Exam Review Notes

Exam Review Notes: Cardiovascular and Respiratory Systems

General Exam Information

  • Duration: The exam is 11 hour and 5050 minutes long.

  • Number of Questions: There are 4848 questions for both online and in-person students.

  • Format: The exam is entirely multiple-choice; there are no written questions.

  • Case Studies: Includes 22 case studies, but all associated questions are multiple-choice (no written PES statements or interventions).

  • Allowed Materials:

    • Scratch paper.

    • Malnutrition diagnostic criteria (can be accessed digitally on D2L or printed; printing is highly encouraged to avoid technical issues).

    • Two feeding formulary (can be accessed digitally or printed; may not be extensively needed for calculations as full prescriptions are not required).

  • Scope of Content: You are responsible for all readings, YouTube videos posted under lectures, slides, and notes taken during in-person classes.

  • NELMS Chapters: Chapters 1111 and 1919 are relevant. Ignore sections on bronchopulmonary dysplasia and cystic fibrosis.

  • Disclaimer: The review covers major points, but it's impossible to cover every single detail that might appear on the exam. Some material outside the explicit review questions may still be present.

Cardiovascular Disease

Atherosclerosis and Lipid Metabolism

  • Earliest Visible Sign of Atherosclerosis: Fatty streaks are the earliest visible signs, forming as early as age 55. Foam cell rupture indicates advanced plaque.

  • Atherosclerosis Process:

    1. Macrophages engulf oxidized LDL cholesterol, becoming foam cells.

    2. Foam cells build up, forming plaque in arteries.

    3. This condition is called atherosclerosis.

  • LDL (Low-Density Lipoprotein): Transports cholesterol to tissues. In atherosclerosis, LDL gets oxidized, stimulating the migration of macrophages to the site.

  • HDL (High-Density Lipoprotein) Protective Role: Removes cholesterol from tissues for disposal in the liver.

  • Lipoprotein Transport Overview:

    • Chylomicrons: Transport dietary triglycerides from the intestines to the liver. Along the way, muscle and fat cells “pluck off” triglycerides. Remnants are absorbed by the liver.

    • VLDL (Very Low-Density Lipoprotein): Produced by the liver; transports new triglycerides and cholesterol to tissues. Becomes denser as triglycerides are removed.

    • IDL (Intermediate-Density Lipoprotein): A transient, denser form after some triglycerides are removed from VLDL.

    • LDL (Low-Density Lipoprotein): Formed from IDL after further triglyceride removal. Carries cholesterol to cells.