Cardiovascular and Lymphatic Systems

A function of the pericardium is to:

provide a barrier against extracardial infections.

A 65-year-old male develops blockage in the pulmonary artery. As a result, blood would first back up into the:

right ventricle

The chamber of the heart that generates the highest pressure is the:

left ventricle.

A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in papillary muscles. Which of the following would occur?

Backward expulsion of the atrioventricular valves

_____ are the anchors of the atrioventricular valves.

Chordae tendineae cordis

The _____ artery travels down the interventricular septum and delivers blood to portions of the left and right ventricle.

left anterior descending

A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. This result indicates:

increased isovolumetric contraction time.

The _____ conducts action potentials down the atrioventricular septum.

bundle of His

A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following would be expected?

Increased cardiac cycle speed

A 54-year-old male is diagnosed with left bundle branch block. Which of the following structures would not receive an electrical impulse?

The left ventricles

Depolarization of a cardiac muscle cell occurs as the result of:

the rapid movement of ions across the cell membrane.

In a normal electrocardiogram, the P-R interval represents:

onset of atrial activation to onset of ventricular activity.

The _____ represents the sum of all ventricular muscle cell depolarization.

QRS complex

A new drug is released to aid in weight loss. It stimulates the sympathetic system to increase heart rate by:

altering the threshold potential.

One difference between cardiac muscle and skeletal muscle is that:

cardiac muscle cells are arranged in branching networks.

_____ are thickened areas of the sarcolemma of myocardial cells that enable electrical impulses to travel in a continuous cell-to-cell fashion.

Intercalated disks

Which of the following occurs during muscle contraction?

Decreased distance between Z lines

Within a normal physiologic range, an increase in left ventricular end-diastolic volume leads to:

an increased force of contraction.

Right ventricular afterload is determine by:

pulmonary vascular resistance.

Pressure in the left ventricle must exceed pressure in the _____ before the left ventricle can eject blood.

aorta

The primary cardiovascular control center is located in the:

medulla.

A 50-year-old female presents with a low heart rate and low blood pressure. She is given an IV infusion of fluids. The increase in atrial distension results in:

increased heart rate.

Multiplying heart rate by stroke volume determines:

cardiac output.

The internal lining of the cardiovascular system is formed by what tissue?

Endothelium

Poiseuille formula states that resistance to blood flow is inversely related to:

blood vessel diameter.

Baroreceptors are located in the:

carotid sinus.

In the renin-angiotension-aldosterone system, conversion of angiotensin I to angiotensin II happens in the:

lungs.

One of the most important mechanisms for maintaining venous return to the right atrium is:

skeletal muscle contraction.

The thoracic lymphatic duct drains into the:

left subclavian vein.

A 60-year-old male presents to his physician complaining of chest pain. He is diagnosed with atherosclerosis. This disease is caused by:

abnormal thickening and hardening of vessel walls.

In general, atherosclerosis is caused by:

endothelial injury and inflammation.

Normal blood pressure for adults age 18 or older is:

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

A 30-year-old Caucasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. Which of the following risk fact

Genes

A 52-year-old male is diagnosed with primary hypertension. He could be treated with a drug that acts by which of the following mechanisms?

Diuretic

A 55-year-old female has undiagnosed hypertension. She presents to her physician complaining of impaired vision and chronic edema. Lab tests reveal that she also has renal insufficiency. The most likely cause for these findings is:

end organ damage.

The rapid onset of malignant hypertension results in:

encephalopathy

Orthostatic hypotension refers to a drop in blood pressure with:

standing up.

Acute orthostatic hypotension can be caused by:

drug action.

A 65-year-old female presents to the ER complaining of difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:

aorta.

A 60-year-old male is diagnosed with cerebral aneurysm. The most likely area for it to occur is the:

circle of Willis.

A detached blood clot is called a(n):

thromboembolus.

Individuals with Raynaud disease have severe symptoms under which of the following conditions?

Cold exposure

A 75-year-old obese female presents to her physician complaining of edema in the lower extremities. Physical exam reveals that she has varicose veins. Which of the following is a possible cause?

Long periods of standing

A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The most likely manifestation of this disorder is:

skin depigmentation.

A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following is the most likely diagnosis?

Superior vena cava syndrome

A 52-year-old female is diagnosed with coronary artery disease. She would be expected to suffer from myocardial:

ischemia.

A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would most likely influence development of this disease?

Cigarette smoking

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He is told that _____ fats raise LDL levels and lower HDL levels and should be avoided.

trans-fat

The most common cause of myocardial ischemia is:

atherosclerosis

A 53-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. The pain he experiences occurs when:

the myocardial oxygen supply has fallen below demand.

A 62-year-old male presents to his physician complaining of chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

Prinzmetal

A 51-year-old male is at his health clinic for an annual physical exam. After walking from the car to the clinic, he developed a substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with

stable angina.

A 68-year-old male presents to the ER complaining of chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:

impending myocardial infarction.

A 55-year-old male died of myocardial infarction. Autopsy would most likely reveal:

platelet aggregation within the atherosclerotic coronary artery.

Cardiac cells can withstand ischemic conditions for _____ before irreversible cell injury occurs.

20 minutes

A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived but now has impaired ventricular function because:

the resulting ischemia leads to hypoxic injury and myocardial cell death.

A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of creatinine phosphate and lactic dehydrogenase. These elevated levels indicate:

myocardial infarction.

A 56-year-old male presents to his physician for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is a concern?

Tamponade

A 42-year-old female is diagnosed with constrictive pericarditis. She would also have a decreased cardiac output because of:

fibrosis and calcification of the pericardial layers.

A 60-year-old female was diagnosed with mitral stenosis. As a result, she has incomplete emptying of the:

left atrium.

Which valve disorder is manifested by a widened pulse pressure and throbbing peripheral pulses?

Aortic regurgitation

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

mitral valve prolapse.

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. The most likely cause of this disease is

group A �-hemolytic streptococcus infections.

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. This disease is usually characterized by:

antigens that bind to the valvular lining, triggering an autoimmune response.

A 30-year-old female presents to her physician with fever, cardiac murmur, and petechial skin lesions. She is diagnosed with infective endocarditis. The most likely cause of her disease is:

bacteria.

A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no PR interval and a variable rate QRS with rhythm irregularity. Which of the following is the most likely diagnosis?

Atrial fibrillation

A 59-year-old female is diagnosed with left ventricular failure. The decrease in kidney perfusion would ultimately cause:

increased systemic vascular resistance.

A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure most likely caused by:

sympathetic nervous system compensation for decreased cardiac output.

Pulmonary symptoms, such as dyspnea and cough, common to left heart failure are a result of:

pulmonary vascular congestion.

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?

Significant edema to both lower legs and feet

High output failure occurs with:

anemia.

When a person is in shock, impairment in cellular metabolism is caused by:

inadequate tissue perfusion.

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

decreased ATP production

During shock states, glucose uptake is usually:

impaired.

An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What

Hypovolemic

A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:

vasodilation caused by a decrease in sympathetic stimulation.

Neurogenic shock can be caused by any factor that inhibits the:

sympathetic nervous system.

A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock and develops:

bronchoconstriction, hives or edema, and hypotension.

The onset of anaphylactic shock is usually:

immediate and life threatening.

For an infection to progress to septic shock, which of the following must occur?

Bacteria must enter the bloodstream.

The hypotensive state seen in septic shock can cause:

gut lining disruption and the translocation of bacteria into the bloodstream.

A 75-year-old female has been critically ill with MODS for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is:

The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver.

An 8-week-old infant presents to his pediatrician for a well-baby checkup. Physical exam reveals a murmur and an echocardiogram confirms a ventricular septal defect. Which of the following genetic factors would most likely accompany this diagnosis?

Down syndrome

A newborn is diagnosed with pulmonary stenosis. Which of the following intrauterine factors could have caused this defect?

Infection

A 40-year-old pregnant woman is concerned about the health of her unborn child. She has phenylketonuria (PKU) and recently had a viral infection. If the child is born with a congential heart defect, which of the following is the most likely based on the m

Patent ductus arteriosus

A newborn child is diagnosed with Trisomy 18. Which of the following congenital heart defects will she most likely have?

Ventricular septal defect

A 1-month-old infant visits his physician for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur suggestive of aortic stenosis. Which of the following would be expected with this diagnosis?

Ventricular hypertrophy

A newborn develops a murmur and cyanosis shortly after birth. She is diagnosed with pulmonary stenosis after an echocardiogram revealed narrowing of the:

pulmonary valve orifice.

The patent opening between the aorta and pulmonary artery in a fetus is called the:

ductus arteriosus.

An infant undergoes an echocardiogram for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. This defect is referred to as:

ostium secundum atrial septal defect.

The most common type of congenital heart defect is:

ventricular septal defect.

An 8-week-old infant presents to her physician for a well-baby check. Physical exam reveals a murmur, and an echocardiogram shows a large ventricular septal defect. Left untreated, this defect will result in:

pulmonary hypertension.

A 22-year-old pregnant woman presents to her OB/GYN for a prenatal checkup. The heartbeat sounds irregular, and a fetal echocardiogram reveals an atrioventricular canal defect. This defect is characterized by:

blood flow between all four heart chambers.

A newborn child has a murmur and cyanosis. An echocardiogram reveals that the tricuspid valve failed to develop and no blood flows between the right atrium and ventricle. This condition is referred to as tricuspid:

atresia.

Which of the following statements best describes total anomalous pulmonary venous connection?

Pulmonary venous return is to the right atrium.

A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. Which of the following occurs with this defect?

The aorta leaves the right ventricle

A 1-month-old infant was diagnosed with truncus arteriosus with a ventricular septal defect. Which of the following would also be expected?

Blood from both ventricles mixing in a common vessel

A 22-year-old pregnant female presents for a fetal echocardiogram. Tests reveal small left atrium and mitral valve and an absent left ventricle and aortic valve. This defect is:

an indication for neonatal heart transplant.

A 3-year-old Japanese male is diagnosed with Kawasaki disease. Which of the following is the most likely cause?

Systemic vasculitis of unknown etiology

A 5-year-old female is found to have hypertension during three separate visits to her physician. Lab tests reveal that the hypertension is secondary to:

renal disease.