cardiology p 64 - 70

Question 1

most accurate method of detecting coronary artery disease?

Answer 1

angiography

Question 2

what kinds of rhythm disorder Holter can detect?

Answer 2

a fib, flutter, ectopy such as premature beats, or ventricular tachycardia

Question 3

what are the 3 meds that lower mortality for pts with chronic angina

Answer 3

aspirin, beta blockers, nitroglycerin

Question 4

a pt with acute coronary syndrome arrives at ER, what are the drugs you must give right away

Answer 4

2 antiplatelet meds

aspirin, and any one of the below med
clopidogrel, prasugrel, ticagrelor

Question 5

what is the mech of clopidogrel, prasugrel, or ticagrelor?

Answer 5

P2Y12 receptor inhibitor

Question 6

true or false

the use of 2 antiplatelet meds also apply to chronic/stable coronary artery disease

Answer 6

false

Question 7

what meds have the best mortality benefit in chronic angina

Answer 7

aspirin and beta blocker

Question 8

what are the 3 indications for clopidogrel?

Answer 8

1. combination with aspirin on all acute coronary syndrome
2. aspirin intolerance such as allergy
3. recent angioplasty with stenting

Question 9

what is the indication for Prasugrel?

Answer 9

angioplasty and stenting

Question 10

what is the additional therapy for angina refractory or persistent through other treatment

Answer 10

ranolazine

Question 11

what are the two cardiac issues that can benefit the best from ACE inhibitors/Angiotensin receptor blockers

Answer 11

1. low ejection fraction/systolic dysfunction

2. regurgitant valvular dz

Question 12

what is the name of the drug that is an alternative to prasugrel or clopidogrel that is added to aspirin?

Answer 12

ticagrelor

Question 13

with CAD, what is the goal of LDL?

Answer 13

less than 100 mg/dl

Question 14

what are the 3 indications for calcium channel blockers?

Answer 14

1. severe asthma preventing the beta blocker usage
2. prinzmetal variant angina
3. cocaine-induced chest pain

Question 15

a pt who used cocaine came to ER for chest pain, would you give beta blocker?

Answer 15

no, it’s contraindicated.

Question 16

name 3 side effects of calcium channel blockers

Answer 16

edema, constipation (verapamil especially), heart block

Question 17

3 indications for coronary artery bypass grafting?

Answer 17

1. 3 vessels with at least 70% stenosis in each vessel
2. Lt. main coronary artery occlusion
3. two vessel dz in a pt with diabetes

Question 18

percutaneous coronary intervention (PCI) is also called

Answer 18

angioplasty

Question 19

what is the best therapy for acute coronary syndrome especially with ST segment elevation?

Answer 19

percutaneous coronary intervention

Question 20

does PCI provide mortality benefit for stable pts?

Answer 20

No

Question 21

Side effects of Niacin?

Answer 21

Elevation in glucose and uric acid, pruritus

Question 22

A pt comes in with LDL of 120 and you decide to give statin, what lab must you do before you give statin?

Answer 22

AST, ALT

Question 23

What particular lipid lowering agent increases the risk of myositis?

Answer 23

Fibric acid derivatives

Question 24

True or false?

Calcium channel blockers lower mortality

Answer 24

False, actually they increase mortality why? Bc of reflex tachy à inc heart rate

Question 25

What is the effect of calcium channel blockers in terms of myocardial oxygen consumption?

Answer 25

Decreases, since it is a negative ionotrope

Question 26

So if calcium channel blockers reduce myocardial oxygen consumption as a negative ionotrope, why isn’t it beneficial for CAD?

Answer 26

B/c of the inc heart rate, overall increases myocardial oxygen consumption