NR 507 Pathophysiolgy Midterm Questions & Answers

S1 - ANSWERSFirst heart sound, closure of mital and tricuspid valves in systole S2 - ANSWERSSecond heart sound, closure of aortic and pulmonica valves in diastole Preload - ANSWERSDiastolic filling with venous blood Contractility - ANSWERSSystolic ejection Afterload - ANSWERSResistance to systolic ejection Equation for cardiac output - ANSWERSstroke volume x heart rate Sustained tachycardia causes ___ - ANSWERSDecreased stroke volume Ischemia, acidosis and cardiomyopathy cause___ - ANSWERSDecreased contractility HTN, pulmonary disease and aortic valve damage cause ___ - ANSWERSIncreased afterload What is the most immediate effect on afterload? - ANSWERSHTN Hemorrhage and decreased volume decreases ___and ___ - ANSWERSPreload and afterload Increased preload increases ___ - ANSWERSStroke volume Right sided HF is also called ___ - ANSWERSCor pulmonale Cor pulmonale causes ___ and is caused by ___ - ANSWERSEnlargement of RV, pulmonary HTN from chronic lung disease 5 causes of lung disease leading to cor pulmonale? - ANSWERSCOPD, PE, pulmonary fibrosis, OSA, myasthenia gravis, polio 4 causes of heart failure - ANSWERSCAD, HTN, cardiomyopathy, faulty valves 4 events that lead to HF - ANSWERSHTN, increased LV preload, increased LA preload, pulmonary edema Define ventilation - ANSWERSThe ability to inhale and exhale air Define perfision - ANSWERSThe ability of lungs and tissues to perform gas exchange Intrinsic asthma - ANSWERSInternal trigger (anxiety) Extrinsic asthma - ANSWERSExternal trigger, allergic response mediated by IgE Asthma s/s - ANSWERSWheezing, chest tightness, SOB Asthma treatment - 3 classes/medications - ANSWERSBeta 2 agonists-albuterol, anticholinergics for bronchodilation-ipratropium, oral steroids to reduce inflammation-prednisone Chronic bronchitis s/s - ANSWERSProductive cough, dyspnea, wheezing, rhonchi, cyanosis Where does damage occur in bronchitis? - ANSWERSAirway What is the lamina propria? - ANSWERSThin connective tissue, forms moist linings/mucous membranes Where are inflammatory cells activated in chronic bronchitis? - ANSWERSLamina propria What plays a significant role in chronic brnonchitis development? - ANSWERSLamina propria What is a long term effect of COPD? (Blood) - ANSWERSSecondary polycythemia S/S in polycythemia secondary to COPD - ANSWERSIncreased HCT by RBC compensation, can lead to blood clot What is a long term effect of COPD? (lungs) - ANSWERSAlveolar hyperinflation, decreased ability to exhale, air trapping Where is erythropoietin produced? - ANSWERSKidneys Where is angiotensin converting enzyme (ACE) produced? - ANSWERSLungs Where is angiotensinogen synthesized? - ANSWERSLiver What is the role of ACE? - ANSWERSActivate angiotensin I to form angiotensin II What is the most important component of filtration? - ANSWERSBlood (hydrostatic) pressure Define reabsorption - ANSWERSMovement of content from glomerular filtrate to blood Define excretion - ANSWERSElimination from the body Define secretion - ANSWERSMovement of contents from blood to the nephron Define glomerularnephritis - ANSWERSDecreased GFR causes increased BUN and creatinine Acute renal failure is ___ - ANSWERSReversible Most common cause of ARF? - ANSWERSPre-renal Causes of pre-renal failure (5) - ANSWERSVolume depletion, polyuria from DM, v+d, fluid loss from burn or hemorrhage, hypoperfusion Causes of pre-renal hypoperfusion - ANSWERSDecreased CO from HF or MI, atherosclerosis Pathophysiology of pre-renal failure - ANSWERSDecreased blood to glomerulus, decreased GFR, decreased renal blood flow = activation of RAA Cause of intra-renal failure - ANSWERSDamage to kidney (glomerulus, tubules, interstitium, or vasculature) Most common cause of intra-renal failure - ANSWERSATN-ischemia, toxins Pathophysiology of intra-renal failure - ANSWERSInjury causes loss of function, decreased tubule reabsorption, increased sodium and h2o excretion Cause of post-renal failure - ANSWERSObstruction in collecting duct, ureter, bladder or urethra What can cause post-renal failure? (6) - ANSWERSStones, calculi, strictures, BPH, tumor, neurogenic bladder Define contrast-induced nephropathy (CIN) - ANSWERSInjury from contrast administration, 3rd most common hospital-acquired ARI Who is at risk for developing CIN? - ANSWERSDM, CKD Define chronic kidney disease (CKD) - ANSWERSLong-term permanent decline in renal function ___ is used to determine stage of CKD - ANSWERSGFR CKD can be caused by ___ and ___ factors - ANSWERSIntrinsic (glomerulonephritis), extrinsic (DM) ___ and ___ are the primary causes of ESRD - ANSWERSDM and HTN Normal GFR - ANSWERS125 mL/min Define RIFLE - ANSWERSRisk (90-120), injury (60-89), failure (30-59), loss (15-29), end (<15) Define viscoureteral reflux - ANSWERSRetrograde flow of urine from bladder to ureters RBCs lack ___ and ___ - ANSWERSEndoplasmic reticulum and nucleus Average RBC lifespan - ANSWERS120 days, 3-4 months RBCs are removed by ___ located primarily in the ___ - ANSWERSMacrophages, spleen Define hematopoiesis - ANSWERSFormation of blood cellular components Where is the primary site of hematopoiesis in adults? - ANSWERSRed bone marrow Consequences of decreased o2 due to lack of Hgb (5) - ANSWERSFatigue, pallor, weakness, dyspnea, dizziness Microcytic anemia (2) - ANSWERSIron deficiency, thalassemia Macrocyclic anemia (2) - ANSWERSB12 deficiency (pernicious anemia), folate deficiency Iron deficiency anemia is ____/____ - ANSWERSMicrocytic/hypochromic ___reflects the body's total iron stores - ANSWERSFerritin Low ferritin = - ANSWERSAnemia