NURBN 2023 Cardiac Exam Questions with

NURBN 2023 – Cardiac Exam Questions with Correct Answes Define heart failure - Correct Answer The inability of the ventricles to pump enough blood to meet the body's metabolic demands. Loss of contraction leads to heart failure.systolic heart failure - Correct Answer inability of the heart to generate an adequate cardiac output to perfuse vital tissues diastolic heart failure - Correct Answer ventricles can't relax and fill cause of heart failure - Correct Answer Atherosclerosis. Hypertension. High cholesterol. Smoking.Clinical symptoms of hear failure - Correct Answer Hypertension. Shortness of breath/congested lungs. Fluid retention/oedema . Chest pain. Tachycardia.Pathophysiology of heart failure - Correct Answer Dysfunctional ventricle that is unable to eject enough blood (systolic dysfunction) Inability of ventricles to fill with enough blood (diastolic dysfunction) Ischemic heart disease & HTN are the most common underlying causes

• HTN: excess mechanical stress on ventricles -> structural change of hypertrophy & eventual left

ventricular dysfunction Differences between left and right heart failure - Correct Answer Left: fluid build up in the lungs and

Right: fluid retention in peripheral organs and tissue.

Causes of CHF (Right-sided) - Correct Answer Congestion of peripheral tissues Causes of CHF (Left-Sided) - Correct Answer Decreased cardiac output & pulmonary congestion Clinical symptoms of right-sided HF - Correct Answer Peripheral & visceral congestion. Fatigue.Ascites. Enlarged liver & spleen. Bloating. Anorexia. Distended neck. Nausea. 1 / 2

Clinical symptoms of left-sided HF - Correct Answer Fatigue. Othopnea. Restlessness. Confusion.Extreme weakness, cyanosis. Dyspnea.Pathophysiological steps in HF patients - Correct Answer - Myocardial injury --> *fall in LV* performance (lower cardiac output)

• *Kidneys* sense decreased perfusion, *secrete renin to vasoconstrict + retain Na+ and H20* via

aldosterone; also stimulates sympathetic

• Heart *works against increased filling pressure*; more myocardial injury + hypoperfusion +

downregulate B-receptors

• Main point is that it is a *vicious cycle* caused by *compensatory mechanisms*

How does the RAAS system lead to raised blood pressure? - Correct Answer Angiotensinogen converted to angiotensin 1 (by renin from kidneys) AT-1 to AT-2 via ACE (from pulmonary and renal epithelium) - angiotensin 2 leads to vasoconstriction and raised ADH from posterior pituitary gland Aldosterone (ADH) increases water absorption - BP increases Define arrhythmia - Correct Answer Any variation from the normal electrical rate and/or sequence of cardiac activity.bradyarrhythmia - Correct Answer slow, irregular heartbeat tachyarrhythmia - Correct Answer a fast, irregular heart rate, usually over 150 bpm Hypertension, High cholesterol & Diabetes. Smoking and weight control. - Correct Answer Modifiable hypertensive risk factors C-reactive protein. Insulin resistance. Oxidative stress. Periodontal disease. Age. - Correct Answer Non-modifiable hypertension risk factors List lifestyle factors which reduce hypertension - Correct Answer Maintain healthy body weight.Reduce fatty foods. Be physically active.Hypertension - Correct Answer abnormally high blood pressure

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