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Atherosclerosis and aneurysms

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Atherosclerosis and Aneurysms

Atherosclerosis and Aneurysms

Question 1 of 21

1

Which of these is not a common symptom of hypovolemic shock?

Select one of the following:

  • Pale

  • DIzzy

  • Low urine output due to reduced kidney end-organ oxygenation

  • Increased CVP

Explanation

Question 2 of 21

1

Fill the blank spaces to complete the text.

Cardiogenic shock arises from failure. This causes decreased contractility, which therefore reduces SV and therefore reduces the Cardiac Output. Poor forward flow will eventually cause a back-log of pressure into the venous system which can lead to an CVP/JVP.

Explanation

Question 3 of 21

1

CVP is used as a surrogate for preload and is normally between 15-25mmHg?

Select one of the following:

  • True
  • False

Explanation

Question 4 of 21

1

Fill the blank spaces to complete the text.

The 3 mechanisms in which preload increases force of contraction via the Frank-Starling Law of the heart are:
-Increased -tension relationship placing cardiac muscle in place of best contraction (due to optimal actin-myosin cross bridges).
-Increased Calcium sensitivity of the
-Increased on the stretch-activated calcium channels, thereby increasing Ca2+ entry. Calcium is increased intracellularly resulting in more cross-bridge formation.

Explanation

Question 5 of 21

1

Which of these is not a benefit of gelofusine?

Select one of the following:

  • Similar properties to blood

  • Half life of 4-5 hours

  • Don't need to know blood type

  • Good for intracellular shock

Explanation

Question 6 of 21

1

Normal saline distributes about 25% of the solution into the vascular compartment

Select one of the following:

  • True
  • False

Explanation

Question 7 of 21

1

Dextrose can be used to treat low blood sugar, insulin shock or dehydration, as it is rapidly taken up by cells and is useful to replenish intracellular fluids.

Select one of the following:

  • True
  • False

Explanation

Question 8 of 21

1

Select from the dropdown lists to complete the text.

Arteries consist of 3 layers (tunica intima, ( tunica media, tunica medusa ) and tunica externa). The tunica intima consists of ( squamous, columnar ) epithelium and a basement membrane (thin fibrous, non-cellular Laminin, protein, collagen).
The Internal ( elastic, collagenous ) membrane separates the tunica intima from the tunica media.
The tunica media consists of SMC's, ( collagen, fibrin ), elastin and proteoglycans
The next structure is the external elastic membrane which separates the tunica media from the tunica externa.
-The outermost structure is the adventitia or tunica externa, which consists of ( fibroblasts, monocytes, serosa ), collagen and elastin.

Explanation

Question 9 of 21

1

What prominent structures on arteries are not a feature of veins?

Select one of the following:

  • Elastic Fibres

  • Single layer of endothelium

  • Collagen

  • High distensibility

Explanation

Question 10 of 21

1

Atherosclerosis is not associated with?

Select one or more of the following:

  • Chronic Endothelial Injury

  • Increased permeability with monocyte and leukocyte adhesion

  • SM emigration from tunica media to intima and macrophage activation

  • Macrophages and SMC's engulfing lipid

  • Fibroblast proliferation

  • Smooth muscle proliferation, collagen and other ECM deposition.

Explanation

Question 11 of 21

1

Aortic dissection involves a split in the intimal layer, which allows blood to enter the wall of the vessel.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 21

1

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Peripheral Vascular disease is ( atherosclerotic, inflammatory ) build up in the lower limbs. The stenosis occurs through repeated endothelial injury. During exercise a ( reduced, increased ) blood flow leads to the requirement for anaerobic sources of metabolism, this creates ( lactic acid, energy, inflammation ) which is sensed by nerves as noxious stimuli. Once the patient rests and oxygen demand reduces, the pain leaves.

Explanation

Question 13 of 21

1

Peripheral venous disease is normally due to epithelial damage?

Select one of the following:

  • True
  • False

Explanation

Question 14 of 21

1

Fill the blank spaces to complete the text.

Chronic venous is due to valve dysfunction which causes the normal pressure (mmHg) to rise above 40mmHg. This sees fluid driven the venous vascular circuit and the tissues.
In varicose veins, the of the valves no longer meet properly and this causes a back-log of blood into the veins which become distended and not aesthetically pleasing.

Explanation

Question 15 of 21

1

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Adrenaline binds to ( B1, A1, B2 ) adrenoreceptors on the heart to cause an increase release of cAMP. This increased cAMP will lead to activation of Ca2+ channels and increased Ca2+ will enter the cytosol. This will increase the amount of actin-myosin cross brides formed and therefore increase the force of contraction. NA also binds to a1 adrenoreceptors on blood vessels to cause vasoconstriction.
These can both increase MAP by CO x SVR.

Explanation

Question 16 of 21

1

A person with a blood pressure of 143/ 95 is grade 2 hypertensive?

Select one of the following:

  • True
  • False

Explanation

Question 17 of 21

1

Fill the blank spaces to complete the text.

Ohm's Law = P/ R.
The forces of pressure through the body are hydrostatic, driving pressure and pressure.
In Pouseuille's law- F = P x r4....therefore flow is directly proportional to pressure and but inversely proportional to vessel length and viscosity.

Explanation

Question 18 of 21

1

The following parameters of blood are in line with Poiseulle's assumptions?

Select one or more of the following:

  • Fluid must be incompressible

  • Viscosity of fluid must be constant

  • Flow must be steady

  • Velocity at the wall must be zero

  • Tube must be straight, rigid and cylindrical

  • Flow must be laminar

Explanation

Question 19 of 21

1

Fill the blank spaces to complete the text.

Laminar flow is , whereas turbulent flow is .
Aneurysms result in laminated thrombus as the blood flows more through the vessels resulting in a slow viscous blood near the edges of the lumen. This can cause an aggregation of platelets and a thrombus will form.
In ath, the reduce cross-sectional area will cause an increase in velocity which can further damage the vessels due to the turbulent nature of flow.

Explanation

Question 20 of 21

1

The baroreceptor reflex is found in the carotid sinus and aortic arch. If blood pressure is low, there will be less afferent firing to the medullary cardiovascular centre. This will lead to a decrease in parasympathetic activity and an increase in sympathetic activity. This will cause B1 adrenoreceptors to increase HR and contractility and increase SVR via a1 adrenoreceptors. This mechanism can become sustained after?

Select one of the following:

  • 3 hours

  • 24 hours

  • 2-3 days

  • 4-7 days

Explanation

Question 21 of 21

1

The 2 mechanisms of intermediate blood pressure control are:

Select one or more of the following:

  • Transcapillary volume shift--> low pressures will drive fluid from interstitium into plasma (2 x more effective than baroreceptor reflex)

  • Reverse stress relaxation mechanism: tightening of blood vessels by vascular tone secondary to low stress on the vessel wall.

  • RAAS release- AG2 stimulating constriction, aldosterone, ADH, directly causing na+ reabsorption.

Explanation

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