KIN 462 Quiz 2 Trial Questions

how does sarcopenia affect muscle function at the cellular level

increased neuron loss and fiber atrophy

what is the main pathophysiology mechanism of hypertension that also accelerates atherosclerosis

decreased arterial compliance

sarcopenia's impact on muscle function is primarily due to which of the following cellular changes

loss of muscle fiber number and size

what role does inflammation play in the pathophysiology of heart failure

it contributes to cardiac remodeling and dysfunction

how do decreased hormone levels like testosterone and estrogen relate to sarcopenia

they contribute to muscle atrophy and loss of strength

elevated levels of IL-6 and CRP in this patient suggest a role of:

dysregulated oxidative stress leading to sarcolemmal damage

what role does oxidative stress play in the progression of sarcopenia, particularly in elderly patients

induces protein degradation via activation of proteolytic systems

which of the following cellular mechanisms most likely explains in the synergistic relationships between sarcopenia and cardiovascular disease progression in aging populations

decreased mitochondrial biogenesis and oxidative capacity in muscle tissue, leading to systematic inflammation and endothelial dysfunction

in sarcopenia, what do specific grip strength test results indicate, and how are these measurements used to assess the risk of muscle weakness and cardiovascular disease

grip strength below 26 kg for men and 18 kg for women is used as a threshold for identifying clinically significant muscle weakness, which correlates with higher risks of cardiovascular events and mortality

how does long-term hypertension contribute to the development of CHF

it increases the workload on the heart, leading to the hypertrophy and heart failure

what is sarcopenia primarily characterized by

progressive, generalized loss of skeletal muscle mass and strength

what role does inflammation play in the development of sarcopenia

it decreases muscle mass and strength due to increased proteolysis

how does obesity increase the risk for both hypertension and CAD

it reduces insulin sensitivity and increases vascular resistance

which of the following is a direct physiological effect of hypertension on the cardiovascular system

increased arterial stiffness

which of the following is a common symptom of congestive heart failure

fluid retention and shortness of breath

what is the primary pathological process underlying congestive heart failure with reduced injection fraction (HRrEF)

decreased contractility of the left ventricle

in patients with both hypertension and left ventricular hypertrophy (LVH), which of the following best explains how these conditions can lead to heart failure

hypertension increases afterload, leading to compensatory LVH, which eventually reduces myocardial efficiency and oxygen delivery

chronic hypertension can lead to multi-organ damage through which of the following mechanisms

vascular remodeling and arterial stiffness, reducing blood flow to critical organs such as kidneys, heart, and brain

which muscle fiber type is more likely to be lost in sarcopenia

type II fibers

what is a common cause of right-sided heart failure

it commonly occurs as a result of left-sided heart failure

(T/F) regular resistance training can significantly improve both muscle mass and strength in elderly patients with sarcopenia

True

(T/F) endothelial dysfunction is a reversible precursor to atherosclerosis and directly contributes to vascular inflammation and plaque development

True

(T/F) diuretics are used in heart failure management primarily to improve myocardial contractability

False

(T/F) obesity is a protective factor against sarcopenia due to increased body mass

False

(T/F) angiotensin-converting enzyme (ACE) inhibitors are used in heart failure to reduce overload and prevent adverse cardiac remodeling

True

(T/F) systolic heart failure is characterized by a high ejection fraction (HFpEF)

false

(T/F) hypertension increases the risk of developing coronary artery disease by promoting the formation of atherosclerotic plaques

true

(T/F) aerobics exercise can reverse sarcopenia by increasing muscle fiber size and improving oxidative capacity

false

(T/F) lowering LDL cholesterol with statins can reduce the progression of atherosclerosis and decrease the risk of cardiovascular events

true

(T/F) pharmacological interventions in sarcopenia are primarily focused on hormonal therapies to improve muscle mass

false

(T/F) diabetic patients are more prone to heart failure due to the diabetic cardiomyopathy associated with metabolic disturbances

true

(T/F) targeting the NF-kB pathway can reduce muscle wasting in patients with chronic inflammatory diseases

true

(T/F) smoking is a non-modifiable risk factor for coronary artery disease

false

(T/F) high sodium intake is a risk factor for both hypertension and coronary artery disease

true

(T/F) obesity increases the risk of both type 2 diabetes and coronary artery disease

true

(T/F) hyperglycemia in type 2 diabetes does not contribute to the development of atherosclerosis

false

(T/F) the chronic inflammation associated with obesity contributes to both insulin resistance and endothelial dysfunction, exacerbating risk for cardiovascular disease

true

(T/F) hyperglycemia in patients with T2DM can increase the formation of advanced glycation end products (AGEs), which contribute to vascular stiffness and hypertension

true

(T/F) in atherosclerosis, macrophages internalize oxidized LDL (ox-LDL) and transform into foam cells, which contribute to plaque formation and promote inflammation in the arterial walls

true

(T/F) in patients with congestive heart failure (CHF), increased sympathetic nervous system activity compensates for reduced cardiac output by increasing heart rate and contractability, but over time, this can exacerbate myocardial damage and worsen heart failure symptoms

true

CASE STUDY 1: A 68-year-old male with a longstanding history of smoking and hypertension presents with increasing episodes of chest discomfort on exertion, now occurring with minimal activity or even at rest. His recent lipid profile shows a high LDL level of 160 mg/dL and total cholesterol of 245 mg/dL. His family history reveals significant cardiovascular disease, including early myocardial infarction in his father. An echocardiogram indicates left ventricular hypertrophy, and stress testing reveals ischemic changes suggestive of coronary artery disease

1. TRUE/False: Consistent elevated blood pressure above 140/90 mmHg, especially in the context of additional risk factors such as smoking and high LDL cholesterol, significantly increases the risk of developing coronary artery disease.

2. Which of the following risk factors does NOT directly contribute to the patient's current cardiovascular condition?

D) High protein diet

3. True/FALSE: The patient's symptoms of fatigue and shortness of breath during low-intensity activities are typical in late-stage sarcopenia.

4. Which mechanism is most likely contributing to the patient's symptoms?

C) Coronary artery atherosclerosis

5. Which complication is a direct consequence of the Case risk factors?

A) Acute myocardial infarction

CASE STUDY 2: An 80-year-old male, a retired construction worker, presents with a history of gradual muscle weakness and decreased mobility. He reports difficulty in climbing stairs and carrying groceries. His medical history includes controlled hypertension and a previous myocardial infarction five years ago. On examination, he exhibits noticeable muscle wasting and weakness, particularly in the lower extremities. His gait is slow and he uses a cane for support. Laboratory tests show normal electrolytes and his cardiovascular examination is consistent with stable post-infarction changes but no acute distress.

1. Which chronic condition is primarily indicated by the patient's muscle weakness and physical examination findings?

C) Sarcopenia

2. What is the most appropriate management strategy to improve the patient's muscle function and quality of life?

B) Resistance and balance training exercises

3. True/FALSE: The patient's history of myocardial infarction is unrelated to his current muscle weakness.

4. Given the patient's age and symptoms, which additional health screening is most advisable?

C) Bone density scan

5. What is the primary contributing factor to the patient's increased risk of falls?

B) Sarcopenic obesity

6. Given his past myocardial infarction, which symptom should prompt immediate reevaluation of his cardiac status?

D) All of the above

CASE STUDY 3: James, a 58-year-old male, has been obese (BMI 35) for 20 years and hypertensive for 12 years. He is diagnosed with Coronary Artery Disease (CAD) following chest pain during moderate activity. His lifestyle is largely sedentary, and his diet is high in sodium and saturated fats. Lab results reveal elevated LDL cholesterol (170 mg/dL), fasting glucose of 130mg/dL, and blood pressure of 160/100 mmHg. He has also developed left ventricular hypertrophy(LVH), noted on an echocardiogram, and shows signs of early-stage renal dysfunction. His family history includes a father who died of a heart attack at 60. James continues to smoke despite his CAD diagnosis.

1. How does James' chronic hypertension contribute to the development of left ventricular hypertrophy (LVH)?

B) Hypertension increases afterload, causing the left ventricle to thicken to compensate for increased vascular resistance

2. True/FALSE: Left ventricular hypertrophy (LVH) due to hypertension decreases myocardial oxygen demand, reducing the risk of ischemia in patients with CAD.

3. What role does oxidative stress play in the progression of James' CAD?

A) Oxidative stress promotes LDL oxidation, which contributes to atherosclerotic plaque formation

4. In James' case, his combination of obesity, hypertension, and CAD significantly increases his risk of myocardial infarction. Which of the following molecular events is most likely to occur during a myocardial infarction due to plaque rupture in the coronary arteries?

B) Formation of a thrombus due to exposure of tissue factor from ruptured plaques, leading to coronary artery occlusion

5. James' obesity contributes to his left ventricular hypertrophy (LVH) and heart failure. Which of the following best describes how obesity-induced hyperinsulinemia exacerbates cardiac hypertrophy and hypertension?

A) Hyperinsulinemia reduces renal sodium excretion, increasing blood volume and afterload on the heart, which promotes hypertrophy

6. True/FALSE: James' obesity contributes to endothelial dysfunction by increasing the levels of anti-inflammatory adipokines such as adiponectin