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Medicine General 6af4d8ba

CCF is associated with increase in all the following except:

A
Right atrial mean pressure
B
Serum Sodium
C
Urea
D
Nor epinephrine
High-Yield Explanation
Answer is B (Serum Sodium) Congestive Cardiac failure is associated with Hyponatremia or Decreased Serum Sodium levels. Hea failure is associated with Hyponatremia. - CMDT/Harrison Mechanism of hyponatremia is primary Na- gain exceeded by secondary water gain. In hea failure total body sodium is increased, yet effective circulating volume is sensed as inadequate by baroceptors. Increased ADH and Aldosterone results which causes retention of water and sodium. Secondary water gain exceeds primary sodium gain resulting in hyponatremia. Elevated serum urea levels may be seen. Biochemical studies in hea failure may show renal insufficiency. Renal functions tests also determine whether cardiac failure is associated with prerenal azotemia. Right atrial mean pressure is increased congestive hea failure. In hea failure one or the other ventricle fails to discharge its contents or fails to fill normally. As a result the pressure in the atrium and venous system behind (upstream) the failing ventricle rise. - Harrison In patients will hea failure the levels of circulating norepinephrine may be markedly elevated reflecting the increased activity of the adrenergic nervous system. - Harrison

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