N334 PATHOPHARM EXAM 3 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED GRADED A

8/21/25, 8:21
AM

N334 PATHOPHARM EXAM 3 QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS
VERIFIED GRADED A


Terms in this set (66)



Inability of heart to pump blood to meet needs
of body d/t impaired pumping or increased
Heart failure definition demand


Results in decreased CO and inadequate tissue
perfusion
Affects 5.8 million in US
5 year mortality 50%; 1/5 die in less than 1 year

Heart failure prevalence after dx; class IV 1 year mortality 35% Etiology:

+ etiology MI, HTN, DM, age > 65

SNS Activation (increased HR, contractility,
vasoconstriction, and dysrhythmias) Results in
insufficient CO which leads to RAAS
activation
Heart Failure Remodeling and hypertrophy- HF
Pathophysiology progression depends on post-MI remodeling
(increases myocardial o2 consumption,
decreases myocardial perfusion, increases risk
of dysrhythmia)
Activated by decreased CO to cause fluid retention
1/33

,8/21/25, 8:21
AM




1. Renin converts angiotensin to angiotensin I
2. Pass through lungs, converts to angiotensin
RAAS (renin-angiotensin-
II (Increases SVR, BP, LV workload which
aldosterone system)
decreases CO)
3. Aldosterone release causes Na+ retention
4. Response to low CO renal arteriole
constriction, decreased GFR and increased
Na+ absorption

right sided heart failure systemic symptoms such as peripheral edema
and engorgement of organs such as the liver




2/33

,8/21/25, 8:21
AM



left-sided heart failure pulmonary symptoms d/t backflow of fluid into lungs
if EF below 40% (seen in systolic failure) decreased
tissue perfusion

Reduced vs. preserved
ejection fraction if EF greater than 40% (seen in diastolic failure)
high filling pressures, venous engorgement, and
inability of ventricle to relax d/t fibrosis in cell
wall (ventricular hypertrophy
Class I: Cardiac dz, no physical activity limitation
NYHA (New York Heart Class II: Ordinary activity causes fatigue, dyspnea,
Association) Functional palpitations, or angina
Heart Failure Class III: Less than ordinary activity causes fatigue,
Classification dyspnea, palpitations, or angina Class IV:
Symptoms at rest
*Complements NYHA, doesn't replace
Stage A: HF risk w/out structural heart
ACC/AHA Heart Failure disease or HF symptoms Managemeng:
Classification + control HTN, DM, lipids; ACEIs, ARBs, stop
Management: Stage A alcohol & smoking
Stage B: Structural heart disease w/out symptoms
ACC/AHA Heart Failure
Classification + Management: control HTN, DM, lipids; ACEIs,
Management: Stage B ARBs, stop alcohol & smoking PLUS BBs
Stage C: Structural heart disease with prior or current
symptoms at rest

ACC/AHA Heart Failure
Classification + Management: control HTN, DM, lipids; ACEIs,

3/33

, 8/21/25, 8:21
AM
Management: Stage C ARBs, stop alcohol & smoking PLUS BBs; add
diuretic; aldosterone antagonist except if
impaired kidney function and high K+; digoxin
improves symptoms; avoid NSAIDs, CCBs, and anti-
dysrhythmics; devices such as biventricular
pacing/ICDs
Stage D: Advanced structural heart disease w/
severe symptoms at rest; require interventions

ACC/AHA Heart Failure such as heart transplant or mechanical

Classification + assistance

Management: Stage D
Management: Heart transplant best treatment;
ventricular assistive device if not eligible for
heart transplant; control fluid retention strict
I&Os, daily weight, loop diuretics; avoid CCBs,
BBs, and ACEIs; discuss end of life planning
Normal BP
120/80
Hypertension Elevated BP
(parameters) 120-129/80
Hypertension stage
1: 130-139/80-89
Hypertension stage
2: >140/>90
Lifestyle Changes:
weight loss
DASH diet (fruit, veggies, whole
grains, low dairy, low fat)
Restrict sodium

4/33