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Semester 5 PMCP Exam 1 > CAD and MI Cardiology (Benzoni) > Flashcards

CAD and MI Cardiology (Benzoni) Flashcards

1
Q

3 types of hypertension

A

1) essential
2) secondary
3) malignant

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2
Q

essential HTN treatment

A

treat via lifestyle modification and meds

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3
Q

secondary HTN treatment

A

treat the cause

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4
Q

malignant HTN treatment

A

treat based on the involved organ system and the cause

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5
Q

malignant HTN can cause

A

CVA, CHF, STEMI etcc

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6
Q

goal BP of essential htn

A

<140/<90

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7
Q

2 types of hypovolemic shock

A

absolute (volume loss) hypovolemia

relative hypovolemia

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8
Q

absolute hypovolemia

A

decrease in volume due to blood or fluid loss

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9
Q

relative hypovolemia

A

normal BV but size of container decreased
- neurologic, meds, cardiac, psychogenic
treatment aimed at the cause

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10
Q

shock is defined as

A

inadequate end organ profusion

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11
Q

Absolute hypovolemic shock

A
  • extreme of orthostatic hypotension
  • findings vary based on involved organ system: brain = altered mental status, tachycardia = heart (ischemia), no urine output = kidney
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12
Q

which type of shock will have mottled cool skin

A

absolute hypolovemia

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13
Q

solution for absolute hypovemic shock

A

fill the tank!

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14
Q

is total blood volume preserved in relative hypovolemic shock?

A

yes

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15
Q

what is the issue with relative hypovolemic shock?

A

distribution issue. the total blood volume is preserved but it is not being distrubuted

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16
Q

types of hypovolemic shock

A

neurogenic, cardiogenic

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17
Q

neurogenic shock

A
  • total BV is preserved
  • issue with distrubtion
  • loss of sympathetic tone = loss of vasoconstrictor reflex
  • occurs at specific spinal cord level and below
  • hyperreflexia can later occur
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18
Q

cardiogenic shock

A
  • ischemic or hypertrophic heart
  • ischemic: dilated and thin; issue with emptying blood
  • hypertropic: thickened and cannot fill with blood
  • result is the same from differnt causes
  • decreased BF, decreased renal fxn
  • decreased CO
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19
Q

RF’s for cardiogenic shock

A

HTN, DM, cholesterol, ASCVD

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20
Q

cardiogenic shock cont

A
  • distal ischemia from lack of BF
  • ischemia causes decreased muscle mass and strength
  • cardioac output is already maxed out when the individual is at rest
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21
Q

cardiogenic shock can progress into what disease

A

myocardial ischemic disease

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22
Q

cause of myocardial ischemic disease

A

blood supply does not equal the demand

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23
Q

Modifiable RF’s for heart disease

A

SMOKING, cholesterol, HTN, DM2

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24
Q

non modifiable RFs for heart disease

A

age, family history, gender, race, DM1

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25
Q

Ischemic disease

A
  • lumina narrows which restricts blood flow to myocardium
  • fat is laid down
  • heart atrophies over time due to decreased BF which can cause an MI or CVA
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26
Q

mechanism for ischemic disease

A

vascular hypertrophy! hypertrophy occurs because of HTN, ischemia present, leading to decreased brain fxn, heart failure, decreased kidney fxn

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27
Q

ischemic disease

A

BP is high, but thickened heart walls has decreased the blood supply in the heart and to the rest of the body

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28
Q

cardiac hypertrophy

A

can’t fill due to large ventricle size, so it can’t distrubte as much blood to the body

  • EKG shows endocardial ischemia
  • HR increases to maintain CO
  • leads to diastolic failure
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29
Q

What is diastolic failure?

A

failure to fill the heart due to hypertrophy of the heart

30
Q

treatment for diastolic failure

A

control HTN, decrease contractile force (workload of heart), decrease HR

31
Q

most common type of cardiogenic shock

A

systolic

32
Q

systolic cardiogenic shock

A
  • most common type
  • result of diminished blood supply
  • leads to systolic failure
33
Q

primary cause of systolic failure?

A

atherosclerosis

34
Q

define atherosclerosis

A
  • arterial narrowing and hardening
  • lipids are deposited between vessel layers
  • lumin narrows due to lipid deposition
35
Q

longer definition of atherosclerosis

A

progressive, chronic inflammatory disease of large arteries that begins in childhood
involves formation of fatty plaques

36
Q

what happens in atherosclerosis?

A 
lining of vessels erode (endothelial dysfxn)
lipids deposited (fatty streak) and layer of myocytes forms over it, making the new lumin mobile! This area is called an atheroma and is reversible! can decrease in size
37
Q

modifiable RF of an atheroma

A

smoking, diabetes, dyslipidemia, HTN, lifestyle, obesity

38
Q

non modifiable RF of an atheroma

A

family age of onset (male 55, female 65)
age of risk onset (male 45, female 55)
CKD (kidney disease)
genetics

39
Q

what can occur at end stage of an atheroma?

A
  • plaque rupture, leading to CVA, STEMI, NSTEMI, angina, or peripheral arterial occlusion
40
Q

RF’s of CVA/stroke

A

atherosclerosis, age, sex, family history, HTN, DM, smoking, cholesterol, a fib

41
Q

why is afib a risk for a CVA

A

a fib increases the risk of having a clot form in the left atrium and travel to the carotids

42
Q

ACS (acute coronary syndrome) - #1 risk?

A
  • spectrum disorder

- #1 risk is previous MI!! (ASCVD)

43
Q

NSTEMI

A
  • looks like an MI
  • labs are positive
  • EKG is negative (may show depression)
  • high risk to prgoress to STEMI
  • treat like a STEMI
  • incomplete occlusion of lamina
44
Q

STEMI

A
  • complete occlusion of lamina (in watershed of carotid artery)
  • abnormal EKG
45
Q

inferior/posterior stemi = what artery

A

RCA

46
Q

anterior stemi = what artery

A

LAD

47
Q

lateral/posterior stemi = what artery

A

circumflex

48
Q

classic MI presentation in elderly

A

weak and dizzy

49
Q

STEMI ekg changes

A

1mm elevation in bipolar (limb leads)

2mm elevation in V (chest leads)

50
Q

LCA: aspect of heart affected and leads

A

heart: lateral
leads: 1, avL, V5, V6

51
Q

LAD: aspect of heart affected and leads

A

heart: anterior
leads: V3, V4

52
Q

septal correlates with which leads

A

V1, V2

53
Q

RCA: aspect of heart affected and leads

A

heart: inferior

leads 2, 3, aVF

54
Q

lateral MI = which leads

A

1, avl, v5, v6

55
Q

inferior MI = which leads

A

2, 3, avf

56
Q

anterior MI = which leads

A

V3, V4

57
Q

septal MI = which leads

A

V1, V2

58
Q

treatment of ACS

A

aspirin, nitro, oxygen, morphine
don’t use NSAIDS (interfere with aspirin)
don’t give O2 if oxygen sat is normal

59
Q

RF for peripheral arterial thrombosis

A

smoking, cholesterol, HTN, family history, DM, age, sex, a fib!

60
Q

Afib is a risk factor for what two pathologies

A

CVA and peripheral arterial thrombosis

61
Q

RF for PAT are the same for what other condition

A

atherosclerosis

62
Q

sudden onset limb arterial occlusion

A
  • painful, cold, pale

- don’t really understand this ?

63
Q

chronic occlusion, aka

A

intermittent claduication
leg pain with activity. can only go a certain distance before pain. muscle builds up an oxygen reserve, so pt is ok at rest but uses up the reserve with activity. once the oxygen is depleted with activity, the legs become painful

64
Q

treatment for chronic occlusion

A

control RFs, encourage statins and exercise to increase collateral formation of vessels (BVs will form around occluded vessels), aspirin, PT!

65
Q

T/F most causes of atherosclerosis are modifiable

A

true! smoking, cholersterol, HTN

66
Q

define cardiac death

A

dead less than 1hr after symptom onset

50% of cardiac deaths

67
Q

1 cause of sudden cardiac death

A 
heart disease (ASCVD) (acute ischemic event such as a STEMI) 
second cause - channelopathy
68
Q

Risks of sudden cardiac deaths

A 
heart diease (ASCVD risks) such as smoking
drugs
time of day/season (morning, winter)
SDH: black race, poverty, stress
exercise
69
Q

treatment of sudden cardiac death

A

defibrillate, CPR, drugs

70
Q

people at risk of sudden cardiac death

A
  • those with ASCVD (smokers or current/past heart damage)
  • syncope in at risk pop
  • family history

Semester 5 PMCP Exam 1 (3 decks)

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