Module 11: Alterations of Cardiovascular Function

Created by cherryobebe 

Upgrade to
remove ads

85 terms

The heart chamber that receives blood from the pulmonary circulation is the:

A) right atrium.
B) right ventricle.
C) left atrium.
D) left ventricle.

C) left atrium.

Which heart valve is situated between the right atrium and right ventricle?

A) Tricuspid
B) Bicuspid
C) Mitral
D) Semilunar

A) Tricuspid

The vessels that supply oxygen to the heart muscle are the:

A) cardiac veins.
B) myocardial arteries.
C) carotid arteries.
D) coronary arteries.

D) coronary arteries.

Which electrolyte accounts for the plateau seen in the action potential of contractile cardiac muscle cells?

A) Calcium
B) Sodium
C) Magnesium
D) Chlorine

A) Calcium

Which structure serves as the pacemaker for the heart's rhythmic contractions?

A) Bundle of His
B) Sinoatrial node
C) Coronary sinus
D) Atrioventricular node

B) Sinoatrial node

The effect of catecholamines on the heart is to:

A) increase the refractory period.
B) decrease calcium influx.
C) increase the strength of myocardial contraction.
D) decrease the heart rate.

C) increase the strength of myocardial contraction.

The pressure of the volume in the ventricle at the end of diastole is called:

A) ventricular resistance.
B) preload.
C) surface tension.
D) afterload.

B) preload.

According to the Starling law of the heart, a small increase in left ventricular end-diastolic volume in the healthy heart will result in:

A) a decrease in force of contraction.
B) an increase in myocardial oxygenation.
C) an increase in heart rate.
D) an increase in cardiac output.

D) an increase in cardiac output.

Left ventricular afterload is determined by:

A) left end-diastolic pressure.
B) pulmonary vascular resistance.
C) systemic vascular resistance.
D) left ventricular compliance.

C) systemic vascular resistance.

Multiplying heart rate by stroke volume determines:

A) vascular resistance.
B) cardiac output.
C) ejection fraction.
D) preload.

B) cardiac output.

Which of the following will cause an increased myocardial workload and oxygen demand?

A) Parasympathetic stimulation
B) Decrease in myocardial metabolism
C) Increased systemic vascular resistance
D) Decreased preload

C) Increased systemic vascular resistance

Which tissue forms the internal lining of the blood vessels?

A) Columnar epithelium
B) Connective
C) Mesothelium
D) Endothelium

D) Endothelium

Exchange of nutrients between the blood and the tissues takes place in the:

A) arteries.
B) veins.
C) blood capillaries.
D) lymphatic capillaries.

C) blood capillaries.

Arterial baroreceptors are located in the:

A) renal artery.
B) superior vena cava.
C) aortic arch.
D) circle of Willis.

C) aortic arch.

Which of the following statements correctly describes a direct end-effect of the renin-angiotensin-aldosterone system?

A) Renin promotes the excretion of sodium and water in the renal tubules.
B) Aldosterone increases renal reabsorption of water and sodium.
C) Angiotensin II causes systemic vasodilation.
D) Angiotensin I promotes water retention by the kidneys without affecting sodium reabsorption.

B) Aldosterone increases renal reabsorption of water and sodium.

The heart chamber that pumps blood to the systemic circulation is the:

A) right ventricle.
B) right atrium.
C) left ventricle.
D) left atrium.

C) left ventricle.

In the cardiac cycle, the ventricles contract during:

A) the refractory period.
B) diastole.
C) repolarization.
D) systole.

D) systole.

The effect of sympathetic nervous system stimulation on the heart is to:

A) increase the refractory period.
B) increase the heart rate.
C) decrease calcium influx.
D) decrease the strength of myocardial contraction.

C) decrease calcium influx.

The effect of stimulating alpha1 receptors is:

A) increasing blood flow to the heart.
B) vasoconstriction.
C) decreased vascular resistance.
D) increased heart rate.

B) vasoconstriction.

Which of the following will cause a decrease in oxygen delivery to the organs and other peripheral tissues?

A) Anemia
B) Hypoxemia
C) Systemic edema
D) All of the above

D) All of the above

Which of the following molecules forms a meshwork to stabilize the platelet plug during hemostasis?

A) Fibrin
B) Collagen
C) Thrombin
D) Fibrinogen

A) Fibrin

Which of the following events initiates the process of atherosclerosis?

A) Oxidation of LDL in the vessel wall
B) Formation of the fatty streak in the tunica media
C) Thrombosis in the vessel lumen
D) Endothelial injury and release of cytokines

D) Endothelial injury and release of cytokines

The most common consequence of atherosclerosis is:

A) increased blood flow through the diseased vessels.
B) formation of aneurysms.
C) autoimmune destruction of the vessel wall.
D) obstruction of the blood vessel lumen.

D) obstruction of the blood vessel lumen.

Factors associated with endothelial injury in atherosclerosis include all of the following except:

A) autoimmunity.
B) anemia.
C) bacterial infection.
D) smoking.

B) anemia

Which of the following white blood cells play a role in the development of the fatty streak in atherosclerosis?

A) Mast cells
B) Neutrophils
C) Macrophages
D) Lymphocytes

C) Macrophages

Which of the following forms of hyperdyslipidemia is associated with the development of the fatty streak in atherosclerosis?

A) High LDL
B) Low LDL
C) High HDL
D) Low triglycerides

A) High LDL

Mitogens, such as angiotensin II, contribute to the development of atherosclerosis by stimulating which of the following events?

A) Smooth muscle proliferation
B) Endothelial injury
C) Cardiac muscle toxicity
D) Activation of phagocytes

A) Smooth muscle proliferation

An unstable plaque in the coronary arteries can result in which of the following complications?

A) Myocardial infarction
B) Stable angina
C) Hypertension
D) Abnormal vasodilation

A) Myocardial infarction

According to the Joint National Commission Seventh Report (JNC VII), normal blood pressure is defined as:

A) systolic pressure greater than 140 mm Hg and diastolic pressure greater than 90 mm Hg.
B) systolic pressure less than 150 mm Hg and diastolic pressure less than 100 mm Hg.
C) systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg.
D) systolic pressure greater than 130 mm Hg regardless of diastolic pressure.

C) systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg.

In the development of primary hypertension, increased sympathetic nervous system (SNS) activity causes:

A) decreased heart rate.
B) increased renal excretion of sodium.
C) peripheral vasoconstriction.
D) decreased insulin resistance.

C) peripheral vasoconstriction.

Dysfunction in the normal secretion of natriuretic hormones affects renal reabsorption of:

A) water only.
B) calcium.
C) sodium.
D) aldosterone.

C) sodium.

A risk factor that is associated with atherosclerosis and primary hypertension is:

A) a high sodium diet.
B) advanced age.
C) hyperhomocysteinemia.
D) a low potassium diet.

B) advanced age.

Over time, sustained hypertension can result in which of the following problems?

A) Insulin resistance
B) Vascular remodeling
C) Retention of fluid by the kidneys
D) Hormone dysfunction

B) Vascular remodeling

Complications of sustained hypertension include which of the following?

A) Retinal damage
B) Stroke
C) Renal disease
D) All of the above

D) All of the above

Malignant hypertension can result in which of the following life-threatening complications?

A) Cerebrovascular accident
B) Encephalopathy
C) Cardiac failure
D) All of the above

D) All of the above

Atherosclerosis of the aorta can cause isolated systolic hypertension by:

A) promoting thrombus formation.
B) stimulating increased cardiac output.
C) decreasing arterial distensibility.
D) increasing lumen diameter.

C) decreasing arterial distensibility.

An individual with secondary hypertension has an abnormal blood pressure caused by:

A) prolonged primary hypertension.
B) high sodium intake.
C) genetics.
D) a systemic disease.

D) a systemic disease.

Orthostatic hypotension refers to a decrease in both systolic and diastolic blood pressure when an individual:

A) sleeps.
B) exercises.
C) sits down.
D) stands up.

D) stands up.

Older adults with chronic orthostatic hypotension are at risk for:

A) aneurysms.
B) heart failure.
C) falls.
D) atherosclerosis.

C) falls.

A ruptured cerebral aneurysm often will result in:

A) stroke.
B) myocardial infarction.
C) hypotension from blood loss.
D) pulmonary embolism.

A) stroke.

The pathophysiology of deep venous thrombosis (DVT) can be described though three processes, known as Virchow's triad. Which of the following is not a component of Virchow's triad?

A) Endothelial injury
B) LDL accumulation
C) Venous stasis
D) Hypercoagulable state

B) LDL accumulation

Clinical manifestations of a deep vein thrombosis (DVT) in the lower leg include:

A) pain and edema in the affected limb.
B) muscle paralysis.
C) reduced pulses in the foot.
D) skin pallor in the area of the thrombosis.

A) pain and edema in the affected limb.

Which of the following patients should be monitored for superior vena cava syndrome?

A) A 76-year-old man with congestive heart failure
B) A 56-year-old woman with bronchogenic (lung) cancer
C) A 26-year-old woman who has just delivered her first child
D) A 6-year-old child with severe asthma

B) A 56-year-old woman with bronchogenic (lung) cancer

Individuals with Raynaud disease experience vasospasm in the small arteries of the fingers under which of the following conditions?

A) Allergic reactions
B) Cold exposure
C) Hot water immersion
D) Tissue injury

B) Cold exposure

Standing for long periods of time causes blood to pool in superficial veins. The result is the development of:

A) pressure ulcers.
B) varicose veins.
C) emboli.
D) thromboangiitis obliterans (Buerger disease).

B) varicose veins.

The most common cause of coronary artery disease is:

A) myocarditis.
B) hypoglycemia.
C) atherosclerosis.
D) vasospasm.

C) atherosclerosis.

Symptoms of stable angina include all of the following except:

A) severe substernal pain that lasts more than a few hours.
B) discomfort that radiates to the left neck or jaw.
C) dizziness.
D) shortness of breath.

A) severe substernal pain that lasts more than a few hours.

Prinzmetal angina is caused by:

A) blood clots in the coronary artery.
B) hypoxemia from respiratory disease.
C) vasospasm.
D) deep vein thromboses.

C) vasospasm.

Which of the following chronic diseases places an individual at high risk for silent myocardial ischemia caused by dysfunction of the autonomic nerves carrying sensory information to the brain?

A) Alzheimer disease
B) Diabetes mellitus
C) Hypertension
D) Emphysema

B) Diabetes mellitus

Why is myocardial ischemia usually reversible within 20 minutes of interruption of coronary blood flow?

A) The heart stores approximately 20 minutes worth of oxygen supply in the myoglobin.
B) Collateral blood flow to the myocardium can maintain the myocardium for 20 minutes.
C) It takes 20 minutes for neutrophils and macrophages to arrive and activate inflammation.
D) Anaerobic metabolism maintains cellular integrity for approximately 20 minutes.

D) Anaerobic metabolism maintains cellular integrity for approximately 20 minutes.

The most important component in the development of acute coronary syndromes is a decrease in supply or an increase in demand for:

A) potassium and sodium.
B) glucose.
C) myoglobin.
D) oxygen.

D) oxygen.

Unstable angina is considered a precursor to:

A) myocardial ischemia.
B) myocardial infarction.
C) acute coronary syndromes.
D) pericarditis.

B) myocardial infarction.

Elevated levels of which of the following markers are indicative of an acute myocardial infarction?

A) Albumin
B) Sodium
C) Isoenzyme of creatine phosphate (CK-MB) and Troponin 1
D) LDL

C) Isoenzyme of creatine phosphate (CK-MB) and Troponin 1

When a myocardial infarction occurs, the myocardial cells surrounding the infarct undergo structural and functional changes. Which one of the following changes can be observed in these tissues following a myocardial infarction?

A) Temporary increase in contractile activity
B) Increased metabolism
C) Myocardial remodeling
D) Necrosis

C) Myocardial remodeling

Which of the following conditions is caused by the collection of fluid in the pericardial sac, resulting in tamponade?

A) Pericardial rub
B) Pericardial effusion
C) Cardiomyopathy
D) Constrictive pericarditis

B) Pericardial effusion

Aortic stenosis results in the incomplete emptying of the:

A) right atrium.
B) right ventricle.
C) left atrium.
D) left ventricle.

D) left ventricle.

Which of the following valve disorders is most likely to result in left ventricular failure?

A) Aortic stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) All of the above

D) All of the above

The most common cardiac valve disease in the United States, which tends to be most prevalent in young women, is:

A) mitral valve prolapse.
B) pulmonary stenosis.
C) tricuspid regurgitation.
D) aortic stenosis.

A) mitral valve prolapse.

In the elderly, aortic stenosis usually results from which of the following conditions?

A) congenital disorders.
B) rheumatic heart disease.
C) degeneration and calcification of the valve.
D) Marfan syndrome.

C) degeneration and calcification of the valve.

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following can result in both types of valve dysfunction?

A) Rheumatic heart disease
B) Syphilis infection
C) Connective tissue disorders
D) Heart failure

A) Rheumatic heart disease

Infective endocarditis is most often caused by:

A) viruses.
B) bacteria.
C) fungi.
D) autoimmunity.

B) bacteria.

Congestive heart failure (CHF) results in which of the following intraventricular hemodynamic changes?

A) Increased left ventricular preload
B) Increased ejection fraction
C) Decreased right ventricular preload
D) Decreased right ventricular end-diastolic pressure

A) Increased left ventricular preload

A patient is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures generally results from this condition?

A) Right heart failure
B) Left heart failure
C) Low-output failure
D) High-output failure

A) Right heart failure

Of the following diseases, which is the most common cause of right heart failure?

A) Primary hypertension
B) Infective endocarditis
C) Left heart failure
D) Pericarditis

C) Left heart failure

Manifestations of increased left atrial and pulmonary venous pressures in left (congestive) heart failure include:

A) syncope.
B) weak pulses and decreased skin temperature.
C) oliguria.
D) dyspnea and cough.

D) dyspnea and cough.

Which problem is a pathophysiological consequence common to all shock states?

A) Hypoperfusion
B) Vasoconstriction
C) Pulmonary edema
D) Hypertension

A) Hypoperfusion

A consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:

A) increased ATP production.
B) cellular dehydration.
C) lactic acidosis.
D) free radical formation.

C) lactic acidosis.

In shock, how does the body maintain blood glucose levels once available glucose and glycogen stores are used up?

A) By stimulating the release of glucose stores from the spleen
B) By breaking down protein to fuel gluconeogenesis
C) By converting urea and ammonia to glucose
D) By inhibiting the release of cortisol and thyroid hormone

B) By breaking down protein to fuel gluconeogenesis

Which of the following conditions is not a potential cause of cardiogenic shock?

A) Tension pneumothorax
B) Spinal cord injury
C) Tamponade
D) Cardiac arrhythmias

B) Spinal cord injury

Which of the following shock states manifests with tachycardia, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment?

A) Anaphylactic
B) Hypovolemic
C) Neurogenic
D) Septic

B) Hypovolemic

Which of the following shock states is (are) characterized by vasodilation of the systemic arteries?

A) Hypovolemic
B) Cardiogenic
C) Distributive
D) All of the above

C) Distributive

Which of the following shock states is (are) characterized by acute, severe bronchoconstriction?

A) Cardiogenic
B) Anaphylactic
C) Hypovolemic
D) All of the above

B) Anaphylactic

Causes of hypovolemic shock include all of the following except:

A) dehydration.
B) blood loss.
C) brainstem injury.
D) diuresis.

C) brainstem injury.

Clinical manifestations of hypovolemic shock include all of the following except:

A) pulmonary edema.
B) tachycardia.
C) hypotension.
D) oliguria.

A) pulmonary edema.

Neurogenic shock is caused by:

A) spinal cord injuries below T6.
B) inhibition of the parasympathetic nervous system.
C) injury to the cerebral cortex.
D) a lack of sympathetic activity.

D) a lack of sympathetic activity.

Which of the following pathophysiological events causes the severe hypotension observed in neurogenic shock?

A) Increased capillary permeability
B) Diuresis
C) Decreased peripheral vascular resistance
D) All of the above

C) Decreased peripheral vascular resistance

Anaphylactic shock occurs in response to severe:

A) viral infections.
B) allergic reactions.
C) brain injuries.
D) burn injuries.

B) allergic reactions.

Anaphylactic shock manifests with the rapid onset of which set of symptoms?

A) Bradycardia, decreased arterial pressure, and oliguria
B) Dyspnea, hypotension, and urticaria
C) Hypertension, anxiety, and tachycardia
D) Fever, hypotension, and erythematous rash

B) Dyspnea, hypotension, and urticaria

Which of the following conditions presents the most significant risk factor for developing septic shock?

A) Use of immunosuppressant medications
B) History of severe allergies
C) Diagnosed with chronic congestive heart failure
D) Genetic predisposition to disorders of hemostasis

A) Use of immunosuppressant medications

What is the primary cause of hypotension in early stages of septic shock?

A) Blood loss
B) Arterial vasodilation
C) Activation of the parasympathetic nervous system
D) Heart failure

B) Arterial vasodilation

Which set of clinical manifestations is highly characteristic of a septic shock state?

A) Tachycardia, generalized edema, and warm skin
B) Confusion, bradycardia, and truncal rash
C) Severe respiratory distress, jugular venous distention, and chest pain
D) Decreased cardiac output, hypertension, and poor skin turgor

A) Tachycardia, generalized edema, and warm skin

Low levels of which molecule contributes to the pathophysiology of septic shock?

A) Nitric oxide
B) Interleukin 1
C) Activated protein C
D) Epinephrine

C) Activated protein C

The most common cause of multiple organ dysfunction syndrome (MODS) is:

A) myocardial infarction.
B) septic shock.
C) chronic pulmonary disease.
D) autoimmune disease.

B) septic shock.

Secondary MODS is defined as the progressive dysfunction of two or more organ systems resulting from:

A) a drug overdose.
B) severe hemorrhaging.
C) an uncontrolled inflammatory response.
D) myocardial depression.

C) an uncontrolled inflammatory response.

In MODS, which of the following events contribute to organ failure?

A) Microvascular clotting
B) Interstitial edema
C) Exhaustion of fuel supply
D) All of the above

D) All of the above

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

NEW! Voice Recording

Click the mic to start.

Create Set