Brainscape's Knowledge GenomeTM

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


See full index

FA17 Cardio 2 > CAD 2 > Flashcards

CAD 2 Flashcards

1
Q

symptoms of cardiac ischemia (6)

A

retrosternal chest pain (dull, pressure, crushing, constricting)

radiation of pain to L arm/shoulder

dyspnea

nausea

diaphoresis

feeling of impending doom

SYMPTOMS LAST 3-10 MIN

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

signs of cardiac ischemia (5)

A

normal with no ischemia

uncomfortable/pale.diaphoretic

dyspnea

altered mentation

additional heart sounds

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

CAD symptoms suggestions

A

worseingin dyspnea or exercise intolerance

palpitations and light headedness

weight gain over days

DO NOT RELIABLY CORRESPOND WITH DISEASE

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

women symptoms?

A 
fatigue
sleep disturbance
SOB
indigestion
anxiety

1 month before HA

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

symptoms suggesting something else

MSK cause (4)

if have P = pulmonary (3)

A

pleuritic pain (knife like related to movements or cough) *P

localized with one finger

discomfort reproduced by movement or palpitation (pushing down) *P

pain lasts longer than a few days *P

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

symptoms suggesting something else

GERD, GI, PUD, esophagitis, pancreatitis

A

primary pain in mid to lower abdomen

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

most sensitive test to use for chest pain CAUSED by CAD

+ types and score

A

history

substernal chest pain
exertion chest pain
chest pain relieved with rest or nitroglycerin

anginal chest pain (3)
atypical anginal chest pain (2)
non anginal chest pain (1)

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

disease manifestations due to arteriosclerosis

A
  1. stable angina
  2. unstable angina
  3. NSTEMI
  4. STEMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

stable angina

A

predictable, reproducible symptoms

induced by exercise, cold, emotional stress

lasts 5-10 min, received by rest or NTG

occurs 2/2 fixed, stable plaque blocking 50% (mc 70%)

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

unstable angina

A

increase in cardiac ischemia symptom frequency, severity, or duration

occurring at rest

less responsive to rest or NTG for relief

caused by plaque rupture or progression

symptoms suggestive of ACS with no elevation in troponin

may have EKG changes

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

NSTEMI

A

increase in cardiac ischemia symptom frequency, severity, or duration

occur at rest

less responsive to rest or NTG for relief

ischemic symptoms suggestive of ACS and ELEVATIONS of tropnonins

with or without ECG NO ST elevation

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

STEMI

A

symptoms of cardiac ischemia

elevated bio markers

ST segment elevation

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

OLDCARTS of CP

A 
O: sudden 
L: substernal 
D: several min-hrs
C: pressure, dull
A: rest, NG (worse w/exertion) 
R: L arm, shoulder, jaw 
T
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

risk of CVD and CP analysis

A

symptoms are not GERD or pleuritic chest pain

CV risk factors? if present increases likelihood of CAD being cause

PE will show carotid bruit, poor peripheral pulses

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

resting EG abnormalities concerning for coronary ischemia

A

T wave inversion
ST depression/elevation
New bungle branch block

increase likelihood 2-10 fold

limitations - not good enough to diagnose

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

pre-test probability

A

probability that target disorder is present PRIOR to performing diagnostic test

diamond Forrester criteria gives likelihood ratio

17
Q

diamond Forrester criteria

high risk is? low risk?

A

High >90%

low <10%

18
Q

what risk of diamond Forrester criteria do you stress test

A

Intermediate

low risk = think of something else
high risk = it’s probably there, move on to cardiac cath

19
Q

grading angina (I-IV

A

I: ordinary activity doesn’t cause angina

II: slight citation of ordinary activity

III: marked limitation of physical activity

IV: inability to do ANY physical activity without discomfort

20
Q

goal of Angina/Cad therapy

A

slow/arrest progression of CAD (decreasing risk of ACS)

relief of anginal symptoms (lifestyle, revascularization, pharmacotherapy)

aggressive risk factor reduction

21
Q

management goals in CAD

A

DM: A1c <7%

Hyperlipid: LDL < 70 (statin) Tgs <200 (fabric acid, fish oils)

smoking cessation

HTN (<140/90)

Obesity

Sedentary lifestyle

22
Q

pharm management of CAD

A

statin therapy and anti-platelet (LOWERS mortality)

ACE/ARBS (DM, LV systolic)

BB, CCB, Nitrates, Ranolazine

23
Q

nitroglycerin

A

decreases preload and after load,, coronary vasodilation

can cause HA, flushing

24
Q

BB/CCB

A

decreases heart rate, contractility, BO

may worsen HF and cause heart block

25
Q

indications for revascularization

A

angina despite medical therapy (class III-iV)

high risk: EKG changes in stress test (VTach), unstable angina, arrhythmia with angina, survive sudden cardiac arrest

26
Q

options for revascularization

A

CABG (coronary artery bypass grafting)

PCI (PCTA or intracornary) PCTA stenting

27
Q

Percutaneous transluminal coronary angioplasty (PTCA)

A

cardiac cath with small balloon inflated at opening of stenosis

5% of patients experience arterial thrombosis

50% develop restenosis in 1-6 months

28
Q

intracoronary stoning

A

1-2% thrombosis, 20-25% restenosis

first choice for coronary arterial lesions, not good for the small ones

two types: BMS and DES

29
Q

bare metal stent (BMS)

A

patient will be on aspirin indefinitely

clopidogrel for 4 weeks to 1 year after stent

good option for patients who need surgery

30
Q

Drug Eluting Stent (DES)

A

coated with anti-proliferative drugs to prevent restenosis

delays endothelialization of stent (higher thrombosis risk)

restenosis in 5-10%, 70% reduction in restenosis

aspirin indefinitely plus thienopyridene for 12 months MINIMUM

31
Q

stent complications

A
  1. hemorrhage/hematoma at access site
  2. vascular damage
  3. peri-procedural MI
  4. real failure
  5. instEnt thrombosis
  6. instEnt restenosis
  7. cholesterol emboli syndrome
32
Q

hemorrhage at access site

A

check H&H to evaluate if suspected

common

retroperitoneal hemorrhage (anemia and back pain)

33
Q

cholesterol emboli syndrome

A

hx of norther atheroma manifests as renal failure, mesenteric ischemia, toe necrosis (with distal pulses) and lived reticular

34
Q

CABG veins used

A

saphenous beins
internal mammary artery** or radial artery

harvested and anastomosed to ascending aorta and coronary to BYPASS areas of atherosclerosis

35
Q

indications of CABG

A

> 50% stenosis of L MAIN CORONARY

three major epicardial coronary arteries w/LV systolic dysfunction (EF <50%)

multi vessel disease in diabetics

36
Q

PCI is better

A

limited lesions, normal ventricular systolic function

37
Q

medication therapy for

A

stable CAD without critical stenosis (<70%) and without left ventricular systolic dysfunction

FA17 Cardio 2 (10 decks)

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