15 pt Quiz

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Author:
leo25
ID:
150293
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15 pt Quiz
Updated:
2012-04-26 19:35:55
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Pathophysiology
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Description:
HTN, CHF, pulmonary, dialysis
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  1. What is the most common of all health problems in adults?
    hypertension
  2. What disease is commonly the silent killer and patients are asymptomatic?
    hypertension
  3. What ethnicity was the patient with hypertension? How old was he?
    • african american
    • 40
  4. What diseases did the hypertension patient's parents have?
    • father: MI and HTN
    • mother: diabetes and HTN
  5. What are the risk factors for the hypertension patient?
    • no exercise
    • high salt, fat, carb diet
    • smoker
    • drinker
    • stressful job
    • african american
    • genetic susceptibility
    • body weight
  6. What was going on with the heart in the patient with HTN?
    left ventricle hypertrophy
  7. What two symptoms/states did the HTN patient present with?
    • gained 20 pounds
    • shortness of breath
  8. What are the systolic and diastolic values that indicate HTN?
    • systolic = greater than 140
    • diastolic = greater than 90
  9. Which type of HTN has known causes and which one has unknown causes?
    • primary: unknown
    • secondary: known
  10. What is the most common type of HTN?
    primary
  11. What are the four main factors that control BP?
    • RAAS
    • electrolyte balance
    • peripheral autoregulation
    • alpha and beta receptors of the CNS and ANS
  12. What electrolytes affect BP?
    • sodium
    • calcium
    • natriuretic hormone
  13. Describe what happens in the RAA system in response to a blockage in the renal artery.
    • renal artery blockage
    • kidneys secrete renin
    • renin converted to Ang I in the liver
    • Ang I converts to Ang II in the lungs
  14. What does Ang II do?
    • increases heart contractility
    • increases cardiac output
    • increases vasoconstriction
    • retains salt and water to increase blood volume
    • increases blood pressure
    • increases total peripheral resistance
  15. What are some of the known causes of secondary HTN?
    • hyperthyroidism
    • hyperaldosteronism
    • hypercortisolism
    • renal artery atherosclerosis
    • pheochromocytoma
  16. What are some tests done to determine HTN?
    • BP times 2 or 3, then avgd
    • Chest Xray
    • EKG/ECG
    • urinalysis
    • blood test
  17. What did the lab values for the HTN patient look like?
    • high BP
    • high BMI
    • high GGT (liver)
    • high lipids, low HDL
    • (+) for microalbuminuria
    • low ejection fraction
    • increased QRS voltage
  18. What drug is questionable for the HTN patient to be taking?
    • Pseudoephedrine: causes vasoconstriction and increases heart rate
    • this could be a problem
  19. What meds can we use to treat HTN?
    • A
    • B
    • C
    • D
    • E
  20. How do alpha 1 antagonist HTN meds work?
    decrease BP by decreasing constriction by blocking NE from binding to the post synaptic receptor
  21. How do alpha 2 agonists HTN meds work?
    inhibit release of NE and epi
  22. How do Ang II receptor inhibitor HTN meds work?
    decrease vasoconstriction and aldosterone release
  23. How do ACE inhibitors work for HTN?
    prevent conversion of Ang I to Ang II which decreases cardiac output
  24. How do beta blockers work for HTN?
    • allow vasodilation
    • block epinephrine
  25. How do calcium channel blockers work for HTN?
    block calcium channels in the heart which decreases heart rate
  26. What type of blood pressure med was the HTN patient currently taking?
    thiazide diuretic (HCTZ)
  27. How do thiazide diuretics work for HTN?
    they get rid of unneeded water and salt
  28. How do endothelin antagonists work for treating HTN?
    they block endothelin receptors which decreases blood pressure
  29. What three OTC products could the HTN patient use to get his BP down?
    • CoQ10
    • garlic
    • fish oil
  30. What are the symptoms of the CHF patient?
    • racing hearbeat
    • shortness of breath
    • swollen ankles and feet
    • weak and tired
    • breathing difficulties at night
  31. What major events have happened to the CHF patient in the past?
    • MI
    • coronary artery bypass
    • gout
    • OA
    • hypercholesteremia
  32. What did the parent's of the 69 yr old female CHF patient have?
    • father died of heart attack
    • mother has had several strokes
  33. What is the most common form of CHF?
    left sided heart failure = shortness of breath
  34. Is CHF more common in males than females?
    yes, from 40-75
  35. What are some common causes of CHF ?
    • viral infections
    • valvular heart disease
    • cardiomyopathies
    • systemic HTN
  36. What did the electrolytes look like for the CHF patient?
    • sodium: high
    • potassium: low
  37. Why were the sodium and potassium abnormal in the CHF patient?
    • increased aldosterone
    • maybe increased RAA activation
  38. What LFT was high in the CHF patient? And what does this indicate?
    • high AST
    • indicative of heart damage
  39. What did the CHF patient's arterial blood gases reveal?
    • PaCO2: high
    • PaO2: low
    • due to impaired breathing b/c of pulmonary edema
  40. Why were the CHF patient's renal function tests both high?
    decreased renal blood flow and urine output = high BUN and high SCr
  41. Was the patient with CHF's ejection fraction high or low?
    low: ventricular dysfunction
  42. What is cor pulmonale?
    right sided heart failure due to problems with the lungs
  43. What does left-sided heart failure look like?
    heart can't contract so it dilates and fails
  44. What does right-sided heart failure look like?
    dilation and failure due to increased resistance to ventricular emptying
  45. Which type of heart failure causes edema and hepatomegaly, JVD, and HJR?
    right sided
  46. What is diastolic heart failure?
    the heart can't relax enough to fill ventricles with blood
  47. What is systolic heart failure?
    the heart cannot contract enough to get blood out of the ventricles
  48. Which two catecholamines cause toxicity to myocytes in the heart?
    epi and NE
  49. What is bronchiectasis?
    • dilation of bronchioles causing risk of infection
    • from foreign bodies, CF
  50. What is atelectasis?
    • incomplete expansion of the lung or portion of the lung due to mucus plug or pores of Kohn
    • alveoli collapse
  51. What is p/x?
    prevention
  52. What is /p?
    after
  53. What is r/o?
    rule out
  54. What does aldosterone do?
    • retains salt and water
    • contributes to high salt and low potassium
  55. What three things (cytokines and hormone) are elevated in CHF patients?
    • endothelin
    • TNF alpha
    • IL-6
  56. What drug was the CHF patient allergic to?
    hydralazine
  57. What type of heart failure did the CHF patient have?
    total: both left and right side heart failure
  58. What is ARDS?
    • diffuse alveolar capillary damage
    • massive inflammatory response to an injury
  59. What risk factors did the CHF patient have?
    • age
    • weight
    • previous heart disease/events
    • potential diabetes
  60. What does triamterene do?
    reduce potassium excretion which will increase potassium levels
  61. What is dyspnea?
    shortness of breath
  62. What is orthopnea?
    dyspnea when lying down
  63. What is eupnea?
    normal breathing
  64. What is a Kussmaul respiration?
    hyperpnea
  65. What is Cheyne-Stokes breathing?
    alternating periods of deep and shallow breathing
  66. What type of breathing causes hypocapnea?
    hyperventilation
  67. What causes respiratory alkalosis?
    hyperventilation and hypocapnea
  68. What is hypocapnea?
    low CO2
  69. What is hypercapnea?
    high CO2
  70. What causes respiratory acidosis?
    hypoventilation or hypercapnea
  71. What drugs are known to cause cough?
    ACE inhibitors
  72. What can cause hemoptysis?
    • lung cancer
    • bronchiectasis
    • TB
    • bronchitis
    • pneumonia
  73. What is polycythemia?
    increased RBCs
  74. What is the difference b/w hypoxia and hypoxemia?
    • hypoxia: decreased oxygen to tissues
    • hypoxemia: decreased oxygen in arterial blood
  75. Is hypoxia always caused by hypoxemia?
    no, could be low cardiac output or cyanide
  76. What is V/Q ratio?
    ventilation to perfusion ratio
  77. What does a low V/Q tell us?
    good perfusion or well-perfused but inadequate ventilation
  78. What does a high V/Q tell us?
    adequate ventilation but inadequate perfusion
  79. What is FVC?
    forced vital capacity
  80. What is FEV1?
    forced expiratory volume in one second
  81. What is the difference between acidemia and acidosis?
    • acidosis: mixed venous blood
    • acidemia: directly from arterial blood
  82. What can measure oxygen saturation once PaO2 has been measured, but not PaCO2 or pH?
    oximetry
  83. In what lung condition does collagen form?
    silicosis
  84. How are the lungs kept dry?
    • surfactant
    • lymphatic drainage
    • capillary hydrostatic and oncotic pressure
  85. What are some common causes of pulmonary edema?
    • CHF
    • ARDS
    • toxic gases
    • injury to pulm capillaries
    • plasma protein leakage
    • lymphatic obstruction
  86. At what pulmonary capillary wedge pressure does pulmonary edema begin?
    >20mm Hg
  87. What is a Swan-Ganz catheter?
    a balloon-tipped catheter used to measure pulmonary capillary wedge pressure by going directly into the pulmonary artery and through the right ventricle
  88. How do we treat pulmonary edema?
    • give oxygen
    • get rid of toxins/irritants
  89. Which lung is more susceptible to aspiration?
    right
  90. What term describes imperfect expansion of the lungs (collapsed lung)?
    atelectasis
  91. What condition of the lungs would you likely see post-op?
    atelectasis
  92. How does deep breathing relieve atelectasis?
    by opening up the pores of Kohn
  93. persistent abnormal dilation of the bronchi
    bronchiectasis
  94. What is more common, focal, or diffuse bronchiectasis?
    focal
  95. What type of bronchiectasis is usually seen after pneumonia and is reversible?
    cylindrical

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