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Dr. Younai Heart Failure

Total questions: 47

Worksheet time: 28mins

Name
Class
Date
1.

How do you define heart failure?

a)

It is a complex syndrome that can result from structural and functional cardiac defect that impairs the ability of the ventricle to effectively fill and eject the blood

b)

it is a complex syndrome that results in the heart not being able to structurally fill the heart

c)

the heart not working because systole and diastole are bad

d)

bad

2.

Why does heart failure occur?

a)

heart cant supply oxygen to the lungs

b)

heart cant supply oxygenated blood to meet the bodys metabolic needs

c)

heart is tired from pumping so much blood

d)

heart is sad because someone. broke it :(

3.

What does Heart Failure involve?

a)

It involves just systolic dysfunction

b)

it involves systolic dysfunction and diastolic dysfunction or both

c)

only sys and diastolic dysfunction

d)

it is when the heart cannot eject and relax

4.

Where is heart failure seen?

a)

Its seen in respiratory disease

b)

its seen in leg disease

c)

its seen in cardiovascular disease

5.

What are some cardiovascular diseases where the mycoytes are in dysfunction?

a)

eating too much sugar

b)

cardiomyopathies and myocarditis

c)

myocardititii

d)

cardivacsular disease

6.

Can cardiovascular diseases be seen with hypertension in the heart?

a)

yes it can be see when the heart has defects in the valve, defects from birth

b)

yes, it can also be seen with not enough blood flow in the heart (cardiac ischemia,) hypertension, valvular or congenital defects

c)

yes

d)

maybe

7.

what is systolic dysfunction?

a)

its when our ventricles dilate and this decreases contractility

b)

its when our ventricles do not dilate and this decreases contractility

c)

its when out ventricles get tired and can not long contract

d)

its when our ventricles are rapidly contractng

8.

what does systolic dysfunction lead to?

a)

cardiomegaly, reduced cardiac output and reduce ejection fraction

b)

cardiosmaller, large cardiac outlet, large ejection fraction

c)

a sad heart

d)

dysfunction of the heart

9.

What is diastolic dysfunction characterized by?

a)

It is characterized by an increased myocardial compliance but the contracting is initially normal

b)

decreased mycocardial compliance and the contraction is not normal

c)

it is characterized by a decreased myocardial compliance but the contracting is initially normal

d)

abnormal contraction

10.

What does diastolic dysfunction in the heart lead too?

a)

Asymmetrical involvement of IVS

b)

it leads to hypertrophy in the left ventricle

c)

Increased diastolic pressure but normal cardiac output

d)

a crying heart :(

11.

What are clinical signs to heart failure?

a)

may lead to sudden arrhythimia

b)

may lead to myocardial ischemia

c)

sudden death

d)

hypertension in the lungs

12.

What is diastolic dysfunction also seen with?

a)

hypertrophic and restrictive cardiomyopathies

b)

hypertension and restrictive cardiomyopathies

c)

cardiomyopthies only

d)

hytertension only

13.

What is a restrictive cardiomyopathy?

a)

its when the heart is reduced

b)

its when an abnormal protein shows up in your heart

c)

its when the myocardial or endocardial tissue of the heart is replaced with cancer, infiltrative or fibrotic disease

d)

its when the heart tissue is replaced with a spongy layer tissue

14.

when the heart is failing, what must it do?

a)

it must just go with the flow

b)

it must adapt to new mechanisms

c)

it has to find a way to survive

15.

Why must the heart adapt to a new mechanism when it is failing?

a)

to maintain pumping functions to keep is alive and to maintain cardiac output and adequate perfusion of vital organs

b)

it has to try to do something to keep the body alive

c)

to try to do something so it doesnt fail!!!

16.

What mechanism must the heart follow to adapt to heart failure?

a)

short term mechanisms

b)

long term mechanisms

c)

peripheral mechanisms

d)

middle mechanisms

17.

What are short term mechanisms?

a)

these are activated within a few hours

b)

activated within a few days

c)

activated within a few months

d)

activated within a few minutes

18.

What are peripheral mechanisms

a)

these are activated all of a sudden

b)

slow mechanisms

c)

these are activated rapidly but they continue over a long period of time

d)

dont work

19.

What are long term mechanisms

a)

mechanisms occurring over years

b)

mechanisms developed within weeks to months to save the heart from failure

c)

tries to help heart adaptive in a few minutes

d)

fast fixing the heart

20.

What is the Frank-Starling relationship?

a)

increasing the muscle length enhances the tension developed during contraction

b)

its a short term adaptive mechanisms

c)

long term mechanism

d)

decrease muscle length does not have tension during contraction

21.

What does an increased preload help maintain the cardiac performance with?

a)

with sleeping

b)

with normal activites

c)

with exercise

d)

with pumping blood

22.

What does the short term adaptive mechanisms activate?

a)

increases volume to activate the kidneys

b)

adregenergic system- increases contractility or the velocity with which the heart muscle contracts and also increases heart rate

c)

it activates the neurohumoral sytem

d)

increases heartrate

23.

What does Renin-angiotensin- aldosterone system maintain?

a)

it maintains arterial pressure and tissue perfusion

b)

increases the cardiac preload

c)

the immune system

d)

increases the cardiac afterload

24.

What is peripheral adaptive mechanisms defined as?

a)

its when cardiac output is working really really fast

b)

its when your cardiac output does not work anymore

c)

It is when the arterial pressure is maintained when you have a reduced cardiac output that is primitive but necessary and effective

25.

What is arteriolar constriction in peripheral adaptive mechanisms?

a)

blood is flowing to the non important parts of the body

b)

It is when the blood flow must be redistributed to more important parts of the body, blood goes from kidneys, skin, to brain and heart

c)

blood must be going everywhere in the body

d)

blood does not flow anymore

26.

Whats the increased venous tone in the peripheral adaptive mechanisms?

a)

Its when the blood shifts from the peripheral pool to the central circulation-- so blood is needed in the kidney so we take the blood away from other parts of our body

b)

it enhances ventricular filling and helps maintain cardiac output

c)

its when cardiac output doesnt work anymore

d)

your body needs blood in all parts of our body

27.

What is long term adaptive mechanisms

a)

Our heart is having a volume overload and this leads to ventricular dilation, increasing the demand of the heart

b)

its when the heart can handle the pressure being presented to it

c)

its when the heart can adapt to change

d)

stress does not affect the heart

28.

What does the law of laplace explain in long term adaptive mechanisms?

a)

T=PxR/M

b)

Its when the heart becomes distended and the radius increases and the wall tension does too to generate the same pressure

c)

its when the heart can handle the pressure

d)

heart is getting bigger and it is in the progression of heart failure

29.

What is mycardial remodeling in long term adaptive mechanisms

a)

When the heart has more pressure and higher wall tension, leadings to pathological ventricular remodeling

b)

we want to reduce wall tension, so wall thickness increases and this increases the muscle cells in our heart, our muscle mass leading to heart failure

c)

heart is remodeling because it can handle the change in mass

d)

heart needs some love

30.

When the heart is failing, what happens to the ejection fraction, end diatolic volume and pressure?

a)

EJ Increases

EDVP decreases

b)

EJ Decreases

EDVP Decreases

c)

EJ decreases

EDVP increases

d)

EJ increases

EDVP Increases

31.

What happens to the cardiac output when the heart is failing?

a)

decreases, the left ventricle is dysfunctional

b)

the resting cardiac output may be normal, but when we try exercising we may suddenly fall or collapse

c)

We can exercise even harder

d)

We are able to live a normal life and exercise constantly

32.

What are some other consequences of Heart Failure?

a)

Diabetes

b)

Blood Redistribution and Edema

c)

High blood sugar

33.

What occurs during blood redistribution in heart failure?

a)

our blood is flowing to every single part of our body now

b)

the heart is going back to normal

c)

Since our blood is going to our heart, other parts of out body are failing

34.

During Blood redistribution in heart failure,

a)

our skeletal muscles are weaking, anaerobic metabolism, lactic acidosis, weakness and fatigue

b)

liver dysfunction, reduced liver perfusion

c)

diminished renal perfusion, na and nitrogen retention

d)

lung failure

35.

During edema, meaning fluid is localized behind the chamber that is initially affected what is happening?

a)

left side failure leads to right side failure :(

b)

on the left side of our heart, we have pulmonary congestion, on the right side we have fluid accumulation

c)

intermitten claudication-- chronic ischemia of the legs with hypoxic pains while walking

d)

ankle edema, congestive hepatomegaly, ascites, pleural effusion

36.

What occurs in left side heart failure?

a)

myocarditis

b)

ischemia heart disease

c)

valve heart disease

d)

cardiomyopathy

37.

Right side heart failure comes from

a)

ischemia heart disease

b)

left side hf, lung disease, pulmonary hpertension, pulmonary emboli

c)

disease

d)

liver

38.

with increased hemodynamic overload and depressed myocardial contractility, what happens to co?

a)

it becomes depressed

b)

it increases

c)

it decreases

d)

its happy

39.

What happens in left sided heart failure?

a)

tachnypea-- increased rate of respiration

rales-- indicating fliud in alveolar spaces

b)

dyspnea- not feeling enough air, feels like ur choking

c)

orthopnea-- difficulty breathing when lying down

d)

paroysmal noctural dyspnea-- sudden inability to breathe, awakeing patient during night

40.

What is assocaited with right side heart failure?

a)

congestion of organs such as liver

b)

clubbing of fingers and cyanosis

c)

swelling, jugular venous distension, and increased jugular vein pressure

d)

edema of lower extremities

41.

What is a pulmonary edema

a)

its fluid moving into interstitial and alveolar spaces, it has to do with profuse sweating and cyanosis

b)

its when you are drowning in your own fliud

c)

but its not always related to heart failure, but it is life threatening and needs to be treated immediately

d)

its when you are okay and nothing happens to your body

42.

What is a chest xray used for?

a)

shows the heart enlarged and pulmonary congestion

b)

used for seeing smoke in your lungs

c)

used to see the liver

d)

used to see how your heart is beating

43.

What is the swan ganz catheter used for?

a)

checking out the heart dancing

b)

it measures the pressure in both the right and left side of the heart with wedging

c)

its when you want to check ur heart beat

44.

Whats an echocardiogram?

a)

its a ultrasound of the heart

b)

is shows the differenes between systolic and diastolic failure

c)

it is when u see the heart beat

45.

What is BNP? B TYPE NATRIURETIC PEDPTIDE?

a)

looks at cardiac vs non cardiac causes of dyspnea

b)

a peptide releassed from the ventricles in the heart in response to changes in ventricular filling pressure

c)

causes natriuresis and vasodilation

d)

its when ur heart is sleeping

46.

define serum electrolytes

a)

seeing the renal functions, aka looking at kidney electrolytes

electrolytes are minerals in blood and other body fliuds that carry an electric charge

b)

looking at the sugars in the kidney

47.

dental implications to heart failure

a)

pay attention to pulmonary edema, ankles

b)

control levels of stress

c)

ask about their diseases, medical history, make sure they dont sit flat in the chair if they cannot, they might not get air.

d)

watch for medication interactiions