Cardiovascular Pathophysiology Exam: Quiz

Pericardial effusion refers to the accumulation of fluid in the pericardial cavity, which is the space between the pericardium (the sac that surrounds the heart) and the heart itself. This condition can be caused by various factors such as inflammation, infection, trauma, or underlying medical conditions. It can lead to symptoms such as chest pain, shortness of breath, and palpitations, depending on the amount of fluid present and the rate of accumulation. Treatment may involve addressing the underlying cause and, in severe cases, draining the fluid to relieve pressure on the heart.

Valvular regurgitation is the best term to describe the situation when leaflets or cusps of a heart valve fail to close completely, resulting in continuous backflow of blood into the chamber. This condition increases the workload of the atrium and ventricle as they have to push the blood "upstream" to compensate for the leakage. Valvular regurgitation is most likely to occur in the left heart, specifically the mitral and aortic valves. Valvular dysfunction and valvular stenosis do not accurately describe this specific scenario.

Peripheral Artery Disease is the best term to describe an atherosclerotic disease of the arteries that perfuse the limbs, especially in the lower extremities. Atherosclerosis refers to the buildup of plaque in the arteries, which can lead to various cardiovascular diseases. Arteriosclerosis is a broader term that encompasses the thickening and hardening of the arteries, while Peripheral Artery Disease specifically focuses on the narrowing and blockage of the arteries in the limbs. Thus, Peripheral Artery Disease is the most accurate term in this context.

Dilated (congestive) cardiomyopathy is a condition where the ventricles of the heart become enlarged and weakened, leading to a decrease in the heart's ability to pump enough blood to meet the body's needs. This can result in symptoms such as fatigue, shortness of breath, and fluid retention. Restrictive cardiomyopathy refers to a condition where the heart muscle becomes stiff and does not relax properly, while hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle. Therefore, the correct answer is Dilated (congestive) cardiomyopathy.

Pericarditis refers to inflammation of the sac surrounding the heart, causing it to become roughened and scarred. This inflammation can lead to symptoms such as chest pain, fever, and a friction rub sound heard with a stethoscope. Pericardial friction rub and pericardial effusion are related terms but do not specifically describe the inflammation of the pericardium. Therefore, the correct answer is pericarditis.

An aneurysm refers to the localized dilation or outpouching of a vessel wall or cardiac chamber. This condition occurs when the wall of the blood vessel weakens, causing it to bulge or balloon outwards. Aneurysms can occur in various parts of the body, including the brain, aorta, and heart. They can be dangerous as they may rupture, leading to severe bleeding and potentially life-threatening complications. Therefore, an aneurysm is the correct term for the described condition.

Malignant hypertension is the best term to describe blood pressure that is rapidly progressive with diastolic above 140 mmHg. Malignant hypertension is a severe form of high blood pressure that can cause damage to organs, such as the brain, leading to cerebral edema and loss of function. Prehypertension refers to slightly elevated blood pressure, isolated hypertension refers to high blood pressure without any underlying cause, and secondary hypertension is high blood pressure caused by an underlying medical condition.

Aspirin is given to inhibit platelet aggregation in the treatment of myocardial infarction. Aspirin works by inhibiting the production of certain chemicals in the body that cause platelets to stick together and form clots. This helps to prevent further blockage of the blood vessels and reduces the risk of complications after a heart attack. Nitroglycerin is used to relieve chest pain by relaxing and widening blood vessels, while oxygen is given to increase the oxygen supply to the heart. Disprin is a brand name for a medication that contains aspirin, so it also inhibits platelet aggregation.

The middle-aged female presenting with a sudden painful, pulsating mass in the midline of her abdomen, along with the confirmed presence of a bruit, is consistent with the findings of an abdominal aorta aneurysm. A bruit is an abnormal sound caused by turbulent blood flow, which is often heard over an aneurysm. An abdominal aorta aneurysm occurs when the wall of the abdominal aorta weakens and bulges, leading to the formation of a pulsating mass. This condition is a serious medical emergency that requires immediate attention and intervention to prevent rupture and potentially life-threatening complications.

The nurse suspects that the diabetic patient is experiencing Peripheral Artery Disease (PAD). PAD is a condition where there is a narrowing or blockage of the arteries that supply blood to the legs and feet. This can cause severe pain in the legs, especially during physical activity like walking (ambulation). Diabetes is a risk factor for developing PAD, as high blood sugar levels can damage the blood vessels. Atherosclerosis and arteriosclerosis are both conditions that involve the hardening and narrowing of the arteries, which can contribute to PAD. Myocardial ischemia, on the other hand, refers to reduced blood flow to the heart, and is not directly related to the patient's leg pain.

Coronary angiography is a test that shows the location and degree of coronary artery stenosis, as well as the condition of the artery beyond the narrowing. It involves injecting a contrast dye into the coronary arteries and taking X-ray images to visualize the blood flow and any blockages or narrowing in the arteries. This test is commonly used to diagnose and evaluate coronary artery disease and to determine the need for further interventions such as stenting or bypass surgery. Intravascular ultrasound and Holter Monitor are not specific tests for evaluating coronary artery stenosis and the condition of the artery beyond the narrowing.

Unstable angina is the correct answer because it presents as new-onset angina, occurring at rest or in increasing severity or frequency. This is important to recognize because it indicates that atherosclerotic plaque has become complicated and infarction is likely to occur. Stable angina, on the other hand, is typically predictable and occurs with exertion or stress. Prinzmetal angina is caused by coronary artery spasm and is not necessarily associated with plaque complications. Therefore, unstable angina is the most appropriate answer in this scenario.

Atherosclerosis refers to the soft deposits of intra-arterial fat and fibrin in the vessel walls that harden over time. It is a condition characterized by the buildup of plaque, consisting of cholesterol, fat, calcium, and other substances, in the arteries. This plaque buildup narrows the arteries and reduces blood flow, leading to various cardiovascular diseases.

The findings of left ventricular gallop and S3 are consistent with silent ischemia. Silent ischemia refers to a condition where there is inadequate blood flow to the heart muscle, leading to symptoms such as fatigue, dyspnea, and a feeling of unease. However, unlike stable angina or Prinzmetal angina, silent ischemia does not typically cause chest pain or discomfort. The presence of left ventricular gallop and S3 suggests impaired heart function, which can be seen in silent ischemia. Pregnancy is unlikely to cause these specific findings.

Nitrates are medications that dilate both arteries and veins, reducing the workload on the heart and decreasing myocardial oxygen demands. By dilating the blood vessels, nitrates improve blood flow and oxygen supply to the heart, relieving angina symptoms. This helps to reduce the risk of a heart attack and improve overall cardiac function. Betq-Blockers, Antilipemics, and Aspirin do not have the same vasodilatory effects as nitrates, making them less effective in reducing myocardial oxygen demands.

Hypertrophic cardiomyopathy is a condition where the walls of the ventricles thicken and become stiff. This leads to a reduced ability of the heart to pump blood effectively. It is a genetic disorder that can be inherited or can occur due to genetic mutations. The thickened walls can obstruct the blood flow out of the heart, causing symptoms such as chest pain, shortness of breath, and fainting. Treatment options include medications, lifestyle changes, and in severe cases, surgical interventions like septal myectomy or alcohol septal ablation.

The patient's symptoms of skin ulcerations, redness, thick and shiny skin, and thickened and malformed nails are consistent with Thromboangilitis (Buerger Disease). This condition is characterized by inflammation and clotting of small and medium-sized blood vessels, leading to reduced blood flow and tissue damage. Raynaud's phenomenon and Raynaud's disease are not consistent with the observed symptoms.

Tamponade refers to the rapid accumulation of fluid in the pericardial cavity, causing compression of the heart. Pleural effusion refers to the accumulation of fluid in the pleural cavity, not the pericardial cavity. Pericardial effusion refers to the accumulation of fluid in the pericardial cavity, but it does not necessarily cause cardiac compression. Therefore, the correct term for the described condition is tamponade.

Restrictive cardiomyopathy is a condition where the ventricles of the heart become stiff and lose their ability to relax and fill properly. This leads to reduced filling of the ventricles and decreased blood flow to the body. Unlike hypertrophic cardiomyopathy, where the ventricles become thickened, and dilated cardiomyopathy, where the ventricles become enlarged, restrictive cardiomyopathy is characterized by stiffness of the ventricles. Therefore, the correct answer is "Restrictive".

Dyslipidemia refers to abnormal concentrations of serum lipoproteins such as lipids, phospholipids, cholesterol, and triglycerides bound to carrier proteins. This condition is characterized by imbalances in the levels of these lipids, which can lead to various cardiovascular diseases such as atherosclerosis and coronary artery disease. Lipoprotemia and phospholipidemia are not correct terms to describe this condition.

Uncontrolled HTN (hypertension) causes the ventricles and septum of the heart to become hypertrophic, meaning they become thickened and enlarged. This leads to the shrinking of the heart chambers and a decrease in the volume of blood that leaves the heart. As a result, cardiac output is decreased, which can be fatal for competitive athletes. Therefore, the correct answer is "Hypertrophic."

An EKG (electrocardiogram) is a test that evaluates the electrical activity of the heart. It can detect damaged heart muscle by analyzing the patterns and rhythms of the heart's electrical signals. Additionally, an EKG can also determine if there is adequate blood supply to the heart by assessing the presence of abnormalities such as ischemia or arrhythmias. Therefore, an EKG is an appropriate test to evaluate both damaged heart muscle and blood supply.

Coronary Artery Disease is the correct answer because it accurately describes a condition where the blood supply to the heart muscles is partially or completely blocked due to atherosclerosis in the arteries surrounding the heart. This causes narrowing of the arteries and obstructs the flow of blood. Peripheral Artery Disease refers to blockages in the arteries outside of the heart, Myocardial Ischemia refers to reduced blood flow to the heart muscles, and Prinzmetal Angina refers to chest pain caused by spasms in the coronary arteries.

Isolated systolic hypertension is the correct answer because it refers to a condition where only the systolic blood pressure is consistently elevated, with a systolic reading greater than 140mmHg and a diastolic reading below 90mmHg. This condition is associated with cardiovascular and cerebrovascular events, highlighting the importance of monitoring and managing blood pressure levels. Prehypertension refers to slightly elevated blood pressure levels, while secondary hypertension is caused by an underlying medical condition. Primary hypertension is a chronic condition with consistently high blood pressure readings.

General transient ST-segment depression and T wave inversion are characteristic signs of ischemia. Ischemia refers to a lack of blood flow and oxygen to a particular area, such as the heart muscle. This can occur due to atherosclerotic plaque build-up in the arteries, which can lead to angina (chest pain) and further complications. Antilipemics, on the other hand, are medications used to lower lipid levels and do not directly cause ST-segment depression or T wave inversion. Therefore, the correct answer is ischemia.

The patient's symptoms, such as severe persistent chest pain, sweating, and changes in blood pressure and heart rate, along with the presence of cardiac murmurs, pericardial friction rub, and crackles in the lung, are consistent with the diagnosis of myocardial infarction. Myocardial infarction, also known as a heart attack, occurs when there is a blockage in the coronary arteries, leading to the death of heart muscle tissue. This can cause symptoms such as chest pain, sweating, and changes in blood pressure and heart rate. Therefore, the correct answer is myocardial infarction.

Disorders of the endocardium can damage the heart valves, which are composed of endocardial tissue. This damage can lead to a dysfunction in the valves, causing them to not open or close properly. Valvular Dysfunction is a broad term that encompasses various disorders of the heart valves, including valvular stenosis (narrowing of the valve opening), valvular insufficiency (leaking of the valve), and valvular deficiency (impaired function of the valve). Therefore, Valvular Dysfunction is the correct answer to describe the overall damage to the heart valves caused by disorders of the endocardium.

Pericarditis is consistent with the given findings because it typically presents with sudden onset severe retrosternal chest pain that worsens with respiratory effort, especially inspiration. The relief of pain when leaning forward is known as the "pericardial friction rub" sign. Difficulty swallowing can also be a symptom of pericarditis, as inflammation of the pericardium can irritate the esophagus. Cardiomyopathy and myocardial infarction may cause chest pain, but they do not typically worsen with respiratory effort or improve with leaning forward.

An aneurysm in the Circle of Willis is the correct answer because it is a common location for aneurysms to occur in the brain. When an aneurysm ruptures or causes compression in this area, it can lead to increased intracranial pressure. This increased pressure can result in decreased levels of consciousness, bradycardia (slow heart rate), widened pulse pressure (difference between systolic and diastolic blood pressure), and small, sluggish pupils. Aneurysms in other locations or a thrombus in a cerebral artery may cause different symptoms or signs.

Calcium channel blockers are a type of medication commonly used to treat angina. Angina is a condition characterized by chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. Calcium channel blockers work by relaxing and widening the blood vessels, allowing more blood and oxygen to reach the heart. This helps to reduce the frequency and severity of angina episodes. Beta blockers can also be used to treat angina, but in this case, the correct answer is calcium channel blockers. Antilipemics are medications used to lower cholesterol levels, and aspirin is primarily used as a pain reliever and blood thinner.

Transmural infarction refers to the death of tissue in the entire thickness of a portion of the cardiac wall. This means that the tissue damage extends from the innermost layer (endocardium) to the outermost layer (epicardium) of the heart. It is a more severe form of myocardial infarction, which refers to the death of heart muscle tissue due to a lack of blood supply. Subendocardial infarction, on the other hand, refers to tissue death limited to the innermost layer of the cardiac wall. Therefore, the correct term to describe the tissue dying in the entire thickness of a portion of the cardiac wall is transmural infarction.

Heparin, warfarin, and thrombolytics are all used as treatments for thrombi. Heparin is an anticoagulant that helps prevent the formation of blood clots. Warfarin is also an anticoagulant that works by inhibiting the production of certain clotting factors. Thrombolytics, on the other hand, are medications that help dissolve existing blood clots. By including these three options in the answer, it covers the different approaches to treating thrombi and provides a comprehensive response.

Multiple myeloma and amyloidosis are examples of restrictive cardiomyopathy. Restrictive cardiomyopathy is a type of heart muscle disease where the walls of the heart become stiff and less flexible, leading to impaired filling and relaxation of the ventricles. In multiple myeloma, abnormal plasma cells produce excessive amounts of protein, which can accumulate in various organs including the heart. In amyloidosis, abnormal proteins called amyloid fibrils are deposited in the heart, causing it to become stiff and less compliant. Therefore, both multiple myeloma and amyloidosis can result in restrictive cardiomyopathy.

Aortic stenosis is the most common valve problem that is usually caused by a congenital bicuspid valve. A bicuspid valve has only two cusps instead of the normal three, which can lead to narrowing of the aortic valve opening over time. This condition is more commonly seen in individuals with a bicuspid valve rather than those with normal valves, degeneration of aging, or inflammatory changes from rheumatic heart disease. Aortic sclerosis refers to the thickening and hardening of the aortic valve without significant narrowing, while valvular stenosis is a general term for any narrowing of a heart valve.

Aneurysms with symptoms of ischemia are probably located in the Femoral and Popliteal Artery. Ischemia refers to a lack of blood supply, which can lead to tissue damage or death. Aneurysms occur when there is a bulging or weakening in the wall of a blood vessel. In this case, if the aneurysm is causing symptoms of ischemia, it suggests that there is a blockage or reduced blood flow in the Femoral and Popliteal Artery, which are located in the lower extremities.

The Holter monitor is used to detect silent ischemia and angina. Silent ischemia refers to a condition where a person experiences reduced blood flow to the heart without any noticeable symptoms. Angina, on the other hand, is chest pain or discomfort caused by reduced blood flow to the heart. The Holter monitor is a portable device that continuously records the heart's electrical activity over a period of time, typically 24 to 48 hours. It can detect abnormal heart rhythms, changes in blood flow, and symptoms that may indicate silent ischemia or angina. Intravascular ultrasound and coronary angiography are tests used to visualize the inside of the blood vessels and are not specifically designed to detect silent ischemia or angina.

Pericardial effusion is the accumulation of fluid in the pericardial sac surrounding the heart. This excess fluid can put pressure on the heart and impede its ability to pump blood effectively. This can lead to right-sided heart failure, where the right side of the heart is unable to pump blood efficiently, causing fluid to accumulate in the body's tissues. Left-sided heart failure may also occur as a result of pericardial effusion, but it is not the primary condition caused by it. Coronary artery disease is unrelated to pericardial effusion. Therefore, the correct answer is right-sided heart failure.

Troponin I and Troponin T are the most important enzymes in identifying Myocardial infarction. These enzymes are released into the bloodstream when there is damage to the heart muscle. Troponin I is a specific marker for cardiac muscle damage, while Troponin T is a sensitive marker. Together, they help in the diagnosis of a heart attack and can indicate the severity of the damage.

Ultrasound, angiography, MRI, and CT are all diagnostic tools used for finding aneurysms. Ultrasound uses sound waves to create images of the blood vessels and can identify the presence of an aneurysm. Angiography involves injecting a contrast dye into the blood vessels and taking X-ray images to visualize any abnormalities, including aneurysms. MRI uses magnetic fields and radio waves to create detailed images of the body, allowing for the detection of aneurysms. CT scans use X-rays to produce cross-sectional images of the body, helping to identify aneurysms.

Doppler ultrasound and angiography are both diagnostic tools used to confirm the presence of thrombi. Doppler ultrasound uses sound waves to create images of blood flow, allowing doctors to identify the presence and location of thrombi. Angiography involves injecting a contrast dye into the blood vessels and using X-rays to visualize the blood flow, which can also help identify thrombi. MRI and CT scans can provide valuable information about blood vessels and potential blockages, but they are not specifically used to confirm the presence of thrombi.

Colchicine and anti-inflammatory drugs are used as treatments for pericarditis. Pericarditis is the inflammation of the pericardium, the sac-like membrane surrounding the heart. Colchicine is an anti-inflammatory medication that helps reduce the inflammation and pain associated with pericarditis. Anti-inflammatory drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, are also commonly prescribed to reduce inflammation and relieve symptoms. These medications can help alleviate chest pain, reduce swelling, and improve overall cardiac function in patients with pericarditis.

Aneurysms can be caused by several conditions including atherosclerotic plaque formation, trauma, congenital abnormalities in the media of the arterial wall, and infection. Atherosclerotic plaque formation refers to the buildup of fatty deposits in the arteries, which can weaken the arterial wall and lead to the formation of an aneurysm. Trauma, such as a severe injury or accident, can also cause damage to the arterial wall and result in an aneurysm. Congenital abnormalities in the media of the arterial wall are structural defects present at birth that can make the artery more prone to developing an aneurysm. Infection, particularly in the arterial wall, can cause inflammation and weaken the artery, increasing the risk of an aneurysm.