Patho Exam 3

It is a medical condition characterized by an elevation of any or all lipid profiles and or lipoproteins in the blood

Probably genetically-based

it may result from diseases such as diabetes, thyroid disease, renal disorders, liver disorders, Cushing syndrome, obesity, alcohol consumption, estrogen administration, and other drug associated changes in lipid metabolism

Low density lipoproteins or LDL

A condition in which an artery wall thickens as a result of the accumulation of fatty material

Occlusion and necrosis of tissue distal to the occlusion

Age, gender, family history, genetic disorders, diet, exercise, hypertension, cigarette smoking, hyperlipidemia

a complete lipid profile

They have thick fiberous caps, they partially blocke vessels, and do not tend to form clots

they have thin fibrous caps, plaque can rupture and cause a clot to form, may completely block the artery, the clot may break free and become an embolus

Refers to the obstruction of large arteries that supply the bodies peripheral structures or a term used to refer to atherosclerotic blockages found in the lower extremities

Men ages 60 to 70

intermittent claudication, thinning of skin, atrophy of leg muscles, color changes, peripheral pulses weak or absent, skin breakdown, eventual necrosis and gangrene

Cigarette smoking and diabetes mellitus

it is a functional disorder caused by intense vasospasm of the arteries and arterioles in the fingers and less often the toes

It is seen in otherwise healthy young woman, and it is often precipitated by exposure to cold or by strong emotions and usually is limited to the fingers

it is associated with previous vessel injury such as frostbite, occupational trauma associated with the use of heavy vibrating tools, collagen diseases, neurologic disorders, chronic arterial occlusive disorders, and drugs

Cold, pale, cyanotic hands and fingers leading to hyperemia, warm reddend burning and throbbing fingers with minimal pain

A limiting factors that cause vasospasm, protecting digits from trauma during ischemic episode, administrating medication to cause vasodilation

is a pathological outpouching or sac-like dilation in the wall of a blood vessel usually caused by weakening of the vessel wall

It is a small spherical dilation of the vessel at a bifurcation usually found in The Circle of Willis in a cerebral circulation

It involves the entire circumference of the vessel and is characterized by gradual and progressive dilation of the vessel and may involve the entire ascending or transverse proportions of the thoracic aorta

Extends over part of the circumference of the vessel and appears sac-like

it is a false aneurysm resulting from a tear in the intimal layer of the vessel that allows blood to enter the vessel wall dissecting its layers to create a blood-filled cavity

It is an abdominal aortic aneurysm that can involve any part of the aorta with multiple aneurysms possibly present

Atherosclerosis, hypertension, degeneration of vessel wall caused by trauma, congenital issues, or infection

Pulsatile mass, often asystomatic, sometimes there's pain

it is any acute life-threatening condition that involves hemorrhaging into the vessel wall and tearing of the vessel wall

Tearing or ripping pain, blood pressure changes, panting, and paralysis of lower extremities

Controlling the blood pressure, surgery, or beta-blockers and sodium nitroprusside

Hypertension not due to disease

Family history, race, and age

High sodium diet, obesity, smoking, and excessive alcohol consumption

It is an elevation of blood pressure due to another disease condition

Renal hypertension, disorders of adrenocortical hormones, pheochromocytomas, coarctation of the aorta, oral contraceptive drugs

Family history, race, age, metabolic X syndrome, smoking, high sodium intake, obesity, physical inactivity, excessive alcohol use, hormonal contraceptive, and sleep apnea

Heart, brain, kidney, retina, peripheral vascular

Lifestyle modifications, medication, and the DASH diet

When our vessels have incomplete valve closure that allows blood to flow backward and increase pressure

Being a woman over the age of 50, obesity, hereditary factors, pregnancy, long periods of standing, and heavy lifting

Incompetent valves or increased intra-abdominal pressure as in pregnancy

Torturous appearance, aching, and edema

Avoid risk factors, support pantyhose, sclerotherapy, vein stripping

It's a disorder that results from Progressive valvular incompetence to deep veins or deep vein thrombosis

Edema, brown skin pigmentation, stasis ulcer formation if advanced

Compression therapy, skin grafting may be necessary to close large or slow healing venous ulcers, growth factors

Formation of a blood clot in a vein

Stasis of blood, vessel wall injury, increased coagulopathy

Bed rest post surgery, immobilization, impaired cardiac function, airplane travel, elderly, hormonal contraception

Pain, swelling, muscle tenderness, fever, malaise, increased white blood cell count, increased erythrocyte sedimentation rate

Prevention (increased activity), anticoagulation (Heparin drip), surgical removal

Is heart disease caused by impaired coronary blood flow

The inability of the coronary arteries to supply blood to meet the metabolic demand of the heart

Atherosclerosus, vasospasm, thrombosis

The cold, stress, or exercise

Pain that occurs when the heart's oxygen demand increases

Pain when coronary arteries spasm

Myocardial ischemia without pain

Constricting, squeezing, suffocating pressure that may radiate to the shoulder, jaw, or arm, nausea/vomiting, diaphoresis, pallor, weakness

It represents a spectrum of acute ischemic heart disease ranging from unstable angina, non ST-segment elevation myocardial infarction, ST segment elevation myocardial infarction

It is the stage between stable angina and myocardial infarction, plaque disruption and platelet aggregation impairs but does not occlude coronary blood flow, and there is no evidence of myocardial damage

New in onset, occurs at rest, worsening pattern, increases in frequency, unpredictable, myocardial emergency, symptoms in women may be more vague

A complete or nearly complete occlusion of a coronary artery

Emotional distress, activity, cold, time of day

It could be normal, have an ST-segment depression, or have T-wave changes

Troponin T and Troponin I

It is occlusion of coronary artery causing the necrosis of myocardial tissue distal to the block

Atypical chest, nausea or dizziness, shortness of breath, difficulty breathing, anxiety, weakness or fatigue, palpitations, cold sweat or paleness

Check vitals, establish IV access, take a brief focused history and perform a physical exam, complete the fibrinolytic checklist and check for contraindications, obtain a 12 lead ECG, obtain blood sample to evaluate initial cardiac markers, electrolytes and coagulation, obtain and review portable chest x-ray

T wave inversion, ST segment changes, abnormal Q wave, proteins released from necrotic heart muscles

Myoglobin, creatine kinase (CK-MB), Troponin I and Troponin T

Coronary angiography, exercise or pharmacologic stress testing, echocardiogram

Morphine, oxygen therapy, nitrates, aspirin (not if person has taken Viagra recently)

Produces CNS analgesia, reduces the adverse effects of neurohumoral activation, produces venodilation, decreases systemic vascular resistance

If the patient is dyspneic, hypoxemic, obvious signs of heart failure, O2 sat is less than 94%

Only if the patient remains hemodynamically stable

Beta blockade and intravenous nitroglycerin

Aspirin, streptokinase, urokinase, tissue-type plasminogen activator (t-PA), intravenous Heparin or a glycoprotein llb/llla is usually continued

A stent or a balloon angioplasty

Leukocytes infiltrate the area of cell death

Proteolytic enzymes of neutrophils and macrophages begin to remove the necrotic tissue

The scar tissue is still weak and the heart muscle is vulnerable to stress

Scar tissue has replaced necrotic tissue and the area is healed but less compliant

Normal myocardium will hypertrophy and I like in an attempt to compensate for the infarcted muscle

Dysrhythmias, heart failure, cardiogenic shock, papillary muscle dysfunction, ventricular aneurysm, acute pericarditis, Dressler syndrome

Dysrhythmias

Severe LV failure

heart failure, dysrhythmias, and angina

An inflammation of visceral and or parietal pericardium that may result in cardiac tamponade, decreased left ventricle filling and emptying, and heart failure

Pericarditis with effusion and fever that develops 4 to 6 weeks after MI

Pericardial pain, pericardial friction rub, pericardial effusion, arthralgia

It is a life-threatening infection of the inner surface of the heart including heart valves. Staphylococci, HACEK group, and streptococcal

Fever, chills, increased white blood cell count, new murmur or change in an existing murmur, and signs of systemic emboli (splinter hemorrhages)

Blood cultures and transesophageal endocardiogram

Antibiotic therapy through a PIC line or prophylaxis for dental procedures for patient with history of valve disease

It is an immune mediated multisystem inflammatory disease involving the heart, skin, and connective tissue that follows a group a beta hemolytic streptococcal pharyngitis

Fever, history of strep throat, polyarthritis, erythema margination on the chest, chorea

Penicillin, aspirin, corticosteroids, limited exercise

A stenotic valve does not open normally and prevents forward flow of blood

A leaky valve allows blood to regurgitate backward into the chamber it came from

It's when blood has difficulty getting from the left atrium to the left ventricle, the left atrium dilates and it's pressure increases, which leads to pulmonary congestion

Shortness of breath, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, cough, fatigue, low O2 saturation

It's backflow from left ventricle to left atrium which can cause compensatory changes that lead to left atrial hypertrophy and left ventricular hypertrophy which leads to pulmonary congestion

Pulmonary congestion, chronic weakness, fatigue, murmur, other symptoms similar to mitral stenosis

Osteogenesis imperfecta or Marfan syndrome

it's resistance to flow from the left ventricle to aorta which leads to left ventricular hypertrophy which leads to heart failure

Exertional dyspnea, exercise intolerance, syncope, angina, fatigability, peripheral cyanosis, loud systolic ejection murmur or sudden death

Dyspnea, orthopnea, paroxysmal nocturnal dyspnea

Inflammation of the pericardium of less than 2 weeks

Viral is the most common, bacterial, connective tissue disease, neoplastic invasion, or trauma

Chest pain, pericardial friction rub, EKG changes and it is treated by NSAIDs such as ibuprofen or antibiotics if it's bacterial

It is an accumulation of fluid in the pericardial cavity, usually as a result of inflammation or infectious process

Infection, inflammation, neoplasms, cardiac surgery, or trauma

If it's small we use a diuretic or anti-inflammatory drug if it's large we do a pericardiocentesis

the left ventricle cannot accept enough blood which leads to decreased cardiac output which leads to decreased blood pressure and shock. The right ventricle cannot accept enough blood which leads to increased venous pressure and jugular distension

Compression of the heart due to fluid accumulation in the pericardial Sac so the heart can't fill property

On inhaling the right ventricle fills with extra blood because of outside pressure from fluid bulging into the left ventricle on the next heartbeat the left ventricle does not send out much blood which means the systolic blood pressure drops

The myocardium loses ability to pump effectively and the malfunctioning heart muscle can cause heart failure

Hypertrophic cardiomyopathy, restrictive cardiomyopathy, dilated cardiomyopathy

It is a defect in the contractile proteins that make cells too weak, the cells hypertrophy to do the same amount of work as normal cells which results in thickened myocardial walls especially the septum and results in poor relaxation, filling, and pumping

Dyspnea, chest pain, syncope, arrhythmias, sudden cardiac death

Focused on symptom management, decreased activity, pacemaker or defibrillator, medications such as beta blockers, and septal myomectomy

ventricular filling is restricted because of excessive rigidity of The ventricle walls not thickening it can be idiopathic or secondary

Dyspnea on exertion, paroxysmal nocturnal dyspnea, peripheral edema, ascites, fatigue, or weakness

Dilation of chambers of heart causes cardiomegaly wall thinning weakens pumping ability which leads to heart failure

It can be genetic, or caused by infection, pregnancy, alcohol use, and is sometimes idiopathic

Dyspnea on exertion, paroxysmal nocturnal dyspnea, fatigue, fluid retention, reduced exercise tolerance, orthopnea or weakness

Beta blockers, diuretics, ACE inhibitors, anticoagulants

Atrial septal defects, ventral septal defects, patent ductus arteriosus, pulmonary stenosis, tetralogy of fallot, transposition of the great vessels, coarctation of the aorta

Myocardial infarction, coronary heart disease, without disease, congenital defects, or cardiomyopathies

60% it is used to evaluate or measure overall heart function

The lungs

The veins

Left side will lead to decreased cardiac output decreased O2 rich blood to brain kidneys and extremities and lead to activity intolerance and mild confusion. Right sided heart failure means the blood is unable to effectively pump to the lungs and if decrease supply to the left side will have decreased cardiac output

It's when fluid is pushed into the alveoli in the lungs due to congestive heart failure

It is Contracting

It is the relationship between diastolic volume and myocardial contraction, increased volume equals increased contraction

Increase stroke volume or increase heart rate or increase both

It goes out to the peripheral tissues and picks up low-density lipoproteins and carries it back to the liver

Peripheral artery disease

The malnourished, incarcerated, immunosuppressed, immigrants, elderly, and overcrowded

The macrophages take 3 to 6 weeks to develop a positive test

Mycobacterium tuberculosis hominis

Small cell is strongly associated with cigarette smoking and non-small cell squamous is more common in men and smokers with adenocarcinoma being more common in women and non-smokers

It is nodules in the lung tissue in the lymph nodes with caseous necrosis inside the nodules and calcium may deposit in the fatty area of necrosis and they are visible on x-rays

The symptoms are fever, rales, chills, productive cough, and sputum, or an abnormal chest x-ray. It is treated depending on which pneumonia it is

The microbes enter the lung where they multiply, the lungs inflame and the alveoli fill with exudate

Acute sinusitis symptoms are Facial Pain, headache, purulent nasal discharge, decreased sense of smell and fever. Chronic sinusitis symptoms are nasal obstruction, fullness in the ears, post nasal drip, hoarseness, chronic cough, loss of taste and smell, unpleasant breath, and headache

The common cold is is much less serious than the flu in the flu is the cause of over 35,000 deaths annually

High fever, pleuritis, lymphadenitis, may spread to other organs

Low grade fever, pleuritis, night sweats, easy fatigability, anorexia, weight loss, chronic cough, dyspnea or orthopnea

The shift will happen in the opposite direction of the affected lung (if the right lung is affected the shift will go left, if the left lung is affected the sheriff will go right)

We treat the underlying cause (antibiotics if it's an empyema) or do a thoracentesis if it's a hemothorax

Tension pneumothorax because the air enters the pleural cavity but cannot leave

It is an incomplete expansion of a lung or portion of the lung and if it is common after surgery or in patients who are in the hospital

An allergen is introduced to the lungs which leads to mast cells releasing inflammatory mediators which leads to white blood cells entering the region and releasing more inflammatory mediators

Unstable plaques

Cool, pale, clammy skin; drop in systolic blood pressure, tachycardia, rapid respirations, oliguria, anxiety, confusion, narrowing pulse pressure, crackles in lungs, neck vein distention, faint heart sounds or a murmur