Perfusion III

Question 0

Cardiac Tamponade

Answer 0

1. Result of inflammation (Myocardial Infarction MI)

2. Can also happen after surgery

Question 1

1 Cause of Right Sided Heart Failure?

Answer 1

1. The number one cause of Right sided heart failure is Left sided heart failure

Question 2

Pulsus Electrical Activity PEA

Answer 2

1. Mechanical (Muscle) doesn’t work
2. Electrical system works

Treat PEA with Epinephrine & Atropine

Question 3

Diseases of the Veins

-Varicose Veins

Answer 3

1. A vein in which blood has pooled
2. Distended, tortuous, and palpable veins
3. Caused by trauma or gradual venous distention
4. Can cause poor venous return

Question 4

Diseases of the Veins

-Chronic Venous Insufficiency

Answer 4

1. Inadequate venous return over a long period due to varicose veins or valvular incompetence
2. Venous stasis ulcers

Question 5

Diseases of the Veins

-Deep Vein Thrombosis (DVT’s)

Answer 5

1. Obstruction of venous flow leading to increased venous pressure

Question 6

Diseases of the Veins

-DVT – Virchow Triad

Answer 6

1. Venous stasis
2. Venous Endothelial Damage
3. Hyper-coagulable states

Question 7

D-Dimer Test

Answer 7

1. Elevated when a patient has DVT’s

- dimers increase with inflammation

Question 8

Worst Complication of DVT

Answer 8

1. Pulmonary Emboli

- Life Threatening

Question 9

Primary Hypertension

Answer 9

1. Essential or idiopathic hypertension
2. Genetic & environmental factors
3. Affects 92-95% of individuals w/ hypertension

Question 10

Complicated Hypertension

Answer 10

1. Chronic hypertensive damage to the walls of systemic blood vessels
2. Smooth muscle cells undergo hypertrophy and hyperplasia w/ fibrosis of the tunica intima & media
3. HTN causes mechanical damage

Question 11

Malignant HTN

Answer 11

1. Rapidly progressive hypertension

2. Diastolic pressure is often >140 mm Hg

Question 12

Diseases of the Arteries & Veins

-Aneurysm

Answer 12

1. Local dilation or out pouching of a vessel wall or cardiac chamber

Question 13

Diseases of the Arteries & Veins

-True Aneurysm

Answer 13

1. Fusiform Aneurysm

2. Circumferential aneurysm

Question 14

Diseases of the Arteries & Veins

-False Aneurysm

Answer 14

1. Saccular aneurysm

Question 15

Diseases of the Arteries & Veins

-Classic s/s of dissecting aneurysm

Answer 15

1. Sudden back pain and restless in bed
2. Feeling of impending doom
3. Discoloration of skin and mottling of skin under aneurysm

Question 16

1st Step of Endothelial cell Injury

Answer 16

1. Mechanical Injury - HTN

2. Chemical Injury - Smoking/Alcohol

Question 17

Atherosclerosis

-Progression

Answer 17

1. Inflammation of Endothelium
2. Cellular proliferation
3. Macrophage migration
4. LDL oxidation (foam cell formation)
5. Fatty Streak
6. Fibrous Plaque
7. Complicated plaque

Question 18

Coronary Artery Disease

Answer 18

1. Any vascular disorder than narrows or occludes the coronary arteries
2. Atherosclerosis is the most common cause of CAD

Question 19

Most Common Cause of CAD?

Answer 19

1. Atherosclerosis

Question 20

Collateral Circulation

Answer 20

1. Response to CAD over time

2. New blood vessels created around the Coronary Arteries

Question 21

CAD

-Risk Factors

Answer 21

1. Dyslipidemia
2. HTN
3. Smoking
4. DM
5. Obesity/Sedentary Lifestyle

Question 22

Unstable Angina

-Characteristics

Answer 22

1. Angina that does not go away with rest or Nitroglycerin

Question 23

Prinzmetal Angina (Varient)

Answer 23

1. Angina due to spasm of the coronary arteries rather than from exertion or other increased demands on the heart
2. Pain typically occurs at rest.

Question 24

Myocardial Infarction | -What happens?

Answer 24

1. Cellular injury 2. Cellular Death 3. Structural & functional changes 4. Repair

Question 25

Myocardial Infarction | -Structural & Functional Changes

Answer 25

1. Myocardial Stunning 2. Hibernating myocardium 3. Myocardial remodeling

Question 26

Myocardial Infarction | -What happens during Repair?

Answer 26

1. Inflammation usually takes place during the repair stage | 2. Can predispose to cardiac tamponade

Question 27

MI Manifestations

Answer 27

1. Pain 2. Stimulation of SNS 3. Elevated Temperature

Question 28

MI: Manifestations | -Pain

Answer 28

1. Lasts more than 15-20 minutes | 2. Unrelieved by rest or NTG

Question 29

MI: Manifestations | -Stimulation of SNS

Answer 29

1. Anxiety 2. Tachycardia 3. Vasoconstriction

Question 30

MI: Manifestations | -Elevated Temp

Answer 30

1. Inflammatory reaction

Question 31

MI Complications

Answer 31

1. Dysrhythmias 2. Pump-failure 3. Infarct Extension 4. Structural Deficits 5. Pericarditis

Question 32

MI: Complications | -Dysrhythmias

Answer 32

1. PVC's 2. Heart Block 3. VT/VF

Question 33

MI: Complications | -Pump Failure (Cardiogenic Shock)

Answer 33

1. 20-30% exhibit Lt heart failure | 2. >40% Cardiogenic shock

Question 34

MI: Complications | -Infarct Extension

Answer 34

1. 10% extend in the following 2 week period

Question 35

MI: Complications | -Structural Deficits

Answer 35

1. Ventricular aneurysm | 2. Papillary muscle or septal rupture

Question 36

MI: Complications | -Pericarditis

Answer 36

1. Dressler's syndrome (can cause cardiac tamponade) | - caused by inflammatory byproducts

Question 37

MI: Lab & Diagnostics

Answer 37

1. CKMB 2. Troponin I 3. EKG

Question 38

Dressler Syndrome

Answer 38

1. Post myocardial infarction syndrome, characterized by pleuritic chest pain, pericarditis, fever, and leukocytosis