Pathophysiology 1 Final - Exam 2

Plasma makes up what percent of blood volume

55-60% blood volume

What is erythropoietin?

a hormone from the kidney that stimulates erythrocyte production

Per one hemoglobin molecule, how many oxygen molecules can bind to it?

4 oxygen molecules

What does hemoglobin carry?

Oxygen

Where does the production of hemoglobin take place?

in immature RBCs

A decrease in hemoglobin decreases what in kidneys?

Decreases the tissue oxygen tension in kidneys

What do RBCs need energy for?

To operate membrane pumps for maintaining ion channels

Where do RBC get digested by macrophages?

80-90% in spleen, and 10-20% in liver

True or False: The 3% that is dissolved in plasma is measured as PO2

True

What three forms is CO2 transported as?

• Dissolved gas (3%)

• Bicarbonate ion (HCO;75%)

• In association with hemoglobin forming carbaminohemoglobin (20%)

True of False: Carbaminohemoglobin release CO2 in the lungs which we exhale out

True

What is the pathogenesis of aplastic anemia?

Stem cell disorder characterized by reduction of hematopoietic tissue, fatty marrow replacement

Anemia in relation to vitamin B12 or Folate deficiency causes a disruption in what?

Disruption in DNA synthesis of blast cells produces megaloblasts (macrocytic)

True or False: Thalassemia has increased RBC destruction referred to as hemolysis

True

Polycythemia can be defined as?

Excess RBC results in increased blood viscosity which can lead to hypertension

What do arteries contain in comparison to veins?

Arteries contain in elastic tissue, whereas veins contain elastic tissue only in large veins

What are the determinants of vascular resistance?

• Vessel length

• Vessel radius

• Blood viscosity (know the laws)

True or False: the longer the blood vessels, the higher the resistance and lower the flow

True

What happens when systemic vascular resistance is increased?

It causes the heart to work harder to meet metabolic demands of the body

Thrombosis is initiated by alterations in what?

• Blood flow: slow or turbulent flow

• Blood vessel wall: damage or inflammation to the intimal wall of vessel

• Blood coagulability: emergence of a hypercoagulable state

What is atherosclerosis an underlying condition of?

hypertension, renal disease, cardiac disease, and peripheral arterial disease

Where are aneurysms mostly found?

Frequently found in cerebral circulation - thoracic and abdominal aorta

Alterations in venous flow can be accompanied with?

By edema, venous stasis, inflammation, ulcers, and pain

True or False: Lymphedema is most common in the US because of lymph node removal and radiation

False; secondary lymphedema

Systemic arterial blood pressure is the result of what?

Cardiac output and the resistance to the ejection of blood from the heart

Beta receptors of the heart increase or decrease heart rate?

Increase

When the kidney is stimulated by low arterial pressure, what happens?

Release of renin, which activates angiotensinogen to angiotensin 1

What is the function of the aldosterone?

Hormone that causes reabsorption of sodium and water passively follows

What does the silent killer refer to?

Primary hypertension - damage has already occurred to organs before diagnosis

The blood supplied to the heart muscle is provided by?

Coronary arteries

What does blood flow equal to?

Blood flow=pressure/resistance

What are the two general cardiac myocytes?

• Working cells: Mechanical pumping functions

• Electrical cells: Transmit electrical impulses

How do the heart cells store excess ATP?

Heart cells are able to store the excess ATP as creatine phosphate (CP) by the enzyme creatine kinase (CK)

True or False: Both cardiac contraction and relaxation require energy

True

What is cardiac output?

Amount of blood pumped out of the heart each minute

What is stroke volume?

Amount of blood ejected from the ventricle with each contraction

True or False: Coronary Heart Disease is responsible for approx 50% of deaths by CVD

True

What is CHD characterized by?

By insufficient delivery of oxygenated blood to the myocardium caused by atherosclerotic coronary arteries

What is atherosclerotic plaque formation initiated by?

Injury to coronary artery endothelium

What can ischemia result in?

It can result in chronic or acute coronary syndromes

True or False: Ischemia results in oxygen supply insufficient to meet metabolic demands

True

True or False: Acute Coronary Syndrome is associated with acute changes in plaque morphology and thrombosis (clot formation), which causes a sudden obstruction of coronary artery

True

True or False: Chronic or acute coronary heart syndromes may precipitate sudden cardiac arrest and associated dysrhythmias

True

True or False: Stable angina cannot be relieved by rest

False, it can

True or False: MI occlusion is complete and the thrombus lasts long enough to cause irreversible damage

True

Mitral valve is between which atrium and ventricle

Left atrium and left ventricle

What is stenosis?

Is failure of the valve to open completely results in extra pressure work for the heart

What is regurgitation?

Is the inability of a valve to close completely results in extra volume work for the heart

What defines infective endocarditis?

Invasion and colonization of endocardial structures by microorganisms with resulting inflammation-vegetations

What defines heart failure?

Is the inability of the heart to maintain sufficient cardiac output to meet metabolic demands of tissues and organs

What is the hallmark of a diastolic dysfunction with preserved ejection fraction?

The patient exhibits low cardiac output, congestion, and edema formation with normal ejection fraction (EF)

True or False: Biventricular heart failure is most often the result of primary left ventricular failure that has progressed to right sided heart failure

True

What is the cardinal sign associated with left HF?

Pulmonary congestion

What is the difference between tachycardia and bradycardia?

Tachycardia is fast heart rate, bradycardia is slow heart rate

True or False: Escape rhythms are associated with low cardiac output

True