NURS 340: Cardiovascular, Fluid & Electrolyte, and Hematological Pathophysiology

Comprehensive vocabulary flashcards covering the pathophysiology of cardiovascular diseases, fluid, electrolyte, and acid-base disturbances, and hematological disorders.

Epicardium

The outer serous membrane of the heart wall that produces lubricating serous fluid within the pericardial cavity to reduce friction during cardiac contractions.

Myocardium

The middle muscular layer of the heart composed of specialized cardiac muscle cells that contract rhythmically to pump blood through pulmonary and systemic circulations.

Endocardium

The inner endothelial lining of the heart chambers that folds over to form the four cardiac valves governing one-way blood flow.

Sinoatrial (SA) Node

The primary intrinsic pacemaker of the heart, located in the right atrium, which spontaneously generates action potentials at an inherent sinus rhythm of $60\text{--}100\text{ bpm}$.

Cardiac Output (CO)

The total volume of blood ejected by each ventricle in $1\text{ minute}$, calculated as $\text{CO} = \text{HR} \times \text{SV}$ with a resting normal range of $4900\text{--}5000\text{ mL}$.

Preload

The end-diastolic volume and stretch placed on ventricular myocardial fibers produced by venous return delivered to the heart prior to contraction.

Afterload

The systemic vascular resistance and force that the ventricles must overcome to force open the semilunar valves and eject blood into the aorta or pulmonary artery.

Primary Hypertension

Persistently elevated systemic arterial blood pressure without an identifiable single secondary cause, arising from multifaceted genetic, renal, neural, and vascular mechanisms.

Secondary Hypertension

Elevated arterial blood pressure that develops directly from an identifiable underlying disorder, such as renal parenchymal disease, renal artery stenosis, or endocrine disorders.

Gestational Hypertension

New-onset elevated blood pressure with systolic $\ge 140\text{ mm\,Hg}$ and/or diastolic $\ge 90\text{ mm\,Hg}$ appearing after $20\text{ weeks}$ of gestation without proteinuria or signs of end-organ damage.

Preeclampsia

A multisystem pregnancy disorder presenting after $20\text{ weeks}$ of gestation characterized by new-onset hypertension accompanied by proteinuria and/or maternal organ dysfunction.

Eclampsia

The occurrence of new-onset grand mal seizures or coma in a pregnant patient with a hypertensive disorder of pregnancy, unrelated to preexisting neurologic pathology.

HELLP Syndrome

A severe variant of preeclampsia defined by the triad of Hemolysis, Elevated Liver enzymes, and Low Platelets.

Hypertensive Emergency

Marked acute blood pressure elevation (systolic $> 180\text{ mm\,Hg}$ and/or diastolic $> 120\text{ mm\,Hg}$) characterized by active, progressing target-organ damage requiring immediate intravenous antihypertensive therapy.

Arteriosclerosis

A general clinical term designating degenerative vascular changes in small arteries and arterioles leading to thickened, rigid walls, loss of vessel elasticity, and luminal narrowing.

Atherosclerosis

The progressive formation of fibrofatty plaques (atheromas) containing lipids, cholesterol, cellular debris, and fibrin within the tunica intima of large- and medium-sized arteries.

Angina Pectoris

Transient, recurrent substernal chest discomfort or pain precipitated by temporary myocardial ischemia when myocardial oxygen demand exceeds coronary oxygen supply.

Myocardial Infarction (MI)

Irreversible ischemic necrosis of cardiac myocytes resulting from prolonged total obstruction of blood flow through a coronary artery.

Congestive Heart Failure (CHF)

A clinical syndrome wherein the heart cannot pump an adequate cardiac output to satisfy the metabolic and oxygenation demands of peripheral tissues.

Cor Pulmonale

Right ventricular enlargement, strain, and eventual right-sided heart failure induced by elevated pulmonary vascular resistance from chronic pulmonary disorders.

Ventricular Septal Defect (VSD)

The most common congenital cardiac anomaly, characterized by an abnormal opening in the interventricular septum allowing a left-to-right shunt of oxygenated blood.

Tetralogy of Fallot

A severe congenital cyanotic heart disease consisting of four structural anomalies: pulmonary valve stenosis, ventricular septal defect, dextroposition (overriding) of the aorta, and right ventricular hypertrophy.

Rheumatic Fever

An acute systemic immune-mediated inflammatory disease occurring weeks after an untreated group A beta-hemolytic streptococcal infection that can cause permanent valvular damage.

Infective Endocarditis

An infection of the endocardium and heart valves characterized by the colonisation of microbes and formation of friable vegetations composed of fibrin, platelets, and microorganisms.

Pericarditis

Inflammation of the fibroserous pericardial sac surrounding the heart, which causes sharp chest pain, an audible friction rub, and possible pericardial effusion.

Intermittent Claudication

Ischemic skeletal muscle pain in the lower extremities brought on by physical exercise and relieved by rest, serving as a classic symptom of peripheral artery disease.

Aortic Aneurysm

A localized abnormal dilation and weakness of the medial layer of the aortic wall, commonly occurring in the abdominal or thoracic aorta with a significant risk of fatal rupture.

Thrombophlebitis

The development of a blood clot within a vein associated with vascular endothelial inflammation and platelet adhesion.

Cardiogenic Shock

A category of circulatory shock resulting from primary myocardial pump failure and decreased stroke volume, often caused by extensive left ventricular myocardial infarction.

Septic Shock

A severe form of distributive shock caused by overwhelming systemic infection—frequently gram-negative bacteremia—where endotoxins trigger systemic vasodilation and vascular permeability.

Hydrostatic Pressure

The mechanical pushing force exerted by fluid against capillary walls that promotes filtration of water and solutes out into the interstitial fluid space.

Osmotic Pressure

The inward pulling force created by impermeable solute concentrations, notably plasma albumin, that draws fluid into capillaries across semipermeable membranes.

Edema

The abnormal collection and expansion of fluid volume within the interstitial tissue spaces.

Third-Spacing

The pathological shift and pooling of circulating fluid into non-functional body compartments or transcellular cavities (e.g., peritoneal space in peritonitis) where it is physiologically unavailable.

Antidiuretic Hormone (ADH)

A neurohypophyseal peptide that increases water reabsorption in the renal collecting tubules, thereby conserving water, lowering serum osmolarity, and decreasing urine volume.

Aldosterone

A mineralocorticoid synthesized by the adrenal cortex that stimulates renal tubular reabsorption of sodium and water while promoting urinary potassium excretion.

Atrial Natriuretic Peptide (ANP)

A hormone released by atrial cardiomyocytes in response to high atrial stretch that lowers blood volume by increasing GFR and promoting renal excretion of sodium and water.

Hyponatremia

A serum sodium level below $135\text{ mEq/L}$, which creates hypotonic extracellular fluid and drives water into cells, producing cell swelling and cerebral edema.

Hypernatremia

A serum sodium level exceeding $145\text{ mEq/L}$, resulting in hypertonic extracellular fluid that pulls water out of body cells, precipitating cellular dehydration.

Hypokalemia

A serum potassium level below $3.5\text{ mEq/L}$, leading to membrane hyperpolarization, neuromuscular weakness, diminished bowel motility, and cardiac dysrhythmias.

Hyperkalemia

A serum potassium concentration above $5\text{ mEq/L}$, causing altered myocardial repolarization, progressive ECG changes, muscle weakness, and cardiac arrest risks.

Chvostek's Sign

A clinical manifestation of hypocalcemia elicited by tapping the facial nerve anterior to the ear, resulting in ipsilateral twitching of facial muscles.

Trousseau's Sign

A spasm of the hand and wrist (carpopedal spasm) triggered by inflating a blood pressure cuff above systolic pressure for three minutes, indicative of latent tetany from hypocalcemia.

Hypomagnesemia

A serum magnesium concentration below $0.7\text{ mmol/L}$, causing neuromuscular hyperirritability, tremors, chorea, personality changes, and cardiac arrhythmias.

Respiratory Acidosis

An acid-base disturbance characterized by an arterial pH below $7.35$ and carbon dioxide retention resulting from alveolar hypoventilation or compromised respiratory gas exchange.

Metabolic Acidosis

A condition characterized by an arterial pH below $7.35$ caused by excessive nonvolatile acid accumulation (e.g., ketoacids, lactic acid) or severe bicarbonate loss.

Kussmaul Respirations

Deep, rapid, involuntary respirations characteristic of severe metabolic acidosis (such as DKA) designed to eliminate carbon dioxide and compensate for systemic acidemia.

Respiratory Alkalosis

An arterial acid-base imbalance with pH exceeding $7.45$ produced by hyperventilation and excessive pulmonary exhalation of carbon dioxide.

Metabolic Alkalosis

A systemic acid-base disturbance with arterial pH rising above $7.45$ caused by gastric acid loss, hypokalemia, or elevated serum bicarbonate.

Hematocrit

The volumetric percentage of red blood cells in whole blood, normally $42\text{\%}\text{--}52\text{\%}$ in adult males and $37\text{\%}\text{--}47\text{\%}$ in adult females.

Erythropoietin

A hormone produced by the renal cortex in response to tissue hypoxia that stimulates the red bone marrow to accelerate erythropoiesis.

Bilirubin

A yellow pigment formed by the breakdown of the heme component of hemoglobin from hemolyzed erythrocytes, conjugated in the liver and excreted in bile.

Complete Blood Count (CBC)

A core diagnostic hematology panel assessing quantities and morphology of erythrocytes, leukocytes, and thrombocytes, along with hematocrit and hemoglobin concentrations.

Normocytic, Normochromic

Erythrocytes demonstrating normal volume (MCV $80\text{--}100\text{ fL}$) and normal central pallor (covering about one-third of the cell), seen in acute hemorrhage and early chronic disease anemia.

Microcytic, Hypochromic

Red blood cells characterized by small size (MCV $< 80\text{ fL}$) and pale appearance with large central pallor due to deficient hemoglobin content, typical of iron deficiency and thalassemia.

Poikilocytosis

The abnormal variation in the morphological shape of red blood cells circulating in peripheral blood.

Anisocytosis

A hematologic condition characterized by marked inequality and abnormal variations in the size of circulating erythrocytes.

Target Cells (Codocytes)

Abnormally shaped red blood cells presenting a distinct 'bull's-eye' central hemoglobin concentration surrounded by a clear zone and outer colored rim.

Spherocytes

Small, spherical red blood cells that lack the characteristic central area of pallor, typical of hereditary spherocytosis and autoimmune hemolytic anemia.

Iron Deficiency Anemia

A microcytic, hypochromic anemia resulting from inadequate iron stores, leading to impaired hemoglobin synthesis, reduced oxygen-carrying capacity, and low serum ferritin.

Pernicious Anemia

A megaloblastic anemia caused by autoimmune mucosal atrophy or surgical loss of gastric parietal cells, resulting in intrinsic factor deficiency and impaired vitamin $\text{B}_{12}$ absorption.

Aplastic Anemia

A life-threatening bone marrow failure disorder producing pancytopenia (loss of RBCs, WBCs, and platelets) alongside replacement of functional hematopoietic tissue with fat.

Sickle Cell Anemia

An autosomal recessive hemoglobinopathy in which abnormal hemoglobin S ($\text{HbS}$) polymerizes upon deoxygenation, causing rigid, crescent-shaped erythrocytes that trigger microvascular occlusion and hemolysis.

Thalassemia

An inherited genetic defect in the synthesis of alpha or beta globin polypeptide chains of hemoglobin, causing microcytic hypochromic hemolysis and ineffective erythropoiesis.

Polycythemia Vera

A primary neoplastic myeloproliferative disorder marked by the autonomous, unregulated overproduction of erythrocytes, leukocytes, and thrombocytes, resulting in hyperviscosity and thrombosis risks.

Hemophilia A

A classical inherited X-linked recessive coagulopathy caused by a quantitative deficit or functional abnormality of clotting Factor VIII.

Disseminated Intravascular Coagulation (DIC)

A severe secondary systemic thrombo-hemorrhagic disorder characterized by widespread microvascular clotting that depletes platelets and clotting factors, culminating in refractory hemorrhage.

Acute Lymphocytic Leukemia (ALL)

A rapidly progressive hematopoietic malignancy characterized by bone marrow accumulation of non-functional, undifferentiated lymphoblasts, occurring predominantly in children.

Reed-Sternberg Cell

A giant, atypical, multinucleated neoplastic cell derived from B lymphocytes that serves as the pathognomonic histological hallmark of Hodgkin lymphoma.

Non-Hodgkin Lymphoma (NHL)

A diverse group of malignant neoplasms originating primarily from B lymphocytes, characterized by diffuse lymph node enlargement and early extranodal spread without Reed-Sternberg cells.

Multiple Myeloma

A malignant plasma cell neoplasm of the bone marrow characterized by osteolytic bone destruction, hypercalcemia, renal impairment, and excessive monoclonal M protein or light-chain production.