33 Coronary Artery Disease

Question 1

atherosclerosis is characterized by…

Answer 1

lipid deposits w/in the intima of the artery

Question 2

____ + ____ play a key role in the dvlpt of atherosclerosis

Answer 2

endothelial injury + inflammation

Question 3

C-Reactive Protein [CRP]

Answer 3

protein made by liver

-nonspecific marker of inflammation

Question 4

markers of inflammation in CAD

Answer 4

c-reactive protein + lipoprotein

Question 5

usually, when pt becomes symptomatic…

Answer 5

the disease process usually is well advanced

Question 6

stages of CAD

Answer 6

1 fatty streak
2 fibrous plaque
3 complicated lesions

Question 7

complicated lesions

Answer 7

fibrous plaque grows>
contd inflammatn can result in plaque instability , ulceration, + rupture>
plaque rupture>
platelet accumulation>
thrombus>

Question 8

collateral circulation

Answer 8

arterial anastomoses or connections

Question 9

2 factors that contribute to formation of collateral circulation

Answer 9

1 inherited predisposition to dvlp new blood vessels [angiogenesis]
2 presence of chronic ischemia [poor blood flow]

Question 10

CAD modifiable risk factors

Answer 10

• serum lipids
• HTN
• diabetes
• tobacco
• phys inactivity
• obesity

Question 11

serum lipids as risk factors

Answer 11

CHOLSTRL>200
TRGLCRD>150
LDL>130
HDL<40 in men <50 in women

Question 12

obesity as risk factors

Answer 12

waist circumference
>102cm/40in in men
>88cm/35in in women

Question 13

collateral circulation provides adequate blood + O2 except…

Answer 13

during increased workload like exercise

Question 14

nicotine

Answer 14

causes catecholamine (epinephrn, norepinephrn)
>causes incr HR, BP, and peripheral vasoconstriction

Question 15

tobacco smoke

Answer 15

cause incr LDL, decr HDL, release of toxic O2 radicals

Question 16

homocysteine

Answer 16

made by breakdown of essential amino acid methionine found in dietary protein

• causes damage to inner lining of bld vssls
• promtes plaque buildup
• incr clotting

Question 17

fat intake should be…

Answer 17

25-35% of total cals

-w most coming fr monosat + polysat fats

Question 18

statin drugs

Answer 18

• inhibit the synth of cholesterol in liver
• incr hepatic LDL receptor
• —-allows for liver to remove more LDL
• minor incr in HDL
• lower CPR levels

Question 19

most potent statin

Answer 19

rosuvastatin

Question 20

fibric acid derivative (drug + moa)

Answer 20

gemfibrozil

• removes VLDL
• lowers trglcrd
• incr HDL
• *no effect on LDL**