GCU PATHO FINAL BIO 322
QUESTIONS & ANSWERS 100%
SOLVED
Describe coronary artery disease, how it develops, and the pathophysiological basis
of the various risk factors that can lead to this disorder - ANSWER- Caused: by the
narrowing of the arteries that supply the blood to they myocardium. this could be due
to plaque build up, and fatty mater
- most common is arthersclerosis.
- Risk factors: poor nutrtion/obesity, smoking, high LDL, and low HDL.
Myocardial Ischemia - ANSWER- the decrease in the blood supply to the heart which
leds to chest pain or angina.
- S/S: chest heaviness, possible pain in left arm, shoulder, jaw and neck, Nausea &
breathlessness
Right sided heart failure - ANSWER- Backward
-- blood backs up into veins that drain blood to the right heart.
-- JUGULAR VEIN DISTENTION (VEIN BEGINS PULSING), enlarged liver
(hepatomegaly), ankle edema.
High-out put heart faliure - ANSWER- normal heart, but the demand increases
- hyperthyroidism
-- increased metabolism results in increased SV and increase tissue demand
-- increase venous return
- the cycle continues
- BERIBERI
-- decreased thiamine
-- less ATP
-- heart and tissues not enough energy
-- vasodialations leads to same cycle.
Myocardial infarction - ANSWERAKA: heart attack IRREVERSIBLE
- progressive ischemia with damage to myocardium (myoctye necrosis)
- Cause: cardiovascular disease
- S/S: dyspnea, decrease BP (scynocpe), nausea, diaphoresis, anxiety, sudden
sever chest pain that may radiate to left arm
- Women: jaw and back bain
- Men: chest discomfort, arm pain, and SOB.
- Tests: EKG
-- STEMI- indicates transmural MI
-- NON STEMI- indicates subendocardial MI
,Acromegaly - ANSWER- Rare hormonal disorder that develps when the pituitary
produces to much GH.
- can result in noncancerous tumor
- cause swelling, bone enlargement, skin thicking, and face, hand and feet
enlargement.
- occurs AFTER growth plates have sealed.
- big jaw, chin, forehead- president Lincoln had this.
Giantism - ANSWERToo much GH Secreted by pituitary BEFORE epiphyseal plates
seal
Thyroid hormone function - ANSWER- regulates metabolism
- regulates sympathetic nervous system
- controls oxygen consumption
- practically controls bodies endocrine system
Thyroid gland - ANSWER- releases T3 and T4
- T3 is used in the cells
- T4 is used to transport
- Calorgenic effect:
-- cells consumes more energy, resulting n increased heat generation.
-- is responsible for strong, immediate and short lived increase rate of cellular
metabolism (hot flash)
What are the two types of myocardial infarctions - ANSWER1. transmural
2. subendocardial
Transmural MI - ANSWERthrombus remains and myocardium involved transcend to
epicardium
- STEMI (ST elevation in MI)
-- Q- wave MI
Subendocardial MI - ANSWERthrombus dislodges and only myocardium directly
beneath endocardium involved.
- NON STEMI (no ST elevation in mycardial infarction)
-- non Q wave MI
Transmural Vs. Subendocardial MI - ANSWER
Transmural MI vs. Subendocardial EKG - ANSWERALSO REVIEW SLIDE 6
Test for MI - ANSWERBlood tests values increased
- TROPONIN I AND T: 12 hours- 2 weeks (most specific)
- LDH: (Lactate dehydrogenase): 72hrs-10 days
-CK-MB (creatine phophonkiase- myocardial band : 10 -48 hrs
MYOGLOBIN: 2hrs- lasts 24 hrs.
* TROPONIN AND CK0MB ARE THE TWO MAIN LABS WE LOOK AT TO
CONFIRM HEART ATTACK.
** review slide 22
,Treatment for MI - ANSWERANGIOPLASTY- with in 90 mins
- thrombolytic therapy- with in 3 hours
- cardioportection after MI
-- beta-blockers: blocks sympathetic innervation
-- ACE inhibitors
Angina Pectoris - ANSWERChest pain caused by REVERSIBLE myocardial
ischemia
- S/S: sudden severe chest pain last *3-5 minutes*. pressure/squeezing, fatigue,
nausea, SOB.
- cause: cardiovascular disease or anemias
- tx: Rest, nitrates (dialte arteries and viens)
Tests for Angina pectoris - ANSWER-EKG- may be normal
- stress tests
- coronary ANGIOGRAPHY and cardiac catheterization
--- dye with x rays to show coronary lumen
- CBC
-- increased C REACTIVE PROTIEN (CPR) INDICATES INFLAMMATION
SOMEWHERE IN THE BODY.
-- ESR- erythrocyte sedimentation rate. shows how quickly red blood cells peel and
rop to the bottome
-
CABG - ANSWERcoronary artery bypass
- graft involves bypassing major blocks in the blood vessels of the heart to improve
blood flow to cardiac muscle
Define ischemia and consequences of prolonged ischemia and how it relates to
atherosclerosis (cell death). - ANSWER
Normal EKG - ANSWER
Hypokalemia EKG - ANSWER
Congestive heart failure - ANSWER- Decreased pumping ability of the heart to meet
demands of tissue
- decreased cardiac output, pooling in venous system/organs
- cause: Atherosclerosis- CAD, HTN, valvular disorders, arrhythmias, anemia, MI
- S/S: fatigue, weakness, dyspnea, orthopnea, PINK FROTHY SPUTUM, cough,
edema, JVD, PULMONARY EDEMA, HPETAOMEGALY.
- Testin: BNP, CXR, EKG, echocardiogram, ejection fraction
-- cardiac output= stroke volume X heart rate
Left sided heart failure - ANSWER- Backward
-- poor left ventricular function
-- fluid backs up into lungs
-Forward
, -- poor left ventricular function
-- decreases blood flow to systemic circulation
- blood pools back into lungs
- cyanosis because O2 cant reach the rest of the body
PULMONARY EDEMA
Cardiomyopathy - ANSWER- diseases of myocardium
1. hypertrophic
2.dilated
3. Restrictive
-cause: HTN, valvular defects, hyperthyroid, THIAMINE (B1) DEF., ETOH, drug use.
- S/S: Dyspena on exertion or rest, dizziness, edema, arrhythmia's, palpitations
- Testing: EKG, ECHOCARDIOGRAM, chest x ray, BNP
Dilated cardiomyopathy - ANSWER* ALL FOUR CHAMBERS ARE DILATED.
- cause: genetic, myocarditis, alcohol, pregnacny, or idopathic
-- it is not caused by HTN or ischemia
- S/S: Dyspena on excerton or rest, dizziness, edema, arrhythmias, palpitations,
similar to heart failure.
- Testing: EKG, echocardiogram, chest x ray, BNP (elevated).
-- Lv dysfunction
Dilated cardiomyopathy image - ANSWER
Hypertrophic cardiomyopathy - ANSWER* DISSEMINATED MUSCLE FIBERS
- decreased contraction ability (hypetrophy)
- decreased filling= decrease outflow (diastole heart failure)
- Outflow obstruction
- Cause: genetic
-S/S: asymptomatic, dyspnea, syncope, sudden death
-Testing: heart murmur (systolic ejection murmur that increasedd with valsalva),
EKG, ECHOCARDIOGRAM, chest x ray, biopsy.
Hypertrophic cardiomyopathy image - ANSWER
Restrictive cardiomyopathy - ANSWER*THINK ENVIORMENTAL*
- ventricles decreased ability to relax (diastolic heart failure)
- BILATERAL DILATION
- fibrosis (scaring)
-- radiation or idopathic
-inflitration
-- AMYLOIDOSIS (PROTEIN DEPOSTION)
-- sarcoidosis (granuloma)
-- Hemochromatosis (iron)
- S/S: heart faliure, SOB, fatigue, edema, ascites
- testing: EKG, ECHOCARDIOGRAM, chest x ray, (pulmonary congestoin), biopsy,
BNP (ELEVATED)
Restrictive cardiomyopathy image - ANSWER
QUESTIONS & ANSWERS 100%
SOLVED
Describe coronary artery disease, how it develops, and the pathophysiological basis
of the various risk factors that can lead to this disorder - ANSWER- Caused: by the
narrowing of the arteries that supply the blood to they myocardium. this could be due
to plaque build up, and fatty mater
- most common is arthersclerosis.
- Risk factors: poor nutrtion/obesity, smoking, high LDL, and low HDL.
Myocardial Ischemia - ANSWER- the decrease in the blood supply to the heart which
leds to chest pain or angina.
- S/S: chest heaviness, possible pain in left arm, shoulder, jaw and neck, Nausea &
breathlessness
Right sided heart failure - ANSWER- Backward
-- blood backs up into veins that drain blood to the right heart.
-- JUGULAR VEIN DISTENTION (VEIN BEGINS PULSING), enlarged liver
(hepatomegaly), ankle edema.
High-out put heart faliure - ANSWER- normal heart, but the demand increases
- hyperthyroidism
-- increased metabolism results in increased SV and increase tissue demand
-- increase venous return
- the cycle continues
- BERIBERI
-- decreased thiamine
-- less ATP
-- heart and tissues not enough energy
-- vasodialations leads to same cycle.
Myocardial infarction - ANSWERAKA: heart attack IRREVERSIBLE
- progressive ischemia with damage to myocardium (myoctye necrosis)
- Cause: cardiovascular disease
- S/S: dyspnea, decrease BP (scynocpe), nausea, diaphoresis, anxiety, sudden
sever chest pain that may radiate to left arm
- Women: jaw and back bain
- Men: chest discomfort, arm pain, and SOB.
- Tests: EKG
-- STEMI- indicates transmural MI
-- NON STEMI- indicates subendocardial MI
,Acromegaly - ANSWER- Rare hormonal disorder that develps when the pituitary
produces to much GH.
- can result in noncancerous tumor
- cause swelling, bone enlargement, skin thicking, and face, hand and feet
enlargement.
- occurs AFTER growth plates have sealed.
- big jaw, chin, forehead- president Lincoln had this.
Giantism - ANSWERToo much GH Secreted by pituitary BEFORE epiphyseal plates
seal
Thyroid hormone function - ANSWER- regulates metabolism
- regulates sympathetic nervous system
- controls oxygen consumption
- practically controls bodies endocrine system
Thyroid gland - ANSWER- releases T3 and T4
- T3 is used in the cells
- T4 is used to transport
- Calorgenic effect:
-- cells consumes more energy, resulting n increased heat generation.
-- is responsible for strong, immediate and short lived increase rate of cellular
metabolism (hot flash)
What are the two types of myocardial infarctions - ANSWER1. transmural
2. subendocardial
Transmural MI - ANSWERthrombus remains and myocardium involved transcend to
epicardium
- STEMI (ST elevation in MI)
-- Q- wave MI
Subendocardial MI - ANSWERthrombus dislodges and only myocardium directly
beneath endocardium involved.
- NON STEMI (no ST elevation in mycardial infarction)
-- non Q wave MI
Transmural Vs. Subendocardial MI - ANSWER
Transmural MI vs. Subendocardial EKG - ANSWERALSO REVIEW SLIDE 6
Test for MI - ANSWERBlood tests values increased
- TROPONIN I AND T: 12 hours- 2 weeks (most specific)
- LDH: (Lactate dehydrogenase): 72hrs-10 days
-CK-MB (creatine phophonkiase- myocardial band : 10 -48 hrs
MYOGLOBIN: 2hrs- lasts 24 hrs.
* TROPONIN AND CK0MB ARE THE TWO MAIN LABS WE LOOK AT TO
CONFIRM HEART ATTACK.
** review slide 22
,Treatment for MI - ANSWERANGIOPLASTY- with in 90 mins
- thrombolytic therapy- with in 3 hours
- cardioportection after MI
-- beta-blockers: blocks sympathetic innervation
-- ACE inhibitors
Angina Pectoris - ANSWERChest pain caused by REVERSIBLE myocardial
ischemia
- S/S: sudden severe chest pain last *3-5 minutes*. pressure/squeezing, fatigue,
nausea, SOB.
- cause: cardiovascular disease or anemias
- tx: Rest, nitrates (dialte arteries and viens)
Tests for Angina pectoris - ANSWER-EKG- may be normal
- stress tests
- coronary ANGIOGRAPHY and cardiac catheterization
--- dye with x rays to show coronary lumen
- CBC
-- increased C REACTIVE PROTIEN (CPR) INDICATES INFLAMMATION
SOMEWHERE IN THE BODY.
-- ESR- erythrocyte sedimentation rate. shows how quickly red blood cells peel and
rop to the bottome
-
CABG - ANSWERcoronary artery bypass
- graft involves bypassing major blocks in the blood vessels of the heart to improve
blood flow to cardiac muscle
Define ischemia and consequences of prolonged ischemia and how it relates to
atherosclerosis (cell death). - ANSWER
Normal EKG - ANSWER
Hypokalemia EKG - ANSWER
Congestive heart failure - ANSWER- Decreased pumping ability of the heart to meet
demands of tissue
- decreased cardiac output, pooling in venous system/organs
- cause: Atherosclerosis- CAD, HTN, valvular disorders, arrhythmias, anemia, MI
- S/S: fatigue, weakness, dyspnea, orthopnea, PINK FROTHY SPUTUM, cough,
edema, JVD, PULMONARY EDEMA, HPETAOMEGALY.
- Testin: BNP, CXR, EKG, echocardiogram, ejection fraction
-- cardiac output= stroke volume X heart rate
Left sided heart failure - ANSWER- Backward
-- poor left ventricular function
-- fluid backs up into lungs
-Forward
, -- poor left ventricular function
-- decreases blood flow to systemic circulation
- blood pools back into lungs
- cyanosis because O2 cant reach the rest of the body
PULMONARY EDEMA
Cardiomyopathy - ANSWER- diseases of myocardium
1. hypertrophic
2.dilated
3. Restrictive
-cause: HTN, valvular defects, hyperthyroid, THIAMINE (B1) DEF., ETOH, drug use.
- S/S: Dyspena on exertion or rest, dizziness, edema, arrhythmia's, palpitations
- Testing: EKG, ECHOCARDIOGRAM, chest x ray, BNP
Dilated cardiomyopathy - ANSWER* ALL FOUR CHAMBERS ARE DILATED.
- cause: genetic, myocarditis, alcohol, pregnacny, or idopathic
-- it is not caused by HTN or ischemia
- S/S: Dyspena on excerton or rest, dizziness, edema, arrhythmias, palpitations,
similar to heart failure.
- Testing: EKG, echocardiogram, chest x ray, BNP (elevated).
-- Lv dysfunction
Dilated cardiomyopathy image - ANSWER
Hypertrophic cardiomyopathy - ANSWER* DISSEMINATED MUSCLE FIBERS
- decreased contraction ability (hypetrophy)
- decreased filling= decrease outflow (diastole heart failure)
- Outflow obstruction
- Cause: genetic
-S/S: asymptomatic, dyspnea, syncope, sudden death
-Testing: heart murmur (systolic ejection murmur that increasedd with valsalva),
EKG, ECHOCARDIOGRAM, chest x ray, biopsy.
Hypertrophic cardiomyopathy image - ANSWER
Restrictive cardiomyopathy - ANSWER*THINK ENVIORMENTAL*
- ventricles decreased ability to relax (diastolic heart failure)
- BILATERAL DILATION
- fibrosis (scaring)
-- radiation or idopathic
-inflitration
-- AMYLOIDOSIS (PROTEIN DEPOSTION)
-- sarcoidosis (granuloma)
-- Hemochromatosis (iron)
- S/S: heart faliure, SOB, fatigue, edema, ascites
- testing: EKG, ECHOCARDIOGRAM, chest x ray, (pulmonary congestoin), biopsy,
BNP (ELEVATED)
Restrictive cardiomyopathy image - ANSWER
