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Clin for Final > Cardiac Diseases > Flashcards

Cardiac Diseases Flashcards

0
Q

What are two types of CVAs? Which is more common?

A

Ischemic (clot blocks blood supply to an area of the brain) and hemorrhagic (blood leaks into brain issue). Majority are Ischemic (80%).

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1
Q

Define cerebrovascular accident.

A

AKA stroke. Occurs when blood flow to the brain is blocked or when blood vessels in the brain rupture, resulting in brain cell death and damage.

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2
Q

What is a tachycardia that occurs when electrical activity in atria is disorganized and very rapid?

A

Atrial fibrillation. Rapid contraction prevents effective pumping.

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3
Q

What can cause a hemorrhagic stroke?

A

Rupture of a vessel, ruptured aneurysm, or head trauma.

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4
Q

What increases the risk of a vessel rupture in the brain?

A

Hypertension.

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5
Q

What is a TIA?

A

Transient Ischemic attack. Brief stroke-like symptoms that last from minutes to 24 hrs, with no permanent damage.

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6
Q

What is an MI?

A

Myocardial infarction. Damage and death to heart tissue by lack of oxygen flow to the heart muscle.

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7
Q

What is primary prevention?

A

Population based guidelines to prevent disease

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8
Q

What is secondary prevention?

A

Address existent disease in early stages before it causes significant morbidity or mortality.

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9
Q

What is tertiary prevention?

A

Reduce negative impacts of existent disease and reduce mortality.

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10
Q

What age based guidelines are there for whose plasma lipid profiles should be screened?

A

Men >=40 and women >=50 OR post-menopausal.

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11
Q

What are conditions that should have plasma lipid profile screening regardless of age (12 total).

A

Diabetes, hypertension, cigarette smoking, obesity, family history of premature CAD (<60 yrs), inflammatory diseases, chronic renal diseases, evidence of atherosclerosis, HIV infection with antiretroviral Tx, clinical manifestations of hyperlipidemia, erectile dysfunction, family history of lipid disorders.

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12
Q

What events are possible with impaired function of coronary arteries?

A

Angina, MI

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13
Q

What events are possible with impaired function of cerebral arteries?

A

CVAs, TIAs

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14
Q

What events can occur with impaired function to peripheral arteries?

A

Peripheral vascular disease (PVD). Poor circulation in limbs and extremities, limb ischemia, ulceration, poor wound healing, gangrene.

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15
Q

At what age does the Framingham risk score become less valid?

A

75

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16
Q

What should the dietary cholesterol be limited to in order to lower CVD risk?

A

200 mg

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17
Q

What diets do the CCS recommend for heart health?

A

Mediterranean, portfolio, or DASH.

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18
Q

What is the exercise recommendation to reduce risk of CVD?

A

150 mn/wk in bouts of 10 mn or more.

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19
Q

What foods are added with the portfolio diet?

A

Plant sterols/sterols, almonds, soluble fibre, and soy protein.

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20
Q

When is a more liberal dietary approach indicated?

A

Advanced age, advanced disease, poor prognosis, poor appetite, poor intake, weight loss.

21
Q

What 13 elements are invoked in the “total diet approach”?

A

Low sodium, low simple sugars, unsaturated fats, increase F&V, energy intake for a healthy weight, 30-60 mn exercise daily, manage stress, alcohol moderation, remove visible fat on meats, red meat 1-2wk max, shrimp + seafood fine, coffee/tea beneficial unless fluid restriction.

22
Q

What factor is risk of CVD increased by with for diabetics?

A

2-4x

23
Q

What are some dietary approaches to lower triglycerides?

A

Reduce alcohol, limit refined carbs, heart healthy fats, avoid extremes in carb or fat intake, include omega 3, weight reduction or management.

24
Q

What are some signs and symptoms of a stroke?

A

All these are sudden in cases of a stroke. Weakness (loss of strength or numbness, usually face arm or leg), trouble speaking, vision problems, headache, dizziness.

25
Q

What is a “mini stroke”?

A

TIA

26
Q

After a stroke, what are some adverse consequences?

A

Disability from weakness, speech loss, vision loss, or paralysis. Emotional problems, including depression. Cognitive deficit, especially with attention and memory.

27
Q

What are some signs and symptoms of an MI?

A

Chest pain (radiate to jaw, shoulder, arm possible), dyspnoea, extreme pallor, nausea + vomiting, fatigue, tachyrhythmias, hypotension, fever, sense of impending doom.

28
Q

What kind of patient will be more likely to show atypical MI symptoms?

A

Women.

29
Q

What 3 different elements will be looked at to diagnose an MI?

A

Muscle damage enzymes- troponin (specific to the heart muscle) and creative kinase (slightly less specific)
Hx of chest pain + ECG
C-reactive protein (CRP)

30
Q

What is the difference between an NSTEMI and a STEMI?

A

Non-ST-Segment elevation MI is less severe, usually a partial blockage. ST-segment elevation MI is more severe. Both have myocardial necrosis and release of troponins or CK.

31
Q

What proportion of MIs have atherosclerosis associated?

A

90%

32
Q

How soon should you measure blood lipids after an MI?

A

3-6 mths. Won’t be accurate sooner than that.

33
Q

What are risk factors for CHF? (9 given)

A

Coronary artery disease, infection of the heart muscle, congenital heart disease, hypertension, MI (most common cause), heart valve disease, arrhythmia, excessive drugs/alcohol, diseases like COPD, anemia, hyper/hypothyroidism.

34
Q

What are some common symptoms with CHF?

A

Shortness of breath with activity/lying down, cough/cold symptoms, swelling of ankles + feet, swelling of abdomen, sudden unexplained weight gain, irregular or rapid pulse, sensation of feeling heart beat (palpitations), difficulty sleeping, fatigue, loss of appetite, increased urination at night.

35
Q

What is an ejection fraction?

A

How much blood is pumped out of the ventricle with each contraction.

36
Q

What is the most commonly measured ejection fraction?

A

Left ventricular.

37
Q

What is a normal ejection fraction?

A

50-65%

38
Q

What are the two types of congestive heart failure?

A

Systolic heart failure AKA systolic left ventricular dysfunction
Heart failure with preserved left ventricular function AKA diastolic heart failure

39
Q

What is systolic heart failure? What EF will be seen? How is it usually managed?

A

Left ventricle doesn’t contract with enough force, less oxygen rich blood gets to be pumped around the body. See low LVEF. Usually treat with sodium/fluid restrictions.

40
Q

What is diastolic heart failure? What EF is seen? How is it usually managed?

A

Normal contraction, but the ventricles do not relax properly or are stiff and less blood enters the heart during normal filling. EF may be normal. Usually manage with Meds and sodium/ fluid restriction.

41
Q

What EF is considered below normal? What is considered life threatening?

A

35-49%. <35%

42
Q

What are important lab values to monitor for CF?

A

B-type natriuretic peptide (BNP). Secreted when the muscle divers in the left ventricle are stretched.
Serum sodium + potassium. When sodium is low, put on fluid restriction.

43
Q

What are the 3 main nutritional concerns for CHF?

A

Sodium intake, fluid intake, and overall nutritional adequacy due to early satiety , shortness of breathe.

44
Q

What are some characteristics of cardiac cachexia?

A

Weight loss with significant loss of lean body mass including heart muscle. Heart becomes soft + flabby, poor prognosis.

45
Q

What are some physiological aspects of cardiac cachexia that impact nutritional status?

A

Inadequate supply of blood to the GI. See anorexia, nausea, feeling full, constipation, pain, and malabsorption.

46
Q

How much sodium should CHF patients be getting per day?

A

> 2 g

47
Q

What should fluids be for CHF patients per day?

A

Usually <2 L. For severely decompensated CHF for hyponatremia might be 1-1.5 L

48
Q

What are digitalis glycosides?

A

Med used in CHF to help the heart muscle to contract and to regulate the heart rhythm.

49
Q

What are some Meds used in the treatment of CHF?

A

ACE inhibitors, diuretics, digitalis glycosides, angiotensin receptor blockers, and beta-blockers.

Clin for Final (5 decks)

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