Cardio Session 2

Question 1

Unstable angina biomarkers?

Answer 1

none after initial onset of pain

Question 2

Unstable angina 3 principal presentations?

Answer 2

1. Rest angina >20 mins
2. New onset
3. Increasing pattern of ocurrence

Question 3

Clinical presentation of NSTEMI?

Answer 3

Myocardial damage resulting in release of biomarkers

Question 4

Clinical presenation of STEMI?

Answer 4

Red clots

Question 5

What % of infarctions are NSTEMI vs. STEMI

Answer 5

NSTEMI: 2/3
STEMI: 1/3

Question 6

Define atherosclerosis

Answer 6

Ongoing process of plaque formation in intima of arteries

Question 7

Stable angina presentation?

Answer 7

Deep diffuse chest pain that is brought on by exertion and relieved by rest and nitroglycerin

Question 8

How does UA differ from SA?

Answer 8

More severe, occurs at rest, substernal and radiates to neck, jaw, left shoulder and left arm

Question 9

Anginal equivalent symptoms include? 5

Answer 9

1. Dyspnea
2. Nausea
3. Vomiting
4. Diaphoresis
5. fatigue

Question 10

Most common anginal equivalent?

Answer 10

Dyspena

Question 11

Five most important history related factors to identify ischemia? (5)

Answer 11

1. Nature of symptoms
2. History of CAD
3. Male
4. Old
5. # of tradiational risk factors

Question 12

High risk ACS patients have what symptoms? (6)

Answer 12

1. Diaphoresis
2. Pale cool skin
3. Sinus tachycardia
4. S3 or S4
5. Rales
6. Hypotension

Question 13

Typical Angina has what 3 parts?

Answer 13

1. Substernal
2. Exertion
3. Relief by rest of nitroglycerin

Question 14

Atypical angina has what requirements?

Answer 14

Two of the typical symptoms

Question 15

Non-anginal chest discomfort has what requirements?

Answer 15

Less than two typical angina symptoms

Question 16

In terms of quality of chest pain what is predictor?

Answer 16

Sharp or stabbing decreased likelihood of MI

Question 17

3 P’s of precipitating factors of non-MI chest pain

Answer 17

Pleuritic
Positional
Palpable chest pain

Question 18

In terms of exercise, what does it predict?

Answer 18

Exertion is associated with MI

Question 19

Chest pain characteristics that increase likelihood of ACS/AMI?

Answer 19

Chest pain that radiates to one shoulder or both shoulders and is precipitated by exertion

Question 20

Chest pain characteristics that decrease likelihood of ACS/AMI?

Answer 20

Pain that is stabbing, pleuritic, positiona, or reproducible by palpation

Question 21

High likelihood of ACS is seen in patients that present how?

Answer 21

Chest/left arm pain, known history of CAD, murmur, edema, ST segment deviation, Elevated cardiac markers

Question 22

Intermediate likelihood of ACS is seen in patients that present how?

Answer 22

Chest/left arm pain as chief symptom, older than 70, male, diabetic, normal ecg and normal cardiac markers

Question 23

Low likelihood of ACS presents how?

Answer 23

Symptoms but no risk factors, cocaine use, chest pain from palpation, no ecg change, normal cardiac markers

Question 24

ANgina equivalents are seen in which population the most?

Answer 24

Elderly, women, and diabetics

Question 25

stable angina usually lasts how long?

Answer 25

2-10 minutes, relieved by rest

Question 26

Common cause of ACS's?

Answer 26

DIsruption of high risk plaques

Question 27

Angiographic evidence of coronary thrombus formation is seen in what % of STEMI patients?

Answer 27

90%

Question 28

Key concept in STEMI is?

Answer 28

Ventricular remodeling

Question 29

What is infarct expansion?

Answer 29

Acute dilation and thinning of area of infarction that is not due to additional necrosis

Question 30

How do sexes differ in STEMI's?

Answer 30

Women present at older age and later onset than men

Question 31

Elderly patients are more or less likely to complain of chest discomfort in STEMI?

Answer 31

Less

Question 32

Elderly patients are more or less likely to complain of shortness of breath and other atypical symptoms in STEMI?

Answer 32

More

Question 33

How has epidemiology changed in STEMI's? 2

Answer 33

Increase in NSTEMI patients | Decrease in STEMI deaths

Question 34

Five most important factors in ischemia due to CAD?

Answer 34

1. nature of symptoms 2. prior history of CAD 3. Male sex 4. Older age 5. Number of traditional risk factors present

Question 35

Age difference in sexes for NSTEMI's?

Answer 35

Older than 55 if male | Older than 65 if female

Question 36

Class I angina grade?

Answer 36

ANgina with prolonged exertion

Question 37

Class II angina grade?

Answer 37

Angina when doing stairs, hills, bad weather, and slightly limits ordinary activity

Question 38

Class III angina grade?

Answer 38

1-2 blocks and 1 flight of stairs

Question 39

Class IV angina?

Answer 39

No physical activity without discomfort

Question 40

Angina Type I?

Answer 40

Atypical chest pain that is not exertional

Question 41

Angina Type II?

Answer 41

Stable angina without a change in frequency and is controlled by rest or nitro

Question 42

Angina Type III?

Answer 42

UA or MI: Angina >20 mins

Question 43

Strongest arguments for CAD in patient with intermittent chest pain?

Answer 43

``` Typical angina Ankle to arm pressure index Prior MI Acus senilis Older than 70 Positive earlob ecrease ```

Question 44

3 characteristics to be wary of when determining CAD?

Answer 44

Earlobe crease, arcus senilis, GI cocktail

Question 45

What predicts the risk of adverse CV outcome?

Answer 45

Parenteral history of MI