{"id":6322,"date":"2023-08-28T01:49:31","date_gmt":"2023-08-28T05:49:31","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathology\/?post_type=chapter&#038;p=6322"},"modified":"2025-08-23T18:34:11","modified_gmt":"2025-08-23T22:34:11","slug":"extra-critical-thinking-questions","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/extra-critical-thinking-questions\/","title":{"raw":"Extra Critical Thinking Questions","rendered":"Extra Critical Thinking Questions"},"content":{"raw":"In this appendix you will find a series of extra critical thinking questions that relate back to all the knowledge you have learned till this point, and they require you to apply the critical thinking skills and methods to solve them\r\n<h2>Heart Failure Chapter<\/h2>\r\n<div style=\"font-weight: 400\">\r\n<ol>\r\n \t<li>Compare the anatomy and function of the right and left sides of the heart.\u00a0 Speculate on some possible defects in the heart that could lead to diseases.\u00a0 Hint: they don\u2019t have to be actual disease, don\u2019t even name disease, just speculate. Eg. Hypertrophy on the left side of heart (the muscle tissue gets too large on the left side)<\/li>\r\n \t<li>\r\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 50%\">Pathophysiology<\/td>\r\n<td style=\"width: 50%\">Physiological manifestations (e.g. chamber volume, cardiac output)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">EXAMPLE: LV is abnormally thick<\/td>\r\n<td style=\"width: 50%\">Reduced LV filling volume --&gt; decr ejection fraction<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">[footnote]RV has reduced contractility or pulmonary valve won't open fully[\/footnote]<\/td>\r\n<td style=\"width: 50%\">Reduced volume in pulmonary circulation &amp; left heart<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">LA is enlarged with abnormally thin walls<\/td>\r\n<td style=\"width: 50%\">[footnote]pulmonary circulation will be overfilled with fluid in alveolar space[\/footnote]<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">[footnote]right heart can't contract and eject [\/footnote]<\/td>\r\n<td style=\"width: 50%\">Superior &amp; Inferior Vena Cava are distended with excess volume, low cardiac output<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">[footnote]aortic valve can't close fully and volume falls back into LV[\/footnote]<\/td>\r\n<td style=\"width: 50%\">LV is enlarged with thin walls &amp; decr CO, murmur is heard during systole<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/li>\r\n \t<li>What do you think would happen if the aortic valve doesn\u2019t work properly?\u00a0 For each of the following scenarios, explain what: i) would\u00a0 would the effect be on cardiac output (i.e. volume ejected into the aorta)? ii) leftover volume after systole (i.e. end systolic volume)? iii) preload (i.e. volume filling the ventricle).\r\n<ul>\r\n \t<li>a. Aortic Valve has problem opening fully [footnote]ai.reduced ejection fraction (i.e. less volume ejected); aii) incr end systolic volume in LV' aiii) reduced filling volume entering LV [\/footnote]<\/li>\r\n \t<li>b. Aortic Valve doesn\u2019t close fully, allowing for leakage [footnote]bi.reduced ejection fraction (i.e. less volume ejected); bii) incr end systolic volume in LV' biii) reduced filling volume entering LV[\/footnote]<\/li>\r\n \t<li>c. Aortic Valve opening is abnormally narrow[footnote]ci.reduced ejection fraction (i.e. less volume ejected); cii) incr end systolic volume in LV' ciii) reduced filling volume entering LV[\/footnote]<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>What respiratory changes (if any) would someone with L-sided heart failure experience? How does this compare with R-sided heart failure? Are these difference enough for you to make a \u201cdiagnosis\u201d?[footnote]4. L-sided heart failure has blood backed up to pulmonary circulation which the fluid will push into the alveoli (pulmonary edema) causing coughing and dyspnea. Right sided heart failure will have less blood going to the pulmonary circulation and a backup of blood going to the SVC &amp; IVC[\/footnote]<\/li>\r\n \t<li>Which would have a greater impact on overall perfusion of the body: concentric vs eccentric hypertrophy? [footnote]The key here is how the hypertrophy affects ejection fraction (EF). If there is reduced filling volume, as with concentric hypertrophy, there would be reduced EF.\u00a0 However, eccentric hypertrophy will preserve filling volume but will have decreased contractile function as the walls thinning causing loss of function.\u00a0 So concentric hypertrophy with reduced EF has a greater impact on cardiac output until eccentric hypertrophy loses its contractile function.[\/footnote]<\/li>\r\n<\/ol>\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n<div>\r\n<h2>Acute Kidney Injury Chapter<\/h2>\r\n[h5p id=\"350\"]\r\n\r\n<\/div>\r\n<\/div>\r\n<h2><strong>Metastatic Melanoma Chapter<\/strong><\/h2>\r\n[h5p id=\"353\"]\r\n\r\n[h5p id=\"354\"]\r\n\r\n[h5p id=\"355\"]\r\n<h2><strong>Diabetes Mellitus Chapter<\/strong><\/h2>\r\n[h5p id=\"358\"]\r\n<div style=\"font-weight: 400\">\r\n<div>\r\n<div>\r\n<div>[h5p id=\"360\"]<\/div>\r\n<\/div>\r\n<\/div>\r\n<div>\r\n<h2><strong>Emphysema &amp; Pneumonia Chapters<\/strong><\/h2>\r\n[h5p id=\"406\"]\r\n<h2><strong>Cirrhosis Chapter<\/strong><\/h2>\r\n<\/div>\r\n<div>\r\n\r\n[h5p id=\"405\"]\r\n\r\n<\/div>\r\n<div><\/div>\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n<div><\/div>\r\n<\/div>","rendered":"<p>In this appendix you will find a series of extra critical thinking questions that relate back to all the knowledge you have learned till this point, and they require you to apply the critical thinking skills and methods to solve them<\/p>\n<h2>Heart Failure Chapter<\/h2>\n<div style=\"font-weight: 400\">\n<ol>\n<li>Compare the anatomy and function of the right and left sides of the heart.\u00a0 Speculate on some possible defects in the heart that could lead to diseases.\u00a0 Hint: they don\u2019t have to be actual disease, don\u2019t even name disease, just speculate. Eg. Hypertrophy on the left side of heart (the muscle tissue gets too large on the left side)<\/li>\n<li>\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%\">\n<tbody>\n<tr>\n<td style=\"width: 50%\">Pathophysiology<\/td>\n<td style=\"width: 50%\">Physiological manifestations (e.g. chamber volume, cardiac output)<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\">EXAMPLE: LV is abnormally thick<\/td>\n<td style=\"width: 50%\">Reduced LV filling volume &#8211;&gt; decr ejection fraction<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\"><a class=\"footnote\" title=\"RV has reduced contractility or pulmonary valve won't open fully\" id=\"return-footnote-6322-1\" href=\"#footnote-6322-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/td>\n<td style=\"width: 50%\">Reduced volume in pulmonary circulation &amp; left heart<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\">LA is enlarged with abnormally thin walls<\/td>\n<td style=\"width: 50%\"><a class=\"footnote\" title=\"pulmonary circulation will be overfilled with fluid in alveolar space\" id=\"return-footnote-6322-2\" href=\"#footnote-6322-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\"><a class=\"footnote\" title=\"right heart can't contract and eject\" id=\"return-footnote-6322-3\" href=\"#footnote-6322-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/td>\n<td style=\"width: 50%\">Superior &amp; Inferior Vena Cava are distended with excess volume, low cardiac output<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\"><a class=\"footnote\" title=\"aortic valve can't close fully and volume falls back into LV\" id=\"return-footnote-6322-4\" href=\"#footnote-6322-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/td>\n<td style=\"width: 50%\">LV is enlarged with thin walls &amp; decr CO, murmur is heard during systole<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<li>What do you think would happen if the aortic valve doesn\u2019t work properly?\u00a0 For each of the following scenarios, explain what: i) would\u00a0 would the effect be on cardiac output (i.e. volume ejected into the aorta)? ii) leftover volume after systole (i.e. end systolic volume)? iii) preload (i.e. volume filling the ventricle).\n<ul>\n<li>a. Aortic Valve has problem opening fully <a class=\"footnote\" title=\"ai.reduced ejection fraction (i.e. less volume ejected); aii) incr end systolic volume in LV' aiii) reduced filling volume entering LV\" id=\"return-footnote-6322-5\" href=\"#footnote-6322-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><\/li>\n<li>b. Aortic Valve doesn\u2019t close fully, allowing for leakage <a class=\"footnote\" title=\"bi.reduced ejection fraction (i.e. less volume ejected); bii) incr end systolic volume in LV' biii) reduced filling volume entering LV\" id=\"return-footnote-6322-6\" href=\"#footnote-6322-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/li>\n<li>c. Aortic Valve opening is abnormally narrow<a class=\"footnote\" title=\"ci.reduced ejection fraction (i.e. less volume ejected); cii) incr end systolic volume in LV' ciii) reduced filling volume entering LV\" id=\"return-footnote-6322-7\" href=\"#footnote-6322-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><\/li>\n<\/ul>\n<\/li>\n<li>What respiratory changes (if any) would someone with L-sided heart failure experience? How does this compare with R-sided heart failure? Are these difference enough for you to make a \u201cdiagnosis\u201d?<a class=\"footnote\" title=\"4. L-sided heart failure has blood backed up to pulmonary circulation which the fluid will push into the alveoli (pulmonary edema) causing coughing and dyspnea. Right sided heart failure will have less blood going to the pulmonary circulation and a backup of blood going to the SVC &amp; IVC\" id=\"return-footnote-6322-8\" href=\"#footnote-6322-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/li>\n<li>Which would have a greater impact on overall perfusion of the body: concentric vs eccentric hypertrophy? <a class=\"footnote\" title=\"The key here is how the hypertrophy affects ejection fraction (EF). If there is reduced filling volume, as with concentric hypertrophy, there would be reduced EF.\u00a0 However, eccentric hypertrophy will preserve filling volume but will have decreased contractile function as the walls thinning causing loss of function.\u00a0 So concentric hypertrophy with reduced EF has a greater impact on cardiac output until eccentric hypertrophy loses its contractile function.\" id=\"return-footnote-6322-9\" href=\"#footnote-6322-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/li>\n<\/ol>\n<\/div>\n<div style=\"font-weight: 400\">\n<div>\n<h2>Acute Kidney Injury Chapter<\/h2>\n<div id=\"h5p-350\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-350\" class=\"h5p-iframe\" data-content-id=\"350\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"critical thinking extras 1\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2><strong>Metastatic Melanoma Chapter<\/strong><\/h2>\n<div id=\"h5p-353\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-353\" class=\"h5p-iframe\" data-content-id=\"353\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Metastatic Melonoma: Oncogenes\"><\/iframe><\/div>\n<\/div>\n<div id=\"h5p-354\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-354\" class=\"h5p-iframe\" data-content-id=\"354\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Metastatic Melonoma: p53\"><\/iframe><\/div>\n<\/div>\n<div id=\"h5p-355\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-355\" class=\"h5p-iframe\" data-content-id=\"355\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Metastatic Melonoma: p53\"><\/iframe><\/div>\n<\/div>\n<h2><strong>Diabetes Mellitus Chapter<\/strong><\/h2>\n<div id=\"h5p-358\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-358\" class=\"h5p-iframe\" data-content-id=\"358\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Diabetes Mellitus: Glucose homeostasis\"><\/iframe><\/div>\n<\/div>\n<div style=\"font-weight: 400\">\n<div>\n<div>\n<div>\n<div id=\"h5p-360\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-360\" class=\"h5p-iframe\" data-content-id=\"360\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Diabetes Mellitus: type 2\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<h2><strong>Emphysema &amp; Pneumonia Chapters<\/strong><\/h2>\n<div id=\"h5p-406\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-406\" class=\"h5p-iframe\" data-content-id=\"406\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ventilation and the blood-air barrier of the alveoli are crucial to gas exchange.\"><\/iframe><\/div>\n<\/div>\n<h2><strong>Cirrhosis Chapter<\/strong><\/h2>\n<\/div>\n<div>\n<div id=\"h5p-405\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-405\" class=\"h5p-iframe\" data-content-id=\"405\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Mr. Vasquez is a 38-year-old man who recently underwent surgery to have his gallbladder removed, after years of colic caused by gallstones.\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div><\/div>\n<\/div>\n<div style=\"font-weight: 400\">\n<div><\/div>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-6322-1\">RV has reduced contractility or pulmonary valve won't open fully <a href=\"#return-footnote-6322-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-6322-2\">pulmonary circulation will be overfilled with fluid in alveolar space <a href=\"#return-footnote-6322-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-6322-3\">right heart can't contract and eject  <a href=\"#return-footnote-6322-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-6322-4\">aortic valve can't close fully and volume falls back into LV <a href=\"#return-footnote-6322-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-6322-5\">ai.reduced ejection fraction (i.e. less volume ejected); aii) incr end systolic volume in LV' aiii) reduced filling volume entering LV  <a href=\"#return-footnote-6322-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-6322-6\">bi.reduced ejection fraction (i.e. less volume ejected); bii) incr end systolic volume in LV' biii) reduced filling volume entering LV <a href=\"#return-footnote-6322-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-6322-7\">ci.reduced ejection fraction (i.e. less volume ejected); cii) incr end systolic volume in LV' ciii) reduced filling volume entering LV <a href=\"#return-footnote-6322-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-6322-8\">4. L-sided heart failure has blood backed up to pulmonary circulation which the fluid will push into the alveoli (pulmonary edema) causing coughing and dyspnea. Right sided heart failure will have less blood going to the pulmonary circulation and a backup of blood going to the SVC &amp; IVC <a href=\"#return-footnote-6322-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-6322-9\">The key here is how the hypertrophy affects ejection fraction (EF). If there is reduced filling volume, as with concentric hypertrophy, there would be reduced EF.\u00a0 However, eccentric hypertrophy will preserve filling volume but will have decreased contractile function as the walls thinning causing loss of function.\u00a0 So concentric hypertrophy with reduced EF has a greater impact on cardiac output until eccentric hypertrophy loses its contractile function. <a href=\"#return-footnote-6322-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":1937,"menu_order":2,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["ghazal","sjlam","kdanigo","jen-2"],"pb_section_license":""},"chapter-type":[],"contributor":[170,59,175,174],"license":[],"class_list":["post-6322","chapter","type-chapter","status-publish","hentry","contributor-ghazal","contributor-jen-2","contributor-kdanigo","contributor-sjlam"],"part":6199,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/6322","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/users\/1937"}],"version-history":[{"count":25,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/6322\/revisions"}],"predecessor-version":[{"id":9539,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/6322\/revisions\/9539"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/parts\/6199"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/6322\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/media?parent=6322"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapter-type?post=6322"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/contributor?post=6322"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/license?post=6322"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}