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33 Cards in this Set
- Front
- Back
1. What is the mechanism of heart failure?
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a. Imbalance between cardiac output, metabolic demands of the organs, muscles, body, and heart tissue
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2. What are the ssx of heart failure?
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a. Dyspnea
b. Exercise intolerance c. Lung rales d. Edema |
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3. What conditions can cause heart failure?
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a. CAD
b. Valvular heart disease c. Idiopathic dilate cardiomyopathy d. Alcoholic cardiomyopathy e. HTN f. Cor pulmonale g. Thyroid dysfunction |
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4. What is stage A HF?
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a. Patients at high risk for developing HF
b. HTN, CAD, DM, family hx of caridiomyopathy c. Tend to be obese with highs erum lipids or smokers d. Screen for BNP |
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5. What is stage B HF?
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a. Patients have asymptomatic heart failure
b. Prior MI, current LV dysfunction, asymptomatic valvular disease c. Screen for BNP |
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6. What is stage C heart failure?
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a. Patients have symptomatic heart failure
b. Known structural heart disease, shortness of breath, fatigue c. Reduced exercise tolerance |
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1. What is stage D heart failure?
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a. Patients have refractory end-stage heart failure
b. Marked symptoms at rest despite maximal medical tx c. High mortality rate |
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8. What happens to the heart as HF progresses?
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a. Left ventricular remodeling
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9. How long does it take HF to develop? How long does it take to cause death once it is symptomatic?
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a. Develop→ decades
b. Kill→ months |
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10. What are some factors that can affect preload?
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a. Body position
b. Intrathoracic pressure c. Intrapericardial pressure d. Venous tone e. Skeletal muscle pump action f. Atrial contractions g. Valvular regurgitation |
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11. What happens to contractility in the LV while undergoing remodeling?
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a. Larger radius=greater wall tension=less contractility=lower CO
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12. What factors affect afterload?
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a. HTN/SVR
b. Aortic valvular stenosis c. Subaortic stenosis d. Hypertrophic cardiomyopathy |
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13. What factor has the greatest impact on the development of HF?
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a. Contractility
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14. What factors affect contractility?
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a. Sympathetic nerve activity
b. Catecholamines c. Inotropic agents d. Physiological depressants e. Rx depressants f. Loss of ventricular mass |
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15. What can cause systolic dysfunctions?
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a. Ischemia
b. Valvular heart disease c. HTN d. Shunts e. Cardiomyopathy→ dilate most common |
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16. What can cause diastolic dysfunctions?
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a. Impaired ventricular relaxation or stiffness due to hypertrophy
b. Ischemia c. Increased loading d. Constriction e. Infiltrating disease leading to restriction |
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17. How do you dx diastolic dysfunctions?
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a. Echo
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18. How do you tx diastolic dysfunctions?
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a. Inotropic agents
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19. What happens to ventricular compliance in systolic dysfunction?
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a. Increases
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20. What happens to ventricular compliance in diastolic dysfunction?
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a. Decreases
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21. What happens to the S3 gallop in systolic dysfunction?
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a. Greatly increased
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22. What happens to the S4 gallop in diastolic dysfunction?
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a. Greatly increased
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23. What causes left ventricular remodeling?
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a. Response to overloading to increased CO
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24. What is the mechanism of left ventricular remodeling?
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a. Myocardial cells elongate, LV walls become thinner
b. Ca loss→ weaker contractions c. Mitral regurgitation ensues due to dilatation of annulus d. Greater work and O2 requirements |
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1. What is the nature of LV remodeling?
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a. Irreversible
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26. How can you prevent LV remodeling?
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a. Pacemakers
b. ACE inhibitors c. B blockers |
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27. What type of remodeling happens acutely after an MI?
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a. Stretching and expansion of the infarct zone
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28. What type of remodeling happens chronically after an MI?
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a. Eccentric hypertrophy of non-infarcted myocardium
b. LV dilatation→ chamber sphericity c. Collagen content in non-infarcted myocardium increases d. Myocytes lose optimum overlap |
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29. When does chronic LV remodeling occur?
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a. Increased infarct size
b. Occluded infarct-related artery c. Anterior/apical infarct location |
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30. What happens to end-systolic volume in LV remodeling?
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a. Increases
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1. How do ACE inhibitors control HF?
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a. Prevent increase in end-diastolic and end-systolic volumes
b. Maintain EF |
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32. How do B-blockers control HF?
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a. Given with ACE inhibitors to potentiate effects of preventing remodeling
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1. What drug increases EF?
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a. Digoxin
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