17. Shock & IHD
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Questions and Answers

What happens during Stage I of shock?

  • Heart rate increases while blood pressure remains normal. (correct)
  • Compensatory mechanisms fail completely.
  • Multiple organ failure occurs.
  • Blood pressure decreases rapidly.

    • What is a significant risk associated with prolonged decompensation in shock?

  • Decreased metabolic demand.
  • Irreversible organ damage. (correct)
  • Hypotension reversibility.
  • Improved organ perfusion.

    • Which type of shock is characterized by hypotension and a weak/rapid pulse?

  • Hypovolemic shock. (correct)
  • Anaphylactic shock.
  • Neurogenic shock.
  • Septic shock.

    • What primarily causes ischemic heart disease (IHD)?

    <p>Atherosclerosis in the coronary arteries. (B)</p> Signup and view all the answers

    What can exacerbate ischemic heart disease?

    <p>Increased metabolic demand. (C)</p> Signup and view all the answers

    Which statement about septic shock is true?

    <p>The skin may initially appear warm and flushed. (D)</p> Signup and view all the answers

    What is the common consequence when compensation fails in Stage II of shock?

    <p>Development of metabolic acidosis. (D)</p> Signup and view all the answers

    What often leads to sudden occlusion in ischemic heart disease?

    <p>Ruptured atherosclerotic plaques. (A)</p> Signup and view all the answers

    What characterizes the early cellular changes in the initial minutes following myocardial ischemia?

    <p>Swelling and loss of glycogen (B)</p> Signup and view all the answers

    What indicates irreversible myocyte injury 30-60 minutes post-ischemia?

    <p>Swollen mitochondria (B)</p> Signup and view all the answers

    What is a consequence of ATP depletion in myocardial cells?

    <p>Impaired energy-dependent functions (D)</p> Signup and view all the answers

    Which process can trigger apoptosis in myocardial cells?

    <p>DNA injury (C)</p> Signup and view all the answers

    What effect does increased intracellular calcium have during myocardial ischemia?

    <p>Activates cellular enzymes promoting necrosis (A)</p> Signup and view all the answers

    During the early stages of myocardial infarction, which cells infiltrate necrotic tissue?

    <p>Neutrophils (C)</p> Signup and view all the answers

    What happens during day 5-7 post-myocardial infarction?

    <p>Macrophages replace neutrophils (A)</p> Signup and view all the answers

    What is a significant risk during the period when macrophages are replacing neutrophils in myocardial infarction?

    <p>Weakened myocardial walls (D)</p> Signup and view all the answers

    What characterizes Prinzmetal angina?

    <p>Typically occurs in the early morning and responds well to vasodilators (B)</p> Signup and view all the answers

    Which adaptation occurs due to chronic ischemia?

    <p>Development of collateral circulation (C)</p> Signup and view all the answers

    During what phase does the heart receive oxygenated blood primarily?

    <p>Diastole (A)</p> Signup and view all the answers

    What type of infarction is characterized by a blockage affecting the entire wall thickness?

    <p>Transmural Infarction (A)</p> Signup and view all the answers

    Which stage describes stable narrowing allowing adequate blood flow at rest?

    <p>Fixed Coronary Obstruction (Typical Angina) (C)</p> Signup and view all the answers

    What is a potential outcome of plaque disruption in coronary artery disease?

    <p>Formation of thrombi that may occlude the artery (C)</p> Signup and view all the answers

    What describes an occlusive thrombus in coronary artery disease?

    <p>Complete blockage resulting in acute transmural MI (B)</p> Signup and view all the answers

    Which of the following vessels is most vulnerable during systole due to high pressure?

    <p>Subendocardial vessels (C)</p> Signup and view all the answers

    What is the primary cause of transudate edema?

    <p>Pressure imbalances (D)</p> Signup and view all the answers

    What does oncotic pressure primarily depend on?

    <p>Concentration of large proteins in the blood (C)</p> Signup and view all the answers

    What happens to fluid movement at the arterial end of a capillary?

    <p>Hydrostatic and oncotic pressure differential pushes fluid out (B)</p> Signup and view all the answers

    Which type of edema is characterized by high protein and high cellular content?

    <p>Exudate edema (D)</p> Signup and view all the answers

    What is a potential consequence of increased hydrostatic pressure at the venous end of a capillary?

    <p>Decreased fluid reabsorption (C)</p> Signup and view all the answers

    How does lymphatic obstruction contribute to lymphedema?

    <p>It leads to excess fluid and protein accumulation (C)</p> Signup and view all the answers

    During inflammation, what mechanism increases vascular permeability?

    <p>Endothelial damage (D)</p> Signup and view all the answers

    What balance leads to net fluid movement at the venous end of a capillary?

    <p>Oncotic pressure is greater than hydrostatic pressure (D)</p> Signup and view all the answers

    What causes the reddish-blue appearance of congested tissues?

    <p>Deoxygenated blood due to impaired outflow (D)</p> Signup and view all the answers

    What is a consequence of chronic congestion in tissues?

    <p>Accumulation of hemosiderin from red cell breakdown (A)</p> Signup and view all the answers

    Which condition is primarily associated with venous ulcers?

    <p>Increased venous pressure and fluid accumulation (A)</p> Signup and view all the answers

    What characterizes white infarcts compared to red infarcts?

    <p>They result from arterial occlusion and are pale in appearance (B)</p> Signup and view all the answers

    What cellular changes occur in the liver during acute hepatic congestion?

    <p>Degeneration of hepatocytes and distended liver sinusoids (A)</p> Signup and view all the answers

    What characterizes contraction band necrosis during reperfusion injury?

    <p>Hypercontracted sarcomeres with thickened Z disks (A)</p> Signup and view all the answers

    What is the typical outcome when blood flow is restored after myocardial injury?

    <p>Some myocardial cells may still die despite restored flow (B)</p> Signup and view all the answers

    Which artery is most commonly involved in myocardial infarction (MI)?

    <p>Left Anterior Descending Artery (C)</p> Signup and view all the answers

    What defines unstable angina compared to stable angina?

    <p>New or changing pain not relieved by rest or nitroglycerine (B)</p> Signup and view all the answers

    What symptom is commonly associated with myocardial infarction (MI)?

    <p>Chest pain that radiates to the left arm (B)</p> Signup and view all the answers

    What type of myocardial infarction is associated with ST-elevation on an ECG?

    <p>ST-elevation Myocardial Infarction (STEMI) (C)</p> Signup and view all the answers

    What is a common presentation in individuals with ischemic heart disease who may be asymptomatic?

    <p>No noticeable symptoms at all (D)</p> Signup and view all the answers

    What characteristic distinguishes a transmural infarct from a non-transmural infarct?

    <p>Transmural infarcts result from large, permanent occlusion of a coronary artery (D)</p> Signup and view all the answers

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