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CMC > ACS/MI/HF > Flashcards

ACS/MI/HF Flashcards

1
Q

ACS is progressive _______________ causing thrombosis formation that leads to imbalance of O2 _________ and ____________

A

Atherosclerosis; supply; demand

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2
Q

O2 supply to heart: determined by coronary ___________, cardiac _________, (systolic/diastolic) _____________ time, HgB, and _______

A

Arteries; output; diastolic filling; SaO2

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3
Q

O2 demand of heart is dependent on the factors that determine _________ ___________

A

Cardiac output

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4
Q

O2 demand of heart is based on ______, _________, afterload, and ______________

A

HR; preload; contractility

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5
Q

Troponin levels in ACS elevate within 3-___ hours, peak in 14-_____ hrs

A

6; 20

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6
Q

Females with ACS May commonly present with ______ symtoms, (chest/pleuritic/back) pain, or fatigue

A

GI; back;

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7
Q

DM pts experiencing ACS may not feel chest _____ - instead, the often present with _____________ of ________

A

Pain; shortness; breath

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8
Q

What symptom is a DM pt with ACS likely to present with?

A

Shortness of breath

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9
Q

What symptom/s is a female pt with ACS likely to present with?

A

GI symptoms; back pain

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10
Q

Causes of non-cardiac chest pain are from ____________ (pleuritic) pain or _____ conditions and associated pain

A

Respiratory; GI

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11
Q

True or False: Pain from GI conditions such as pancreatitis and stomach ulcers can cause non cardiac chest pain

A

True

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12
Q

Pleuritic pain - worse with ______________ and ________________

A

Inspiration; exhalation

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13
Q

Stable Angina is _____________ and symptoms predictably stop if ____________ stops

A

Exertional; exertion

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14
Q

Stable angina May have fixed ________ ____________ with ___________ ischemia - this is why exertion (increase in O2 ___________) causes exertional chest pain

A

Vessel stenosis; demand; demand;

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15
Q

Stable angina may require sublingual ________

A

NTG

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16
Q

Unstable angina is angina that is __________________ in onset/triggers - increasing _____________, _____________, and time/duration of pain. Pain may develop at _______

A

Unpredictable; frequency; intensity; rest

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17
Q

UA is pain that develops at _______, without exertion

A

Rest

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18
Q

In UA, pain developing at rest is due to an imbalance between O2 _________ and O2 ___________

A

Demand; supply

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19
Q

The NSTE-ACS that are anginas are _________ angina, __________ angina, and ____________ angina

A

Stable; unstable; variant’s

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20
Q

Variants angina is chest pain caused by coronary artery ___________ - occurs at ______ or when ______________

A

Vasospasm; rest; sleeping

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21
Q

Variants angina (vasospasm) should be treated with ______ and CCBs - ____________ dinitrate and _____________

A

NTG; isosobide;. Diltazem

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22
Q

With or without symptoms, get a ____-_______ _______ for pt with variant’s angina

A

12-lead EKG

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23
Q

UA - the _________ does not elevate

A

Troponin

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24
Q

UA May be a ____________ to an MI, consider ________________ therapy

A

Precursor; antiplatelet

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25
Q

In NSTEMI there is ___________ _____________ of coronary ________, creating imbalance between supply and demand

A

Partial occlusion; artery

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26
Q

NSTEMI - pain/symptoms occur at ________, and last >_____ minutes

A

Rest; 20

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27
Q

Only in NSTEMI/STEMI does (EKG changes/troponin elevates)

A

Troponin elevates

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28
Q

Hallmark of nSTEMI 12-lead EKG - ST depression and ____ _______ ________________

A

T wave inversion

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29
Q

ST ____________ or ____ _______ __________________ are EKG indicators of ISCHEMIA

A

depression; T wave inversion

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30
Q

ECG changes in different _______ in nSTE-ACS are not ___________ __________, like in STEMI

A

Leads; artery specific

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31
Q

____ or more leads with ST depression/ T ______ _____________ along with ST elevation in lead _______: suspicion for multi-___________ disease, (proximal/distal) _______ occlusion, or _______ ________ artery occlusion

A

8; wave inverstion; aVR; vessel; proximal LAD; left main

32
Q

Treatment for NSTEMI is _______ or ___________ _______, if pt is high risk

A

PCI; early PCI

33
Q

nSTEMI has chest pain that does NOT ___________, even with administration of _______

A

Relieve; NTG

34
Q

In both MI types - nSTEMI/MI - chest pain does _______ relieve, and _____________ are elevated

A

NOT; troponin

35
Q

nSTEMI chest pain does NOT relieve - it is chest pain from __________ coronary artery occlusion and (reversible/irreversible) myocardial __________ and damage

A

Partial; Irreversible; injury

36
Q

UA is unpredictable, but may be relieved with _______

A

NTG

37
Q

UA pain is from ischemia, but is from (reversible/irreversible) myocardial ischemia

A

Reversible

38
Q

Imbalance between coronary O2 __________ and ___________ (thus causing ______________) is reflected by ______ ______________ and T wave __________________ on EKG

A

Supply; demand; ischemia; ST depression; inversion

39
Q

ST depression and T wave inversion on EKG : indication of ___________ between O2 supply and _________

A

Imbalance; demand

40
Q

STEMI is a __________ occlusion of the coronary artery, caused by __________ rupture leading to ____________ formation

A

Complete; plaque; thrombus

41
Q

Treatment for STEMU is immediate _______________ - either through _______ or administration of __________________ (followed by catheterization lab later on)

A

Reperfusion; PCI; fibrinolytic

42
Q

NSTEMI Treatment - ______ or early _______
STEMI treatment - immediate/emergent _______ or ________________ therapy with cath lab later on

A

PCI; PCI; PCI; fibrinolytic

43
Q

Hallmark of STEMI is chest pain >____ min, SOB, and ___________

A

20; diaphoresis

44
Q

Post MI, if a pts EF is <40%, what medication class can be expected to be prescribed to them upon discharge?

A

ACEi/ARB/ANRI

45
Q

Occlusion of the LAD/left ________ artery will cause an ________________ MI, with ST elevation in ____-______

A

Main; Anterospetal; V1-V4

46
Q

Leads V1 - V4 are the (anterior/inferior/septal/anterolateral/posterolateral/anteroseptal) leads

A

Anteroseptal

47
Q

The septal wall and any EKG changes it may have in MI is located in the leads _____-______

A

V1-V4

48
Q

Occlusion of the LCX and possibly left ________ can cause a ____________ MI, with ST Elevation in I, aVL, and _____, ______

A

Main; lateral; V5; V6

49
Q

Inferior MI is seen by ST elevation in the leads ____, III, and _______ - this is caused by occlusion of ________

A

II; aVF; RCA

50
Q

A RV MI occurs usually when there is an occlusion of the ____________ ________

A

Proximal RCA

51
Q

Occlusion of RCA - ___________ MI
Occlusion of proximal RCA - _________ sided MI

A

Inferior; right

52
Q

Other than an inferior or right ventricular MI, what is the other type of MI that can be caused by RCA occlusion?

A

Posterior MI

53
Q

Posterior MI from RCA occlusion has ST elevation in posterior leads that are not seen in 12 lead - BUT, posterior MI has reciprocal changes (______ depression) in leads V1-____, as well as ______ __________ (T/P/R/Q) waves in ___-____

A

ST; V3; tall upright R; V1-V3

54
Q

Inferior MI has reciprocal changes in the leads ____ and ______ leads

A

I; aVL

55
Q

An anteroseptal MI has reciprocal changes in the leads _____, ______, and __________

A

II; III; aVF

56
Q

Bedside monitor for Inferior wall MI is lead _____

A

III

57
Q

In inferior wall MI, if ____ elevation is lead _____ > lead II, likely _______ occlusion

A

ST; III; RCA

58
Q

What lead should be bedside monitored for an inferior MI?

A

Lead III

59
Q

Administration in NTG with MI has to be cautious for what type of MI?

A

Inferior MI/RVMI

60
Q

If patient has inferior MI/suspected RVMI, what two emergent MI medications should be avoided due to concern for _____________ and __________ reduction?

A

Hypotension; preload // NTG and Morphine

61
Q

In a Right sided MI, avoid giving _________ or __________ for painQ

A

Nitroglycerin; morphine

62
Q

Administer ___________ cautiously in _____/nSTEMI, as it can cause ________________

A

Morphine; UA; hypotension

63
Q

Large “v” waves on PAOP waveform are caused by ___________ __________ rupture and/or ___________ regurgitation

A

Papillary muscle; mitral

64
Q

Papillary muscle rupture is often diagnosed by

A

Echocardiogram

65
Q

Papillary muscle rupture treatment is emergent _________ ________ or ________ replacement

A

Surgical repair; valve

66
Q

Ventrical septal rupture (associated with ________ wall MI) results in a _______ to right _________

A

Septal; left; shunt

67
Q

Ventricular septal rupture will appear as large “__” waves on _______ waveform

A

V; CVP

68
Q

Clinical signs of cardiogenic shock (LV Failure) include ____ sound/pulmonary ________, tachycardia, ___________, decreased ______, and signs of decreased ______________ such as mottling

A

S3; edema; arrhythmias; UOP; perfusion

69
Q

True or False: Arrythmias are a clinically presenting sign of oncoming cardiogenic shock

A

True

70
Q

Hemodynamics of cardiogenic shock - decreased CO/____ and decreased _____ (<65%)

A

CI; SvO2

71
Q

ABG in cardiogenic shock will show ____________ respiratory and ____________ _______________ and ______________

A

Mixed; metabolic acidosis; hypoxemia

72
Q

Metabolic acidosis in cardiogenic shock is due to __________ acidosis that is occurring from decreased systemic ______________and ________________ metabolism

A

Lactic; perfusion; anaerobic

73
Q

In cardiogenic shock, respiratory acidosis on ABG is ___________ in etiology, and is a result of ______________ __________

A

Hypercapnic; pulmonary edema

74
Q

Echo in patient with cardiogenic shock will show decreased _______ __________, and reduced _______

A

Wall motion; EF

75
Q

Mixed respiratory and metabolic acidosis in cardiogenic shock - respiratory acidosis from ____________ d/t pulmonary _________, metabolic acidosis d/t __________ acidosis from decreased ______________/CO

A

Hypercapnia; edema; lactic; perfusion

76
Q

Treatment for cardiogenic pulmonary edema includes measures to decrease (preload/afterload), including ___________, NTG, and __________

A

Diuretics; morphine

77
Q

In acute/flash cardiogenic pulmonary edema, treatment is the same (diuretics, _______), but in addition, there is admin of positive ___________ (increase contractility) and ______________ (decrease afterload)

A

NTG; inotropes; vasodilators

CMC (2 decks)

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