What condition may cause poor myocardial perfusion?
Peripheral vascular disease
Deep vein thrombosis
Rheumatoid arthritis
Coronary artery vasospasm
The Correct Answer is D
A. Peripheral vascular disease: Peripheral vascular disease primarily affects arteries supplying the extremities, leading to reduced blood flow to the limbs. Although it reflects systemic atherosclerosis risk, it does not directly impair coronary artery blood flow. Myocardial perfusion depends specifically on coronary circulation rather than peripheral vessels.
B. Deep vein thrombosis: Deep vein thrombosis involves clot formation in the deep venous system, usually in the lower extremities. It affects venous return rather than arterial supply and does not interfere with coronary artery perfusion. While complications such as pulmonary embolism can occur, DVT does not directly reduce myocardial blood flow.
C. Rheumatoid arthritis: Rheumatoid arthritis is a chronic autoimmune inflammatory disorder affecting synovial joints. Although long-term inflammation may increase cardiovascular risk, it does not directly cause acute impairment of coronary blood flow. Myocardial perfusion is not immediately compromised by joint inflammation.
D. Coronary artery vasospasm: Coronary artery vasospasm causes transient constriction of the coronary arteries, reducing or temporarily blocking blood flow to the myocardium. This decrease in oxygen delivery can result in ischemia, chest pain, and ECG changes. Reduced coronary lumen diameter directly impairs myocardial perfusion.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Respiratory acidosis:Respiratory acidosis occurs when hypoventilation causes CO2 retention, leading to a decreased pH (acidemia) and elevated PaCO2. In this scenario, the pH is elevated, and PaCO2 is low, which does not align with respiratory acidosis.
B. Metabolic alkalosis:Metabolic alkalosis involves an elevated pH and increased HCO3-. In this case, HCO3- is within normal limits (24 mEq/L), so the primary disturbance is not metabolic.
C. Respiratory alkalosis:Respiratory alkalosis results from hyperventilation, causing excessive CO2 elimination. This decreases PaCO2 (30 mmHg), elevates pH (7.50), and shows normal HCO3-, indicating a primary respiratory origin with no metabolic compensation.
D. Metabolic acidosis:Metabolic acidosis presents with a decreased pH and low HCO3-, often with a compensatory decrease in PaCO2. The elevated pH and normal HCO3- in this case do not support metabolic acidosis.
Correct Answer is ["B","C","D","E"]
Explanation
A. Cramping and diarrhea:Cramping and diarrhea are gastrointestinal symptoms and are not typical warning signs of a myocardial infarction. While some cardiac events can cause nausea, generalized GI cramping and diarrhea are not reliable indicators of cardiac ischemia.
B. Sudden dyspnea:Sudden shortness of breath can occur during a myocardial infarction due to left ventricular dysfunction, pulmonary congestion, or reduced oxygen delivery. Dyspnea may be an early or primary symptom, especially in women, older adults, or those with diabetes.
C. Anxiety and fear:Anxiety, restlessness, or a sense of impending doom is a common neuropsychological response to myocardial ischemia. It results from sympathetic nervous system activation in response to cardiac stress and inadequate perfusion.
D. Excessive sweating:Diaphoresis is a classic autonomic response to myocardial infarction, caused by sympathetic activation. It is often cold and clammy, reflecting the body’s stress response and perfusion compromise.
E. Chest pressure:Chest discomfort, pressure, tightness, or pain is the hallmark symptom of myocardial infarction. It typically occurs in the substernal region and may radiate to the arm, jaw, neck, or back, indicating myocardial ischemia and injury.
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