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Cardio Board Correlates > Cardiovascular Disease - Coronary Artery Disease > Flashcards

Cardiovascular Disease - Coronary Artery Disease Flashcards

1
Q

most common underlying cause of myocardial ischemia and injury

A

obstruction of coronary arteries by artherosclerosis

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2
Q

most common cause of anterior chest musculoskeletal pain

A

costochondral and chondrosternal syndromes

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3
Q

myocardial perfusion occurs during this time

A

diastole

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4
Q

remains the major cause of death and premature disability in developed societies

A

atherosclerosis

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5
Q

site with higher predilection for developing atherosclerotic disease

A

proximal left anterior descending coronary artery

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6
Q

initial lesion of atherosclerosis

A

fatty streak

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7
Q

age when lipid screening should start (based on current ATP III guidelines)

A

20 y/o (fasting lipid profile; total cholesterol; triglycerides; LDL, and HDL), repeated every five years

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8
Q

initial management of dyslipidemia

A

therapeutic lifestyle changes (TLC)

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9
Q

ultimately causes the gravest complications of atherosclerosis

A

thrombosis

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10
Q

key feature of metabolic syndrome

A

central adiposity

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11
Q

most accepted and unifying hypothesis to describe pathophysiology of metabolic syndrome

A

insulin resistance

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12
Q

driving force behind the metabolic syndrome

A

obesity

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13
Q

primary approach to metabolic syndrome

A

weight reduction ( caloric restriction: most important component)

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14
Q

in LDL cholesterol - generally the first choice for medication intervention

A

HMG-CoA Reductase inhibitors (statins)

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15
Q

drug of choice to lower fasting TG and typically achieve a 35-50% reduction

A

fibrates

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16
Q

only currently available drug with predictable HDL cholesterol raising properties

A

nicotinic acid

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17
Q

most common cause of myocardial ischemia

A

atherosclerotic disease of epicardial coronary artery

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18
Q

major site of atherosclerotic disease

A

epicardial arteries (most common: left anterior descending artery)

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19
Q

predilection for atherosclerotic plaques to develop at sites of increased turbulence

A

branch points in the epicardial arteries

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20
Q

reversible damage in myocardium

A

less then or equal to 20 minutes for total occlusion in the absence of collaterals

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21
Q

typical patient with angina

A

man >50 years or a woman >60years of age who complains of chest discomfort (heaviness, pressure, squeezing, smothering or choking) and only rarely as frank pain

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22
Q

most commonly used test for both the diagnosis of IHD and estimating the prognosis

A

electrocardiographic stress testing

23
Q

route providing most rapid and complete absorption of nitrates

A

mucous membranes

24
Q

most common route in administration of nitroglycerin

A

sublingually

25
Q

most common pathophysiologic cause of unstable angina

A

plaque rapture or erosion with superimposed non-occlusive thrombus

26
Q

clinical hallmark of ACS, typically located in the substernal region or sometimes in the epigastrum, that radiate to the neck, left shoulder, and left arm

A

chest pain

27
Q

only absolute contraindications to nitrate use

A

hypotension

use of sildenafil or similar drugs in previous 24-48 hours

28
Q

most important adverse effect of all antithrombotic agents

A

excessive bleeding

29
Q

most common artery involved in focal spasms of Prinzmetal angina

A

right coronary artery

30
Q

main agents for acute episodes of prinzmetal angina and to abolish recurrent episodes

A

nitrates and calcium channel blockers

31
Q

type of necrosis seen in M.I.

A

coagulation necrosis (preserved architecture, faded details)

32
Q

initial occurrence of gross changes in M.I.

A

12 hours after onset of symptoms

33
Q

color changes in M.I.

A

mottling: 4 hours
bright yellow: 1 week
surrounding red granulation tissue: 2 weeks
gray-white scar: 2 months

34
Q

full-thickness/transmural; ECG: ST-Elevation, Q waves; associated with increased early mortality rate

A

Q-wave infarction (clinically equivalent to STEMI)

35
Q

Partial-thickness/subendocardial; involves inner third of myocardium; ECG: ST depression; increased risk of infarction and sudden cardiac death post-M.I.

A

Non-Q-wave infarction (Clinically equivalent to NSTEMI)

36
Q

Fibrous pericarditis (bread & butter pericarditis) associated with M.I.

A

Dressler’s syndrome (Dressler’s Triad: fever, pleuritic pain, pericardial effusion)

37
Q

Myocardial rupture post-M.I.

A

Usually in 1st time M.I. patients (cardiac scar that forms in those with previous M.I. prevents rupture)

38
Q

most common presenting complaint in STEMI

A

chest pain

39
Q

pivotal diagnostic and triage tool because it is at the center of the decision pathway for screening and management in STEMI

A

12-lead ECG

40
Q

preferred biochemical markers for MI

A

cardiac-specific troponin T & cardiac-specific troponin I

41
Q

most out-of-hospital deaths from STEMI

A

ventricular fibrillation

42
Q

primary cause of in-hospital deaths from STEMI

A

pump failure

43
Q

greatest delay usually occurs between

A

onset of pain and the patient’s decision to call for help

44
Q

principal goal of fibrinolysis

A

prompt restoration of full coronary arterial patency

45
Q

door-to-needle time

A

less than or equal to 30 min

46
Q

most frequent and potentially the most serious complication of fibrinolysis

A

hemorrhage (hemorrhagic stroke: most serious complication)

47
Q

standard antiplatelet agent for STEMI

A

aspirin

48
Q

standard anticoagulant agent used in clinical practice (IN STEMI)

A

unfractionated heparin

49
Q

most common clinical signs of pump failure

A

pulmonary rales; s3 and s4 gallop sounds

50
Q

extent of LV involvement that usually results in cardiogenic shock

A

infarction >40%

51
Q

usual duration of hospitalization for an uncomplicated STEMI

A

5 days

52
Q

most common complication of angioplasty

A

restenosis, or re-narrowing of the dilated coronary stenosis

53
Q

most common thrombi found in NSTEMI

A

white thrombi (composed mainly of platelets)

54
Q

most common thrombi found in STEMI

A

red thrombi (composed of cells and fibrins)

Cardio Board Correlates (15 decks)

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