cardiology: ischaemic heart disease

Question 1

8 modifiable risk factors in IHD?

Answer 1

1. hyperlipidaemia
2. HTN
3. DM
4. smoking
5. physical activity
6. psychosocial stress
7. obesity
8. ETOH

Question 2

pathophysiology of endothelial plaque?

Answer 2

injury
monocyte recruitment
LDL to oxidised LDL
macrophages eat ox-LDL
become foam cells

Question 3

what commonly causes chronic stable angina?

Answer 3

atheroma

Question 4

what causes ACS?

Answer 4

plaque rupture

Question 5

Canadian Cardiovascular Society (CCS) classification?

Answer 5

Class I: normal activity no angina
Class II: angina with >2 blocks >1 stairs
Class III: angina with <2 blocks, <1 stairs
Class IV: angina with slightest or @ rest

Question 6

3 Es of predictability in chest pain?

Answer 6

exertion
emotion
eating

Question 7

Chronic Stable angina treatment 7 things

Answer 7

1. lifestyle
2. antiplatelet
3. ACE inhibitor
4. B-blocker
5. calcium channel blocker
6. NItrates
7. Invasive

Question 8

how to Rx Prinz-metal Angina?

Answer 8

nitrates

CCBs

Question 9

STEMI definition?

Answer 9

ST elevation or new BBB

Question 10

4 things for an MI

Answer 10

Troponin
chest pain
ECG changes
Imaging -

Question 11

Blood tests for MI investigation

Answer 11

CBC
UEC
Coags
CMP
Cr.
Ur
glucose
lipids

Question 12

TIMI risk score is?

Answer 12

to assess early LMWH and angiography

Question 13

Beta blocker in STEMI?

Answer 13

• usually wait to assess if heart failure/shock/asthma/airways disease
• can use CCBs instead

Question 14

2 kinds of PCIs

Answer 14

primary

rescue: after failed thrombolytic therapy

Question 15

post MI, which drugs to give?

Answer 15

1.EC ASA 81mg daily
2. ticagrelor/prasugrel if stetted for 12/12
clopidogrel as alternative
3. b/blocker
4. nitrates(not R sided)
5. ACE
6. spiro/eplerenone

Question 16

CCBs in MIs?

Answer 16

not first line

Question 17

Complications of MI?

Answer 17

CRASH PAD

cardiac rupture
arrhythmia
shock
hypertension
Pericarditis/PE
aneurysm
DVT

Question 18

enoxaparin vs. unfractionated heparin in STEMIs?

Answer 18

enoxaparin

Question 19

statins in ACS?

Answer 19

high dose, mortality benefit

Question 20

Rx of NSTEMI acronym?

Answer 20

BEMOAN

b-blocker
enoxaparin
morphine
O2
ASA
Nitrates

Question 21

triple therapy for stents?

Answer 21

6 weeks no better than 6 months