Exam #2 patho study guide

Which conduction abnormality is associated with an increased risk for clot formation?

afib

What two responses are instituted by the body to compensate for low blood pressure?

RAAS and increased blood volume

A patient comes in with hypotension. What contributes to hypotension?

Reduced blood volume

The backward effect of total heart failure may cause jugular vein distention, pulmonary crackles, pulmonary edema, paroxysmal nocturnal dyspnea, and dehydration. Which of the following symptoms is not related?

dehydration

1 liter of fluid = how many pounds?

2

What elevated hormone on a patient’s chart indicates the body’s attempt to reduce fluid overload?

BNP

What vital signs indicates fluid volume depletion?

Increased heart rate and low blood pressure

For patients suspected of having an endocrine disorder, which of the following diagnostic options will most often be ordered by the provider?

Immunoassay of blood hormone levels

What hormone for an order of a 24-hour urine collection likely assess?

Cortisol

is insulin purging increasing or decreasing the amount of insulin received? What would increasing insulin to normal amounts cause in terms of a patients weight? (increase or decrease)

Decreasing, increase

What is a long-term complication of diabetes mellitus?

Blindness

Hematologic Neoplasms are a malignant disorder originating from blood-forming tissues such as bone marrow or ______ system

lymphatic

Hodgkin’s Has the Reed–Sternberg cell and stays on the Highway (orderly spread) What type of cell does Hodgkins come from?

B-cells

Non-Hodgkin’s = No Rules — no Reed–Sternberg cells, spreads anywhere. What type of cell does Non-Hodgkins come from?

B-cells or T-cells

What does the acronym “CRAB” stand for in Multiple Myeloma?

Hypercalcemia, renal failure, anemia, bone lesions

What lab finding shows a spike on serum protein electrophoresis? (antibody)

Monoclonal antibodies

What does Hemoglobin (Hgb) measure?

Amount of oxygen carrying protein in RBCs

What does Hematocrit (Hct) measure?

% of blood volume made up of RBCs

What does the Mean Corpuscular Volume (MCV) indicate?

The average size of RBCs

What does a low MCV mean?

RBCs are small

A patient’s CBC shows: Hgb 8.0 g/dL, Hct 25%, RBC count low. What condition is most likely?

Anemia

A patient’s CBC shows: WBC 18,000/mm³ with ↑ neutrophils. What does this suggest?

Bacterial infection

CBC shows: WBC 3,000/mm³ with ↓ neutrophils. What does this suggest?

Neutropenia

CBC shows: MCV 72 fL, Hgb 9 g/dL, RBCs small and pale. What type of anemia is likely?

Microcytic anemia

Platelet count 60,000/mm³. What is the main clinical risk?

Bleeding

A patient has WBC 12,000/mm³ with ↑ lymphocytes. What does this pattern suggest?

Viral Infection

A patient with bone pain and fatigue has anemia and hypercalcemia on CBC and chemistry panel. What condition should you suspect?

Multiple Myeloma

What is Polycythemia? A condition where the body produces too many _____

Red blood cells

Elevated RBC count, Hemoglobin, and Hematocrit — thick, viscous blood indicate what?

Polycythemia

what can happen if the body doesn’t have enough vitamin B12

RBCs dont produce

Hemophilia results in clotting factor deficiency, what does the word literally mean?

blood and love

What does the phrase “Clot first, bleed later.” refer to?

DIC

What does the phrase “vWF = Very Sticky Factor” refer to?

Von Willebrand Factor

Hyponatremia = “Low salt, Lots of _____” → brain swells

water

Hypernatremia = “High ____, Low water” → brain shrinks

salt

Treatment for mild, asymptomatic hyponatremia

Restrict water intake

Treatment for hypernatremia

hypotonic fluids

treatment for hypoatremia

hypertonic fluids

Hydrostatic pressure does what

pushes fluids out

Oncotic pressure does what (opposes hydrostatic pressure at the capillary)

Pulls fluids in

Osmotic pressure does what

Pulls fluids to solutes

What forces are being referenced here? “Hydro pushes out, Onco pulls in, Osmotic follows solutes.”

Starling Forces

What is the role of the hypothalamus in the axis?

Commander

What is the role of the pituitary gland?

Messenger

What is the role of the endocrine glands?

Worker

What is negative feedback in the axis?

Maintaining normal hormone levels

What is positive feedback in the axis?

Amplifying the signal

What does “Hypo commands → Pituitary sends → Gland works → Feedback checks” Refer to?

Hypothalamic pituitary endocrine gland axis feedback mechanism

Hypokalemia’s effect on the heart

arrhythmias

A common diagnostic indicator of heart failure is

BNP

PAD (peripheral artery disease) can also by remembered by Pain After Distance, what does the Pain After Distance refer to specifically?

Intermittent claudication

Diagnostic test for PAD

ABI

The mnemonic “FLABBY HEART” refers to

Mitral regurgitation

what are two key symptoms of Mitral Regurgitation

Dyspnea and afib

what happens to the body in Mitral Regurgitation in regards to fluid?

volume overload

Left = Lungs (backs up into lungs) refers to what?

Left sided heart failure

Right = Rest of body (backs up into veins) refers to?

Right sided heart failure

Which of the following best describes the underlying problem in left-sided heart failure?

A) Inability of the right ventricle to eject blood into the pulmonary circulation
B) Increased cardiac output leading to systemic hypertension
C) Inability of the left ventricle to pump blood effectively to the systemic circulation
D) Decreased venous return due to dehydration

C

A patient presents with dyspnea, orthopnea, and crackles on lung auscultation. These symptoms are most consistent with:

A) Right-sided heart failure
B) Left-sided heart failure
C) Pulmonary embolism
D) Myocardial infarction

B

Which clinical finding is most characteristic of right-sided heart failure?

A) Pulmonary crackles
B) Cough with frothy sputum
C) Peripheral edema and jugular vein distension
D) Orthopnea

C

Which statement best explains why right-sided heart failure often follows left-sided heart failure?

A) The right ventricle becomes hyperactive due to increased oxygenation
B) Pulmonary congestion increases right ventricular afterload
C) Left heart failure decreases systemic resistance
D) Right heart failure increases coronary perfusion

B

A patient with right-sided heart failure would most likely exhibit which assessment finding?

A) Crackles in both lung bases
B) Cyanosis and frothy sputum
C) Ascites and dependent edema
D) Shortness of breath when lying flat

C

Which laboratory finding is commonly elevated in both left and right heart failure?

A) Serum calcium
B) Brain natriuretic peptide (BNP)
C) Potassium
D) Hemoglobin

B

Which compensatory mechanism initially helps maintain cardiac output in heart failure?

A) Parasympathetic stimulation
B) Decreased renin secretion
C) Activation of the renin–angiotensin–aldosterone system (RAAS)
D) Decreased sympathetic tone

C

Which valvular disorder is most likely to lead to left-sided heart failure?

A) Tricuspid regurgitation
B) Pulmonic stenosis
C) Aortic stenosis
D) Mitral valve prolapse

C

Which class of medication helps reduce the workload on the heart by lowering afterload in heart failure?

A) Beta-blockers
B) ACE inhibitors
C) Anticoagulants
D) Calcium supplements

B

Which assessment finding in a patient with left-sided heart failure requires immediate intervention?

A) 2+ ankle edema
B) Productive cough with pink frothy sputum
C) Mild fatigue after activity
D) Weight gain of 1 lb in 24 hours

B

Which is the most common cause of myocarditis?

A) Bacterial infection
B) Viral infection
C) Fungal infection
D) Autoimmune reaction

B

Which finding supports a diagnosis of myocarditis?

A) Elevated troponin and diffuse ST-T wave changes
B) Low troponin with normal ECG
C) Elevated cholesterol levels
D) Bradycardia and hypotension only

A

What complication is most associated with chronic myocarditis?

A) Pulmonary embolism
B) Dilated cardiomyopathy
C) Hypertrophic cardiomyopathy
D) Aortic stenosis

B

“BE FEVER” = Bacteria Eating the ValvEs Rapidly refers to?

Infective endocarditis

Which microorganism is most commonly associated with acute infective endocarditis?
A) Staphylococcus aureus
B) Streptococcus viridans
C) Candida albicans
D) E. coli

A

A new murmur and splinter hemorrhages under the fingernails are most characteristic of:
A) Myocarditis
B) Infective Endocarditis
C) Pericarditis
D) Rheumatic fever

B

What diagnostic test is most definitive for infective endocarditis?

A) Chest X-ray
B) ECG
C) Blood cultures and echocardiogram
D) Stress test

C

An IV drug user is diagnosed with infective endocarditis. Which heart valve is most likely affected?
A) Mitral
B) Aortic
C) Tricuspid
D) Pulmonic

C

A 62-year-old man develops unilateral leg swelling after hip surgery. His leg is warm, red, and tender. Which of the following best explains the underlying mechanism?

A) Increased capillary permeability
B) Activation of the coagulation cascade due to venous stasis
C) Lymphatic obstruction from tissue damage
D) Arterial spasm from endothelial injury

B

A nurse notes that a patient’s leg is swollen and warm but pulses are intact. Which finding would most strongly suggest chronic venous insufficiency rather than DVT?

A) Sudden onset of pain and redness
B) Presence of a deep, dry ulcer on the toes
C) Brown skin discoloration near the ankles
D) Positive Homan’s sign

C

Which of the following patients is most at risk for developing a DVT?

A) A 23-year-old athlete with a sprained ankle
B) A 50-year-old truck driver who drives long distances daily
C) A 70-year-old woman with chronic anemia
D) A 45-year-old with asthma

B

Which finding would differentiate DVT from cellulitis?

A) Localized erythema
B) Fever
C) Calf pain that worsens with dorsiflexion
D) Warmth and swelling

C

A patient with chronic venous insufficiency asks why her legs ache more when standing. The nurse’s best response is:

A) “Gravity pulls blood down, increasing pressure in your leg veins.”
B) “Your arteries narrow when you stand, causing leg pain.”
C) “You lose blood flow to your legs when you stand.”
D) “Your legs swell because you’re not moving enough oxygen.”

A

Which of the following best describes the difference between venous and arterial ulcers?

A) Venous ulcers are dry and deep; arterial ulcers are wet and irregular.
B) Venous ulcers are painless; arterial ulcers are painful.
C) Venous ulcers are wet and irregular; arterial ulcers are dry and punched-out.
D) Both are dry with necrotic bases.

C

Which lab or diagnostic test confirms a DVT?

A) D-dimer and duplex ultrasound
B) Chest X-ray
C) ECG
D) Arterial blood gas

A

Which intervention best prevents DVT in an immobile hospitalized patient?

A) Increasing sodium intake
B) Applying compression stockings
C) Encouraging bedrest
D) Massaging the calves

B

During the cardiac cycle, which event occurs simultaneously with closure of the semilunar valves?

A) Onset of atrial contraction
B) End of ventricular ejection and beginning of diastole
C) Peak ventricular filling
D) Beginning of isovolumetric contraction

B

Which of the following valve disorders would directly cause volume overload in the left atrium?

A

The aortic valve opens when:

A) Left ventricular pressure exceeds aortic pressure.
B) Aortic pressure exceeds left ventricular pressure.
C) Left atrial pressure exceeds left ventricular pressure.
D) Right ventricular pressure exceeds pulmonary pressure.

A

A nurse hears a “lub-dub” heart sound. Which valves close to produce each?

A) Lub = semilunar; Dub = AV
B) Lub = AV; Dub = semilunar
C) Lub = tricuspid only; Dub = mitral only
D) Lub = all valves open; Dub = all valves close

B

Which valve disorder would most likely cause right ventricular hypertrophy?

A) Aortic regurgitation
B) Pulmonic stenosis
C) Mitral stenosis
D) Aortic stenosis

B

The chordae tendineae and papillary muscles are essential for:

A) Opening the semilunar valves
B) Maintaining closure of AV valves during systole
C) Increasing coronary blood flow
D) Generating conduction impulses

B