Brainscape's Knowledge GenomeTM

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


See full index

Clin phar > CAD > Flashcards

CAD Flashcards

1
Q

supplies oxygenated blood to the (posterior portion) back portion of the left atrium & ventricle

A

Left Circumflex Artery (LCA)

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

supplies oxygenated to the front portion of the ventricle to the septum of the heart

A

Left Anterior Descending Artery (LDA)

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

— supply oxygenated blood to the front portion of the right atrium

A

Right Marginal Artery (RMA)

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

supply oxygenated blood to the back poriton of the right ventricle

A

Posterior Descending Artery

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

form re-route when there is blockage so that the blood can reach other parts of the artery

A

collateral circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vascular supply to the heart is impended by

A

Atheroma
Thrombosis
Spasm of the coronary artery

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

Accumulated fatty deposits and scar tissues

A

Atheroma

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

Atheroma leads to ________ and risk of ________

A

restriction in blood flow; thrombosis

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

patchy deposit of plaque

A

atheromas or atherosclerotic plaque

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

condition in which patchy deposit of plaque
(atheromas or atherosclerotic plaque) develop in the
wall of the medium and large sized arteries, leading to
reduced or blocked blood flow

A

Atherosclerosis

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

Atherosclerosis is a condition in which patchy deposit of plaque
(atheromas or atherosclerotic plaque) develop in the
wall of the medium and large sized arteries, leading to

A

reduced or blocked blood flow

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

T/F: Atherosclerosis can lead to stroke (in brain)

A

T

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

rupture, causing thrombosis

A

Unstable plaque

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

What do you give to patients with unstable plaque?

A

give antiplatelet medication just in case of rupturee (lead to coagulation/platelet adhesion)

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

T/F: Plaque rupture can cause MI

A

T

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

Blood clot

A

Thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fragment of blood clot travelling through vein

A

Emboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk factors for CAD

A

atherosclerosis, htn, high cholesterol, diabetes, obesity, smoking + alcohol consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Etiology of CAD: Decrease blood flow to the myocardium

A

*Atherosclerosis
*Coronary spasm
*Traumatic Injury
*Embolic event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Etiology of CAD: Increased oxygen demand

A

*Diastole
*Systole
*Contractile state of the heart
*Increase in systolic wall tension
* Lengthening of ejection time
*Change in the heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

unbalanced oxygen supply and oxygen demand

A

Myocardial Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: during MI, px can experience angina pectoris (chest pain)

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Oxygen demand exceeds myocardial oxygen
supply

A

Myocardial Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Myocardial Ischemia may be silent if

A

the length is insufficient
* Afferent cardiac nerves are damages
* Inhibition of pain at the spinal or
supraspinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Occurs when oxygen demand exceeds the oxygen supply

A

Myocardial Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: during Myocardial infarction, heart muscles already died due lack of oxygenated blood for a long time

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Transient chest discomfort that are
attributed to insufficient myocardial oxygen

A

Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Ordinary activity does not cause angina, such as walking and climbing stairs

A

Class I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Slight limitation of ordinary activity

A

Class II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Marked limitation of ordinary physical activity

A

Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Inability to carry on any physical activity without discomfort

A

Class IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

T/F: not all chest pain is classified as angina

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Characterized by chest pain and breathlessness
on exertion, symptoms are relieved promptly
with rest

A

Stable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Patient has a reproducible pattern of pain or
other symptoms

A

Stable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Components to Consider in Anginal Pain

A

1.Quality of pain (suffocating type of pain)
2.Location of pain (chest pain)
3.Duration of pain (0.5 to 30 minutes)
4.Factor provoking pain
5.Factors that relieve pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Symptoms of Stable Angina

A

Pressure over the sternum but not
always radiating
Pain usually lasting for 0.5 to 30 minutes
Precipitating factors include exercise, cold weather,
emotional stress
Relief occurs with rest and nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

> 20 minutes occurring within a week of
presentation

A

Rest Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Previously diagnosed angina with distinctly more
frequency, longer duration or lower threshold

A

Increasing angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

-Rest Angina
-Increasing Angina
-decrease response to NTG

A

Unstable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Nocturnal angina

A

Angina Decubitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Angina Decubitus occurs when patient is in a

A

recumbent position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Coronary artery spasm that reduces blood flow

A

Prinzmetal Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Prinzmetal Angina is due to a

A

thrombi or plaque formation

44
Q

Prinzmetal Angina occurs at

A

rest rather than exertion

45
Q

ECG shows ST-elevation

A

Prinzmetal Angina

46
Q

only occurs when patient is lying down; upright position, relieved

A

nocturnal

47
Q

chest pain even if px is in upright position

A

prinzmetal

48
Q

Diagnostic Test

A

*Resting ECG
*Exercise test
* Myocardial scintigraphy
* Stress Echocardiography
*Coronary Angiography (gold standard)

49
Q

Treatment Goals for Angina

A

Prevent MI and death, thereby improving the patient’s
quality of life
Reduce symptomatology
Remove or reduce risk factors

50
Q

Chronic Stable Angina treatment

A

*A – Aspirin and Antianginal Therapy
*B – Beta blocker and BP
*C – Cigarette smoking and Cholesterol
*D – Diet and Diabetes
*E – Education and Exercise

51
Q

Recommendations

A
  • Weight reduction/ maintenance
  • Physical activity for 30 - 60 minutes/day x 7 day
  • LDL-C <100mg/dL
    *BP < 130mmHg
    *No smoking and no environmental exposure to smoke
    *Reduce intake of saturated fats
    *If Diabetic HbA1c <7%
52
Q

recommended physical activity for Chronic Stable angina

A

30 - 60 minutes/day x 7 day

53
Q

recommended LDL-C for Chronic Stable angina

A

<100mg/dL

54
Q

recommended BP for Chronic Stable angina

A

130mmHg

55
Q

recommended Diabetic HbA1c for Chronic Stable angina

A

<7%

56
Q

Management for Chronic Stable angina

A

*Anti-platelets/Anti-thrombotic
*ACEI’s and ARBS
*Statins
*Beta-blocker
*Calcium Channel Blocker
*Nitrates

57
Q

Anti-Thrombotic Agents

A

Aspirin
Clopidogrel
COX- 2 Inhibitor

58
Q

Acts via irreversible inhibition of platelet COX-1 and thus
thromboxane production

A

Aspirin

59
Q

Aspirin’s Antiplatelet action is apparent within an hour of taking _________

A

300mg

60
Q

Effect on platelet last for the lifetime of the platelet

A

Aspirin

61
Q

Optimal maintenance dose for aspirin

A

75 -150mg/day

62
Q

Lower dose of Aspirin have _________

A

limited cardiac risk protection

63
Q

Higher dose of aspirin _______

A

increase risk for GI side effect

64
Q

Inhibits ADP activation of platelet

A

Clopidogrel

65
Q

Useful alternative to aspirin in patients who are allergic or cannot
tolerate aspirin

A

Clopidogrel

66
Q

As effective as aspirin in patients with stable coronary disease

A

Clopidogrel

67
Q

Usual dose is 300mg once then 75 mg daily

A

Clopidogrel

68
Q

Less likely to cause gastric erosion and ulceration

A

Clopidogrel

69
Q

Reduces the production of Prostacyclin

A

COX- 2 Inhibitor

70
Q

More traditional non-selective NSAIDs increase
cardiovascular risk

A

COX- 2 Inhibitor

71
Q

NSAID with high _______ specificity increase the risk of MI

A

COX-2

72
Q

SHOULD BE AVOIDED IN CHRONIC STABLE
ANGINA

A

COX- 2 Inhibitor

73
Q

Proven beneficial for post MI

A

ACE Inhibitor

74
Q

Vasodilatory effect caused by the inhibition of the
production of Angiotensin II

A

ACE Inhibitor

75
Q

Anti-inflammatory, anti-thrombotic and anti-proliferative
property

A

ACE Inhibitor

76
Q

Reduces ROS production

A

ACE Inhibitor

77
Q

Demonstrate the benefit of reducing cholesterol,
especially LDL-C, in patients with CHD

A

Statin

78
Q

Earlier studies focused on patients with
“elevated” cholesterol, but all patients with
coronary risk factors benefit from reduction of
their serum cholesterol level

A

Statin

79
Q

T/F: all patients with
coronary risk factors that is treated with statin benefit from reduction of their serum cholesterol level

A

T

80
Q

statins reduce cardiovascular risk by

A
  • Shift LDL cholesterol particle size to a larger particle, lesser atherogenic
  • Improve endothelial function
  • Prevention of pro-inflammatory mediators
  • Possibly improve atherosclerotic plaque stability
81
Q

No safe level for cholesterol for patients with CAD and there is a
continuum of risk down to very low cholesterol level

A

Statins

82
Q

Level of LDL-C of __________ and total cholesterol__________ are
recommended for patients with established CVD

A

<2mmol/L; <4mmol/L

83
Q

Considered first line agent in angina

A

Beta-Blocker

84
Q

Reduce mortality both in patients who suffered from
previous MI and patients with HF

A

Beta-Blocker

85
Q

Beta-Blocker reduce myocardial oxygen demand by blocking β- adrenergic receptor, there by ___________ (increasing/decreasing) the heart rate and
force of left ventricular contraction and lowering blood
pressure

A

decreasing

86
Q

Beta Blockers are useful in

A

exertional angina

87
Q

Patients treated optimally with B blockers should have a resting
heart rate of around

A

60 beats/minute

88
Q

B blockers are used in caution in patients with _________

A

diabetes

89
Q

Tendency to cause bronchospasm and peripheral
vascular spasm

A

Beta Blockers

90
Q

Should not be stopped abruptly

A

Beta Blocker

91
Q

Contraindicated in the rare Prinzmetal’s
angina where coronary spasm is a major
factor

A

Beta Blocker

92
Q

Acts on a variety of smooth muscle and cardiac
tissue

A

Calcium Channel Blocker

93
Q

______ have been
implicated in the exacerbation of angina

A

Calcium Channel Blocker

94
Q

valuable in angina

A

Organic nitrates

95
Q

Dilate vein → decrease preload

A

Nitrates

96
Q

Dilate arteries to a lesser extent → decrease afterload

A

Nitrates

97
Q

Promote flow in collateral coronary vessel, diverting
blood from the epicardium to the endocardium

A

Nitrates

98
Q

Relax vascular smooth muscle by releasing nitric oxide

A

Nitrates

99
Q

Tolerance is one of the main limitation

A

Nitrates

100
Q

Nitrate preparation

A

*IV infusion
*Tablet / capsule
*Transdermal patch
* Sublingual tablet
* Spray

101
Q

Exhibits the properties as nitrate

A

Nicorandil

102
Q

Also activates ATP dependent potassium channel

A

Nicorandil

103
Q

main benefit of nicorandil

A

Reduction in unplanned admission to hospital with chest
pain

104
Q

Anti-ischemic agent

A

Ranolazine

105
Q

T/F:Ranolazinen is not commonly used in the management of chronic stable angina

A

T

106
Q

Inhibit inward sodium current during plata

A

Ranolazine

Clin phar (3 decks)

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