Luckyall
Forum Guru
Topics: 11
Posts: 592
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meoo7, the Qs simply asks what is stillCOMPROMISED in a pt that comensated chf ? what is still compromised ???? now what " compromised" means... is purely english guys, purely paying atention to what exactly Qs asks for ...
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| me007
Forum Guru
Topics: 72
Posts: 803
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i don't think that compromised means diminished.
more likely that it is not like normal
here from wikipedia
"a compromise" (singular) refers to particular aspects and item pairs as representing deviations from previous objectives. ...
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| Luckyall
Forum Guru
Topics: 11
Posts: 592
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–adjective Pathology. unable to function optimally, esp. with regard to immune response, owing to underlying disease, harmful environmental exposure, or the side effects of a course of treatment.
------------------------------------------------------------------------- -------
[Origin: compromise + -ed2]
A concession to something detrimental or pejorative: a compromise of morality
com·pro·mised, com·pro·mis·ing, com·pro·mis·es
v. intr.
To arrive at a settlement by making concessions.
To reduce the quality, value, or degree of something.
To reduce in quality, value, or degree; weaken or lower.
To impair by disease or injury: an immune system that was compromised by a virus
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| epica
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Agree with NNL and Luckyall
" EF never gets back to previous Normal values" even in compensated
I feel that this Q is incomplete, maybe somebody was lazy to rewright all Q from the book and posted only 50% from the Q.
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| me007
Forum Guru
Topics: 72
Posts: 803
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the q is about compensatory mechanism in HF
In heart failure it will be decr in SV due do impaired contractile function.
decr SV-->incomplete chamber emptying -->blood acumulates in ventricle more than normal
-->incr. stretchon myofibers --> via Frank-Starling greater SV.
Another compensatory mechanism - adrenergic activation via baroreceptors (incr HR and TPR) and RAA system.
And finally ventricular hypertrophy what is compensatory process as well.
q is not complete, it's obvious. it is all just for review.
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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besides, we can have high output CHF, where EF/SV is not compromised
question is definitely incomplete
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| epica
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BabyDoc; I know , but Very very rarely there is a High output failure, ( in A-V FISTULA)
This is not our case...Agree?
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| keepgoing
Forum Guru
Topics: 62
Posts: 1,673
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CHF= reduced EF=low CO= low SV or CHF= low SYSTOLIC,low Diastolic......
EF whicH is already reduced how will FURTHER reduce whn its being compensated by various mech????if its the case its not compensated its decompensated....
acc to question(might be incomplete) thats which is being compensated(compromised variable) in compensated CHF???whn sv is low ef is low co is low ????
everyone explained reasoning based on understanding of mech for which everyone is right but what cud be the ans thn...or leave it thinking incomplete...
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| usmle4me
Forum Elite
Topics: 6
Posts: 283
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To me HR sounds a prefered answer
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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what i understood from reading on topic - when HF occures the way to keep it COMPENSATED is to MEDICATE
and what kind of medication you use - differes based on EF, which can be WNL, incr, or decr
question does not say spesifically what kind of HF we have on hands. let's assume that question is complete and we deal with decreased EF, increased HR is ome of mechanisms thta keeps CO in check.
and assuming that USMLE wants us to know that CO depends on SV and SV, HR is the best answer.
BUT will HR be COMPROMISED?
to many assumptions...
yes, high output CHF is not as often as low output or N output...but can you tell what are we dealing with from reading this question?
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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compensatory mechanism for decreased CO is increased SV given myocardium has normal contractility and in that case where is failure? it's not failure, but simply compenation
problem with CHF - cntractility is altered, how you'll increase SV without it?
but CO still has to be mainained by any means...
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| babydoc4usmle
Forum Guru
Topics: 18
Posts: 634
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besides, having SV increased you'll increase EF
now can you tell me which answer is more correct?
honestly, i have hard time finding correct answer to this question...too vague for me....
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| keepgoing
Forum Guru
Topics: 62
Posts: 1,673
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thanks G^I so the ans is EF...IT WILL NEEVR COME TO NORMAL...it is not compensated by any mech...we can inc sv,co by various mech but never ef...this pathology of CHF...
THRAED CLOSED
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| indidoc1
Forum Guru
Topics: 50
Posts: 978
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___________________
"Whether you think you can or whether you think you can't, you're right!" ~ Henry Ford
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| me007
Forum Guru
Topics: 72
Posts: 803
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sorry for annoying.
in systolic dysfunction HF - EF decreases.
But in diastolic (with stiff ventricle) - EF normal or increased.
(path rapid review 2004 p 104)
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| epica
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Guys, please,
Heart failure with preserved EF is assoc. with a high MORTALITY rate.
These pt. were not COMPENSATED.....
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| epica
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Do u know that u can read about the combined (diastolic and systolic HF)?
Is this a case?
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| epica
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To me007
I found this Q today in Guytong Physiology
You are were the first and only one who ans this Q correct----- (SV), be confident and good luck to you. Now I am sure that u r ready for exam.
Thank u very much, if not u I would never open this book
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| Luckyall
Forum Guru
Topics: 11
Posts: 592
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Epica, you say something weird, Girl interrupted already post the answer to this Qs... can you plz, tell me the exact pages where you found this in Guyton ???
Or, atleast under what Chapter , in case we dont have same edition ?
Actually we all will VERY VERY MUCH appreciate if you can QUOTE exact words of Guytong !!!
We will all improve our concepts, huh ? So if you make a statement, plz, take 10 min from your time and quote thise PRETIOUS WORDS where it says is NOT EF, but is SV !!!
Atleast I will VERY VERY MUCH APPRECIATE IT !
Thanks !
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| epica
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Luckyall. please ignore my post.
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| epica
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Sorry, I did not see Girl-Inerrupted post before and her ans. Ignore my post.
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