Cardio14

Question 1

Definition of Hypertension.

Answer 1

BP ≥ 140/90 mmHg

Question 2

1˚ Hypertension (essential) is associated with -

Answer 2

INcreased CO or INcreased TPR

*90% of cases

Question 3

Other than essential HTN, what is the rest of HTN due to?

Answer 3

Renal disease

Question 4

Malignant Hypertension.

Answer 4

> 180/120 mmHg

Rapidly progressing

Question 5

Hypertension predisposes patients to what other conditions?

Answer 5

Atherosclerosis
LVH
Stroke
CHF
Renal Failure
Retinopathy
Aortic Dissection

Question 6

Hyperlipidemia sign:

Atheromas

Answer 6

Plaques in blood vessel walls

Question 7

Hyperlipidemia sign:

Xanthomas

Answer 7

Plaques or nodules composed of lipid-laden histiocytes in the skin

*especially eyelids (xanthelasma)

Question 8

Hyperlipidemia sign:

Tendinous Xanthomas

Answer 8

Lipid deposit in tendon

*Achilles tendon most common

Question 9

Hyperlipidemia sign:

Corneal Arcus

Answer 9

Lipid deposition in cornea

*nonspecific (arcus senilis)

Question 10

What is Monkeberg?

Answer 10

Calcification in the media of the arteries
- especially radial or ulnar
Benign - don’t affect blood flow
“pipestem” arteries

Question 11

Arteriolosclerosis types.

Answer 11

Hyaline
-Thickening of Small arteries in 1˚ HTN or DM
Hyperplastic
-“onion skinning” in malignant HTN

Question 12

Atherosclerosis.

Answer 12

Fibrous plaque & atheromas form in INTIMA of arteries

Disease of Elastic arteries & large- & medium-sized muscular arteries

Question 13

What process is important in the pathogenesis of atherosclerosis?

Answer 13

Inflammation

Question 14

Describe the progression of Atherosclerosis

Answer 14

Endothelial cell dysfunction
 Macrophage & LDL accumulation
  FOAM CELL formation
   Fatty Streaks
    Smooth m. cell migration (PDGF & FGF)
     Fibrous plaque
      Complex atheromas

Question 15

What are the common locations of Atheroscleoris (most to least)?

Answer 15

Abdominal Aorta > Coronary a. > Popliteal a. > Carotid a.

Question 16

Abdominal Aortic Aneurysms are associated with:

Answer 16

Atherosclerosis

*HTN male smokers > 50 y/o

Question 17

Thoracic Aortic Aneurysms are associated with:

Answer 17

HTN
Cystic Medial Necrosis (Marfan’s)
3˚ Syphilis

Question 18

A longitudinal tear forma a false lumen in the Aorta is known as?

Answer 18

Aortic Dissection

Question 19

How does Aortic Dissection present?

Answer 19

Tearing Chest pain RADIATING to the back

Question 20

What are the 5 manifestations of Ischemic Heart Disease?

Answer 20

Angina
Coronary Steal syndrome
Myocardial infaction (MI)
Sudden Cardiac Death
Chronic Ischemic Heart disease

Question 21

What are the characteristics of Angina?

Answer 21

CAD narrowing > 75%

NO myocyte necrosis

Question 22

What are the types of Angina?

Answer 22

Stable
Prinzmetal’s variant
Unstable/Cresendo

Question 23

Stable Angina.

Answer 23

2˚ to atherosclerosis
ST depression on ECG
Retrosternal chest pain w/exertion

Question 24

Prinzmetal’s variant Angina.

Answer 24

Occurs at rest 2˚ to Coronary a. spasm

ST elevation on ECG

Question 25

Unstable/Cresendo Angina.

Answer 25

• Thrombosis w/ incomplete coronary a. occulsion
• ST depression on ECG
• Worsening chest pain at rest or w/ minimal exertion

Question 26

Coronary steal syndrome.

Answer 26

Vasodilator may aggravate ischemia by shunting blood from area of critical stenosis to an area of higher perfusion

Question 27

Myocardial Infarction.

Answer 27

• Acute thrombosis d/t coronary a. atherosclerosis w/ complete occlusion of coronary a. and myocyte Necrosis
• Initial ECG - ST depression
• Progress to ST elevation w/ continued ischemia and transmural necrosis

Question 28

Sudden Cardiac Death.

Answer 28

Death within 1 hour of onset of symptoms
D/t lethal arrhythmia (e.g., V. Fib)
Associated with CAD (70%)

Question 29

Chronic Ischemic Heart disease.

Answer 29

Progressive onset of CHF over many years d/t Chronic ischemic myocardial damage