Patho Test #2

What precaution should you take when assesssing a patient with a Abdominal Aortic Aneurysm?

Avoid deep palpations to prevent any ruptures

What modifiable risks can impact the risk for inflammation?

poor diet, high sugar intake, low physical activity, poor sleep, smoking, obesity

What is HDL

High Density Lipoprotein

“good” cholesterol: transports cholesterol from other parts of the body to the liver to be removed

reduces risk for stroke and heart disease

What is LDL

Low density protein

“Bad” cholesterol: transports cholesterol to body tissues

How does atherosclorsis develop in the body?

Plaque buildup inside arteries overtime

What organ releases angiotensinogen? (RAAS)

Liver

What does angiotensin converting enzyme do? (RAAS)

ACE converting enzyme converts angiotensin 1 to angiotensin 2 which causes vasoconstriction and aldosterone release as well as BP increase to allow for fluid to be kept in the body

What changes Angiotensinogen to Angiotensin? (RAAS)

Renin

Where is ACE released from? (RAAS)

Lungs

Where is Renin released from? (RAAS)

Kidneys

What does aldosterone do? (RAAS)

Regulates BP and fluid balance

Where is aldosterone released from and why? (RAAS)

Released from adrenal cortex: restores blood pressure and volume by retaining sodium as part of the RAAS system

What does angiotensin II do to your blood pressure? (RAAS)

Increases BP

What stimulates the kidneys to release renin? (RAAS)

Hypovelemia or dehydration

What things contribute to the devleopment of atherosclerotic plaques?

Damage to the arterial wall, lipid accumulation and inflammation

How do atherosclerotic plaques form (the steps)

Chronic Inflammatory Process: 1. endothelial injury which causes narrowing of the arteries 2. LDL and foam cells create a fibrous cap 3. Causes plaque rupture and thrombosis leading to heart attack or stroke

Why do we ambulate our patients early after surgery to prevent what?

Deep Vein Thrombosis(DVT) and Pulmonary Embolism(PE)

What are the risk factors in Virchow's triad?

Venous stasis, vessel injury, hypercoagulability

What is a pulmonary embolism?

Blood clot that travels and blocks blood supply to the lungs

How is a pulmonary embolism formed?

Deep vein thrombosis forms, thrombus dislodges and travels through the venous system.

What is aerobic metabolism?

Oxygen dependent breakdown of carbs, fat and amino acids in order produce energy(ATP) over a long period of time. Typically seen with lower intensity prolonged activity

What is anaerobic metabolism?

Generating ATP without the use of oxygen to break down glucose and glycogen. Short term energy source that produces lactic acid

What does elevated troponin indicate?

Cardiac muscle damage or stress

What does an elevated myoglobin indicate?

Muscle injury

What is the pathophysiology behind angina?

Oxygen demands for cardiac tissue exceeds the amount actually being delivered

What is an ECG? Why do we perform this?

A test that measures the electrical activity of the heart to assess and diagnose heart conditions like arythmias, structural issues or damage from a heart attack

What is the main goal when treating a patient that has had an Myocardial infarction?

Restoring blood flow as rapidly as possible to salvage the heart

What are some signs and symptoms in someone who has anemia

Fatigue, shortness of breath, weakness, dizziness, cold hands or feet, rapid heart rate

What electrolyte is important in cardiac function?

Potassium: maintains electrical changes and regulates heart beat

What electrolyte is important in neurological function?

Sodium

what is chvosteks sign?

Clinical indicator of hypocalcemia. This can indicate hypoparathyroidism or kidney failure

What is Trousseau's sign?

Muscle spasm in hand and wrist that happens when blood flow os temporarily restricted. This indicates hypocalcemia

Signs of left sided heart failure

Fluid build up in lungs, crackles, cough(frothy pink sputum= pulmonary edema), nasal flaring, tactile fremitus, increase RR, hyporesonance, orthopnea, dyspnea

Signs of right sided heart failure

Ascites, lower extremity edema, hepatomegaly, splenomegaly, JVD, venous stasis, fatigue, GI distress, weight gain

What are the signs of aortic stenosis?

chest pain, dizziness, fatigue, shortness of breath

What are the signs of mitral valve stenosis?

shortness of breath especially with exertion, fatigue, palpations, edema in lower extremities, respiratory infection, chest pain

What causes HYPOkalemia?

vomimtting, diarrhea, diuretics, GI suctioning, corticosteroids

What can cause HYPERkalemia?

Renal failure, kidney excretion, chronic kidney disease, acute kidney injury, medication side effects

What medication is mainly used to treat hyperkalemia?

Kaexylate, calcium gluconate, calcium chloride

What can cause HYPERnatremia?

dehydration and excess sodium

What can cause HYPOnatremia?

Sodium levels fall below 135, caused by sodium loss or excess water in body therefore brain cells swell causing neuro symptoms

What can cause HYPOvolemia?

Loss of fluid in body

What causes HYPERvolemia?

excess sodium and water in the body, kidney failure, heart failure: creates edema

What does hypo/hyper natremia affect in ones body?

Changes level of consciousness

What are the s/s of HYPOvolemia?

poor skin tugor, pale extremities, decreased urine output, vommitting

What are the s/s of HYPERvolemia?

edema, weight gain, fluid in lungs

What are some S&S of someone who has Aortic Stenosis?

external dyspnea(shortness of breath), pulmonary edema, angina pectoris(chest pain), increase in carotid artery pule, lateral displacement LV impulse

What are some S&S of someone who has Mitral valve reguritation?

Pulmonary symptoms due to: backup in lungs, atrial fibiliration, diminshed s1 sound

What does the RBC need to mature from a erythroblast to a ethrythrocyte?

A RBC needs erythrpoietin(mostly produced during low oxygen levels - which is a hormone that stimulates production in the bone marrow, it also needs iron for the hemoglobin and vitamin b12 or folate for mitosis.

What anemia is from a antibody / antigen reaction?

autoimmune hemolytic anemia

What are platelets used for in the body?

coagulagion, agglutination and molecule transport

What does erythropoeitin do? Where is it released from?

Hormone produced and released by the kidneys to stimulate the productioon of red blood cells

A patient with chronic anemia needs what vitamins/minerals for the red cell to mature?

iron, B12, folic acid

What heart valves open during systole?

The semilunar valves open (aortic and pulmonary) and the AV valves close

What heart valves open during diastole?

Atrioventricular(mitral and tricuspid)

Afterload

The pressure or resistance the heart (specifically the ventricles) must overcome to eject blood during contraction (systole)

Preload

Amount heart is filled per beat ; the maximum amount of stretch that is places on the ventricular walls of the heart at the end of diastole (filling)

Contractility

The ability of the heart muscle to generate force and contract.

What is the formula for cardiac output?

heart rate x stroke volume

Cardiac Output

amount of blood from left ventricle per minute

s/s of HYPOmagnesmia

twtitching/tremors, muscle cramps, increased reflexes, seizures, irregular heart beat

What can cause HYPOmagnesmia?

Increased GI loss, alcoholism, diarrhea, malnutrition, impaired absorption, increased renal excretion

What diffuses across semipermeable membranes?

Oxygen

What diffuses out of the capillary into the alveolus?

CO2

What side of the heart carries deoxygenated blood?

Right

What is a common early complication in MI?

arrythmias

What causes arrythmias?

high BP, abnormal potassium levels, smoking, diabetes, stroke, anxiety, dehydration

How is fluid volume balance maintained?

DAILY weight

Which chamber hypertrophies in aortic stenosis?

left ventricle

What is the best test for valve anatomy?

transthoracic echocardiogram

What dies troponin 1 and 2 indicate?

myocardial injury

What diet supports cardiac recovery?

low sodium

First action for chest pain

Assess ABC’s

What cells carry the most oxygen?

erythrocytes