NURS 5315 ADVANCE PATHOPHYSIOLOGY EXAM 3 - UTA EXAM |
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS GRADED A+ | LATEST EXAM UPDATE
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
- 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
-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)
-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:
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)
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.
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
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 - CORRECT ANSWER - -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)
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS GRADED A+ | LATEST EXAM UPDATE
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
- 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
-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)
-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:
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)
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.
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
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 - CORRECT ANSWER - -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)
