Exam Questions with Correct Answers
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Stenosis - ANSWER ✓ Narrowing of the valve orifice and failure of the valve
leaflets to open normally.
Renin-Angiotensin-Aldosterone System (role in heart failure) - ANSWER ✓ One
of the most important effects of lowered cardiac output in heart failure is a
reduction in renal blood flow and GFR, which leads to sodium and water retention
by way of aldosterone production.
Sustained expression of aldosterone may stimulate fibroblast and collagen
deposition, resulting in ventricular hypertrophy as well as fibrosis within the
vasculature and myocardium, contributing to reduced vascular compliance and
increased ventricular stiffness.
Myocardial Hypertrophy and Remodeling - ANSWER ✓ Development of
myocardial hypertrophy constitutes one of the principal mechanisms by which the
heart compensates for an increase in workload.
Inappropriate hypertrophy and remodeling can result in changes in structure (i.e.
muscle mass, chamber dilation) and cardiac function (i.e. impaired systolic or
diastolic function) that often lead to further pump dysfunction and hemodynamic
overload.
Reduced ejection fraction heart failure (HFrEF) - ANSWER ✓ EF < 40%
Systolic heart failure
May result from conditions that impair the contractile performance of the heart
(e.g. ischemic heart disease and cardiomyopathy), produce volume overload (e.g.
valvular insufficiency and anemia), or generate a pressure overload (e.g.
hypertension and valvular stenosis) on the heart.
, Preserved ejection fraction heart failure (HFpEF) - ANSWER ✓ Normal EF (>
50%) and abnormal diastolic function.
Diastolic heart failure resulting from an inability of the left ventricle to fill
sufficiently during diastole.
Hypertension remains the leading cause of diastolic dysfunction.
Left ventricular dysfunction - ANSWER ✓ Diminished cardiac output with a
resultant decrease in peripheral blood flow and a progressive accumulation of
blood in the pulmonary circulation.
Right ventricular dysfunction - ANSWER ✓ Dysfunction of the right ventricle
impairs the ability to move blood from the systemic venous circulation into the
pulmonary circulation.
Often the consequence of disease of the left ventricle. An increase in pulmonary
blood volume eventually produces an increased burden on the right side of the
heart.
Isolated dysfunction of the right ventricle is less common and occurs in persons
with intrinsic lung disease or pulmonary HTN.
Manifestations of heart failure - ANSWER ✓ Fluid retention and edema
Respiratory manifestations
Fatigue, weakness, and cognitive impairment
Cachexia and malnutrition
Cyanosis
Arrhythmias and sudden cardiac death
Sinoatrial node - ANSWER ✓ Site where rhythmic impulse is generated.
Internodal pathways - ANSWER ✓ Conducts the impulse from the SA node to the
AV node.
AV node - ANSWER ✓ Delays the impulse from the atria before passing it on to
the ventricles.