,- Simplified: Skinny mitral valve doesn't let blood pass through easily, so blood
backs up into the left atrium and causes it to swell, then backs up into the lung and
causes resp. symptoms
-S/sx: dyspnea, hemoptysis, a-fib, dysphagia, pulmonary hypertension
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
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
©COPYRIGHT 2025, ALL RIGHTS RESERVE 2
,-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 - Correct answer--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)
©COPYRIGHT 2025, ALL RIGHTS RESERVE 3
, -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.
Atherosclerosis Causes - Correct answer--Begins with tissue injury
Sources of injury:
©COPYRIGHT 2025, ALL RIGHTS RESERVE 4
Summer 2018 UTA 5315 Exam 2026
Questions and Answers
Mitral Valve Stenosis - Correct answer-- Characterized by NARROWING of mitral
valve
- Normal is 4-6 cm
-Narrowed is less than 2.5 cm
- Caused by RHEUMATIC FEVER
-More common in WOMEN
-Oxygenated blood comes back into heart into the left atrium and down through the
mitral valve to the left ventricle
- Complex: Stenosis leads to volume/pressure in left atrium, which results in atrial
hypertrophy/dilation, which increases pressure/volume in the pulmonary
circulation & causes PULMONARY EDEMA
©COPYRIGHT 2025, ALL RIGHTS RESERVE 1
,- Simplified: Skinny mitral valve doesn't let blood pass through easily, so blood
backs up into the left atrium and causes it to swell, then backs up into the lung and
causes resp. symptoms
-S/sx: dyspnea, hemoptysis, a-fib, dysphagia, pulmonary hypertension
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
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
©COPYRIGHT 2025, ALL RIGHTS RESERVE 2
,-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 - Correct answer--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)
©COPYRIGHT 2025, ALL RIGHTS RESERVE 3
, -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.
Atherosclerosis Causes - Correct answer--Begins with tissue injury
Sources of injury:
©COPYRIGHT 2025, ALL RIGHTS RESERVE 4