Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular Diseases > Angina > Flashcards

Angina Flashcards

1
Q

what is it

A

restricted perfusion of heart due to atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is difference between stable and unstable angina

A

stable is on exertion

unstable (ACS) is angina of recent onset or worse at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the symptoms

A

tight, heavy, dull chest pain that passes within few minutes
radiate to left arm, neck, jaw or back
normally following exertion, stress, after meal or cold weather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what causes it

A

atherosclerosis due to hypertension, hyperlipidaemia, smoking, diabetes, age, sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is it diagnosed

A 
symptoms
ECG
exercise tolerance test 
coronary angiography (assess coronary circulation)
myocardial perfusion scinigraphy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is ECG findings

A

between attacks - may be normal, or pathological Q waves (old MI), LVH/LBBB

during attacks - transient ST depression, t wave inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the treatment

A

GTN + secondary prevention (aspirin, ACEi and statin)

B blocker or CCB (verapamil) (if symptoms persist then B blocker + amlodipine)

If B blocker and/or CCB contradicted, give long acting nitrate or HCN channel activator or K+ activator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the mechanism of GTN (nitrate)

A

releases nitrate which are converted to nitric oxide which activates guanylyl cyclase, increasing cGMP. this cGMP activates PKG which relaxes vascular smooth muscle

The reduced [Ca2+], since more is taken up by SER, decreases MLCK activity and relaxation occurs due to reduced light chain phosphorylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

side effects of GTN

A

headaches, hypotension, syncope, tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is mechanism of aspirin (anti-platelet)

A

reduces platelet aggregation and arterial thrombosis by activating plasminogen to plasmin, dissolving thrombi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are side effects of aspirin

A

bronchospasm, GI irritation, GI haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is mechanism of ACEI (lisinopril, ramipril, enalapril)

A

decrease synthesis of angiotensin II, a powerful vasoconstrictor, reducing vascular done (causing vasodilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the side effects of ACEI

A

dry cough, angiodema, proteinuria, neutropenia, renal failure, hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is mechanism of statins (atorvastatin, simvastatin, pravastatin)

A

HMG CoA reductase inhibitors - block cholesterol synthesis in liver. Compensatory mechanism incomplete and reduction of cholesterol in hepatocytes leads to increased LDL receptor expression, increasing clearance from plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is side effects of statins

A

myopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is mechanism of B blocker (bisoprolol)

A

block B-adrenoceptors

lower CO and decrease force of cardiac contraction

17
Q

what are side effects of B blocker

A

cold hands, fatigue, provocation of asthma, heart failure, conductance block, nightmares

18
Q

what is mechanism of calcium channel blockers (amlodipine, nifedipine, verapamil)

A

block L type calcium channels, preventing calcium from entering cells, causing relaxation of arteriolar smooth muscle (reduced TPR so BP falls)

19
Q

what is side effects of CCB

A

dizziness, hypotension, flushing, ankle oedema

20
Q

what is mechanism of long acting nitrate (isosorbide mononitrate)

A

same as GTN

21
Q

what is mechanism of HCN channel inhibitor (ivabradine)

A

reduces HR via specific inhibition of funny current

22
Q

what is mechanism of K+ activator (nicrorandil)

A

potassium channel activator with nitrate component which has arterial and venous vasodilating properties

23
Q

what surgeries can be considered in angina

A

PCI and CABG

24
Q

what is PCI

A

dilation of coronary artery using ballon and stent inserted via femoral/radial/brachial artery
patient must be anticoagulated and antiplateleted beforehand

25
Q

what is CABG

A

left internal thoracic (mammary) cut distally and attached to coronary artery
or saphenous vein used - one end attached to ascending aorta and other to obstructed vessel

26
Q

what are complications of CABG

A

systemic inflammatory response, AF and persistent neurological abnormalities

27
Q

what is complications of angina

A

heart attack
stroke
depression

28
Q

how to tell difference between unstable angina and NSTEMI

A

unstable angina does not have detectible markers

Cardiovascular Diseases (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions