CAD, angina

Question 1

worst vessel to get occluded?

Answer 1

left main, turns into LAD (widowmaker)

Question 2

working cells remain viable for up to

Answer 2

20 minutes

Question 3

stable angina

Answer 3

Chronic obstruction
Chest pain with exertion
May radiate, may have diaphoresis, SOB, pallor
Relief with rest or nitrates

Question 4

prinzmetal angina

Answer 4

spasms that come and go

Question 5

unstable angina

Answer 5

essentially an MI

ASA, ACE, Statin

Question 6

gold standard for a STEMI

Answer 6

EKG

Question 7

what are some drugs for stable angina?

Answer 7

• nitrates (don’t take w/PDE 5 I)
• B blockers
• CCB
• statins

Question 8

chronotropic vs

inotropic

Answer 8

rate

contraction

Question 9

Temporary loss of contractility that persists for hours to days, this can occur post M/I

Answer 9

myocardial stunning

Question 10

Chronically ischemic; myocytes are hibernating to preserve function until perfusion can be restored

Answer 10

myocardial hibernation

Question 11

myocardial remodeling

Answer 11

Loss of contractility mediated by Ang II, catecholamines, and inflammatory cytokines

Question 12

these things are happening during an MI

Answer 12

• increased O2 demand, epi, renin
• necrosis
• conduction problems

Question 13

Q waves can indicate

Answer 13

prior MI

Question 14

classic EKG findings for an MI

Answer 14

T-wave inversion, ST-elevation

Question 15

prodromal symptoms of an MI

Answer 15

Symptoms usually appear 24-72 hours before
Malaise, Tiredness, Weakness fatigue
Visual disturbance

Question 16

acute symptoms of an MI

Answer 16

Chest Pain, Dyspnea, Nausea, Diaphoresis, weakness, fatigue, anxiety
Signs: Gray/ashen (from decreased perfusion), gasping, clutching, loss of consciousness, confused, ECG changes, tachycardia, tachypnea

Question 17

gold standard tx for STEMI

Answer 17

cath lab

Question 18

most chest pain/MI you would give

Answer 18

Morphine
O2
Nitro
ASA

Question 19

best lab test for MI

Answer 19

troponins, very heart specific

Question 20

when would you give fibrinolytics

Answer 20

If you cant get to a cath lab before 2 hours then give fibrinolytics

Question 21

MCC deathi within 72 hours of MI

Answer 21

cardiac arryhthmias

Question 22

PTT

Answer 22

heparin

intrinsic

Question 23

PT/INR

Answer 23

warfarin

extrinsic

Question 24

new chol goals?

Answer 24

decrease LDL 50% in those with 10 year CAD

Question 25

statins

Answer 25

rhabdo

Question 26

niacin

Answer 26

raises HDL best

Question 27

PSK 9 inhibitors

Answer 27

• familial hyperlipidemia

- repatha