CARDIAC NURS 5315 ADV PATHO EXAM 3 (4.1, 4.2, 5.1, 5.2) QUESTIONS WITH ANSWERS 2024 UPDATED What is heart failure? - CORRECT ANSWER>>>> A syndrome resulting from myocardial injury. What are the causes of heart failure? - CORRECT ANSWER>>>> Ischemic heart disease, cardiomyopathies, valvular heart disease, myocarditis, and others . What are the clinical manifestations of heart failure? - CORRECT ANSWER>>>> Volume overload and poor perfusion. What are the risk factors for heart failure? - CORRE CT ANSWER>>>> Age, ischemic heart disease, obesity, diabetes, HTN, excessive ETOH use, congenital heart disease, valvular heart disease, myocarditis, cardiomyopathies, and renal failure. What are the most common causes of heart failure? - CORRECT ANSWER>>> >HTN and ischemic heart disease. How can heart failure be classified? - CORRECT ANSWER>>>> By location (right -
sided versus left -sided) or effect on contractility (systolic versus diastolic dysfunction). What is heart failure with Reduced Ejection Fraction (HFrEF)? - CORRECT ANSWER>>>> Impairment in left ventricular contraction resulting in an EF of < 40%. What is the most common cause of decreased systolic dysfunction? - CORRECT ANSWER>>>> Myocardial infarction. What are other causes of decreased systolic dysfunction? - CORRECT ANSWER>>>> Myocarditis and cardiomyopathies. What happens when there is a decrease in contractility in the left ventricle? - CORRECT ANSWER>>>> Decrease in stroke volume, decrease in cardiac output, increase in left ventricular end di astolic volume (preload). What is the first step of ventricular remodeling? - CORRECT ANSWER>>> >Decrease in contractility in the left ventricle. What occurs over time as preload increases in ventricular remodeling? - CORRECT ANSWER>>>> Ventricular dilatio n. What does ventricular dilation lead to? - CORRECT ANSWER>>>>F urther compromise in contraction and cardiac output. What is another term for congestive heart failure? - CORRECT ANSWER>>>> An old term that should not be used any longer. Can right ventricular systolic dysfunction occur in heart failure? - CORRECT ANSWER>>>> Yes, it can happen. What is the normal ejection fraction? - CORRECT ANSWER>>>> Greater than or equal to 50%. What is ventricular remodeling? - CORRECT ANSWER>>>>Patholo gical deterioration of myocytes. What triggers ventricular remodeling? - CORRECT ANSWER>>>>Pathologic insult to the myocardium. What is the initial dysfunction caused by ventricular remodeling? - CORRECT ANSWER>>>>Myocardial systolic dysfunction. What i s the role of baroreceptors in ventricular remodeling? - CORRECT ANSWER>>>>Detect low cardiac output and notify the medulla. What does the sympathetic nervous system release in response to low cardiac output? - CORRECT ANSWER>>>>Epinephrine and norepineph rine. What are the effects of epinephrine and norepinephrine in ventricular remodeling? - CORRECT ANSWER>>>>Vasoconstriction, increased afterload, blood pressure, and heart rate. What are the consequences of increased workload on the heart in ventricular remodeling? - CORRECT ANSWER>>>>Hypertrophy, dilation, and impaired contractility. What are the direct toxic effects of catecholamines on myocytes in ventricular remodeling? - CORRECT ANSWER>>>>Induce myocyte apoptosis and cause damage to the heart. What is the role of the renin -angiotensin -aldosterone system (RAAS) in ventricular remodeling? - CORRECT ANSWER>>>>Activation by decreased renal blood flow. What is the end result of the RAAS system in ventricular remodeling? - CORRECT ANSWER>>>>Release of a ngiotensin II and aldosterone. What are the effects of angiotensin II in ventricular remodeling? - CORRECT ANSWER>>>>Vasoconstriction, increased afterload, blood pressure, and left ventricular hypertrophy. What are the direct toxic effects of angiotensin II on myocytes in ventricular remodeling? - CORRECT ANSWER>>>>Contribute to sarcomere death, loss of normal collagen, and interstitial fibrosis. What are the effects of aldosterone in ventricular remodeling ? - CORRECT ANSWER>>>>Enhances renal sodium retention and water, increasing afterload and left ventricular hypertrophy. What are the consequences of aldosterone in ventricular remodeling? - CORRECT ANSWER>>>>Development of myocardial fibrosis, autonomic d ysfunction, and dysrhythmias. What is the role of arginine vasopressin (ADH) in heart failure? - CORRECT ANSWER>>>>ADH causes vasoconstriction and fluid retention. What are natriuretic peptides (ANP and BNP) and their role in heart failure? - CORRECT ANS WER>>>>ANP and BNP stimulate renal excretion of sodium but are not effective in heart failure. What are inflammatory cytokines and their role in heart failure? - CORRECT ANSWER>>>>Inflammatory cytokines, such as endothelin, TNF, and IL -6, are released and contribute to ventricular hypertrophy, remodeling, vasoconstriction, and immune activation. What medications are given to patients with HFrEF? - CORRECT ANSWER>>>>Beta blockers, ACE inhibitors, and ARBs are given to block the effects of catecholamines an d RAAS, preventing progression of heart failure and improving systolic function. What are the pathological effects of remodeling in heart failure? - CORRECT ANSWER>>>>Impaired myocyte calcium transport leads to decreased contractility. What is the role o f insulin resistance in heart failure? - CORRECT ANSWER>>>>Insulin resistance contributes to myocardial deterioration, abnormal myocyte fatty acid metabolism, ATP generation, and enhances the remodeling process. What are the effects of diabetes on heart f unction? - CORRECT ANSWER>>>>Diabetes causes a decrease in heart function, dysfunction in mitochondria, disrupted calcium metabolism, and altered fatty acid and glucose metabolism.
