HF - Pathology

Question 1

Average normal central venous pressure

Answer 1

6mm Hg

Question 2

Average normal LVEDP

Answer 2

10mm Hg

Question 3

Average normal LVEDV

Answer 3

150mL

Question 4

Average normal SV

Answer 4

100mL

Question 5

Normal Ejection Fracture

Answer 5

67%

Question 6

LVEDP, LVEDV, SV, EF, LVESF in failing heart? (increases or decreases)

Answer 6

LVEDP increases, LVEDV increases, SV decreases, EF decreases, LVESV increases

Question 7

Initial symptom of heart failure

Answer 7

dyspnea with exertion

Question 8

Most heart failure patients are right fail, left fail, or both fail?

Answer 8

both

Question 9

Threshold for heart failure- when symptoms begin

Answer 9

25% reduction in forward stroke volume

Question 10

Surgical emergency associated with HF

Answer 10

severe acute uncompensated aortic regurg

Question 11

Mitral valve regurg… cause or effect of HF?

Answer 11

can be either

Question 12

Mitral regurg causes heart murmur during?

Answer 12

systole

Question 13

Mitral stenosis causes heart murmur during

Answer 13

diastole

Question 14

aortic regurg causes heart murmur during

Answer 14

diastole

Question 15

aortic stenosis causes heart murmur during

Answer 15

systole

Question 16

Left heart failure symptoms

Answer 16

1. dyspnea on exertion, progressing to dyspnea at rest 2. Orthopnea 3. PND (paroxysmal nocturnal dyspnea) 4. Fatigue

Question 17

Right heart failure symptoms

Answer 17

1. Edema of feet, then ankles, then legs 2. Abdominal distention

Question 18

Left heart failure signs

Answer 18

1. bibasilar pulmonary crackles 2. Tachycardia 3. S3 4. Pedal, ankle, or leg edema

Question 19

Right heart failure signs

Answer 19

1. Pedal, ankle, or leg edema 2. JVD 3. Hepatomegaly 4. Ascites

Question 20

Pulmonary capillary pressure that causes interstitial pulmonary edema

Answer 20

20mm Hg

Question 21

Pulmonary capillary pressure that causes alveolar pulmonary edema

Answer 21

25 mm Hg

Question 22

What other pathologic conditions can cause acute lung injury and pulmonary edema

Answer 22

septic shock and hemorrhagic shock

Question 23

Septic shock has what pulmonary capillary pressure

Answer 23

normal

Question 24

Hemorrhagic shock has what pulmonary capillary pressure

Answer 24

low

Question 25

The pulmonary capillary wedge pressure is the same as...

Answer 25

the left atrial pressure and the LVEDP

Question 26

Elderly patient with dyspnea, orthopnea, PND, crackles, and normal EF associated with?

Answer 26

Systolic Heart Failure

Question 27

Long standing HTN, obesity, and concentric LVH associated with

Answer 27

Normal (I'm not sure what this means)

Question 28

Noncompliant stiff LV with impaired diastolic function and filling with preserved EF associated with?

Answer 28

Diastolic heart failure

Question 29

HF patients have tachycardia by what pathophys mechanisms?

Answer 29

1. Sympathetic stim 2. Epi and Norepi from the adrenal

Question 30

HF patients have what elevated peptide?

Answer 30

B-type natriuretic

Question 31

What increases release of natriuretic peptides?

Answer 31

stretch or increase in cardiac chamber volume

Question 32

What is the effect of BNP?

Answer 32

vasodilation, increased urinary sodium excretion (counterregulatory)

Question 33

Clinical scenario for HF with preserved EF?

Answer 33

Elderly, HTN, obesity, concentric LVH, impaired compliance

Question 34

Dysfunction with compensated HF w/ preserved EF?

Answer 34

diastolic

Question 35

Dysfunction with decompensated HF and decreased EF?

Answer 35

systolic

Question 36

HF progression of patients with large M.I.?

Answer 36

straight to HF with systolic dysfunction and decreased EF

Question 37

Highest mortality HF hemodynamic profile? (congestion and perfusion)

Answer 37

Cold and wet (40% die)

Question 38

What can cause heart failure by itself

Answer 38

Extreme fat-assness (morbid obesity)

Question 39

Shock that causes vasodilation, making the capacitance of the vascular system too big for the amount of blood volume

Answer 39

distributive shock

Question 40

shock that blocks enough of pulmonary circulation (i.e. T-E, cardiac tamponade)

Answer 40

Obstructive shock

Question 41

biochemical sign of shock

Answer 41

elevated serum lactate

Question 42

hemodynamic sign of shock

Answer 42

hypotension

Question 43

Behavior of shock patient

Answer 43

disoriented, confused, obtundation

Question 44

Skin of shock patient

Answer 44

mottled, cold, clammy, pale, cyanotic

Question 45

urine in shock patient

Answer 45

decreased output

Question 46

Nutmeg liver can be a sign of?

Answer 46

Right heart failure

Question 47

Heart failure cells (siderophages) can be a sign of

Answer 47

Left heart failure