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Ch.10 Flashcards

1
Q

What does IHD stand for?

A

Ischemic Heart Disease

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2
Q

What is Ischemic Heart Disease?

A

A pathologic condition caused by lack of oxygen to the tissue.

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3
Q

What is the most common cause of Ischemic Heart Disease?

A

Atherosclerosis ( A disease of the arteries characterized by the deposits of plaques of fatty material on their inner walls which hardens the arteries.)

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4
Q

What are some risk factors for Coronary Artery Disease(CAD)?

A
  • Gender -Physical Inactivity
  • Age -Tobacco
  • Heredity -High Blood Pressure
  • Obesity -High Cholesterol
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5
Q

Who is most likely to get CAD?

A

Males

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6
Q

When women get CAD what is it most likely due to?

A

Their hormonal status.

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7
Q

Who is at a higher risk for CHD, pre-menopausal or post-menopausal women?

A

Post-menopausal women.

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8
Q

What may reduce the risk of CHD for women?

A

Hormonal replacement therapy.

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9
Q

True/False:

Increasing age gives a greater risk for CHD.

A

TRUE

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10
Q

Why does increasing age also increase the risk of CHD?

A

Because age can result in the progression of atherosclerosis.

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11
Q

True/False:

Family history is not a risk for CHD.

A

FALSE

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12
Q

What are the two races that have the highest CHD mortality rates?

A

1- African Americans

2- Non-Hispanic whites

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13
Q

True/False:

African American women have higher CHD mortality rates than Non-Hispanic women.

A

TRUE

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14
Q

What age group of African American males have the highest mortality rate?

A

Middle aged

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15
Q

True/False:

Smokers are 2-4 times more likely to develop CHD.

A

TRUE

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16
Q

Why are smokers more likely to develop CHD?

A

Tobacco use accelerates the development of coronary plaques and promotes rupture and coronary thrombosis (the formation of a blood clog inside the a blood vessel of the heart)

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17
Q

Individuals over 50 with systolic BP greater than _______

mmHg have significant risk factor for CHD.

A

140

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18
Q

What is cholesterol and what does too much of it result in?

A
  • Cholesterol is a waxy, fat like substance made in the liver.
  • Too much of it results in Atherosclerosis and CHD
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19
Q

What is a common complication of diabetes due to Atherosclerosis?

A

CHD

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20
Q

True/False:

Atherosclerosis is accelerated and more severe in in diabetics.

A

TRUE

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21
Q

True/False:

50% of diabetics die of some form of cardiovascular disease (CVD).

A

FALSE

75% of diabetics die of some form of CVD

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22
Q

True/False:

Obesity and physical activity are not risk factors for CHD.

A

FALSE

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23
Q

What type of diabetes does obesity often result in?

A

Type 2 diabetes

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24
Q

What are some things a person can do to reduce hypertension and hypercholesterolemia?

A
  • Weight control
  • Diets
  • Exercise
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25
What is angina pectoris?
Inadequate supply of oxygen to the heart
26
Angina pectoris is usually induced by an increase demand for oxygen. What is this usually caused by?
Atherosclerosis
27
True/False: | Occlusion of the artery can result in an infarction where the tissue non receiving blood dies.
TRUE
28
True/False: | Angina Pectoris is NOT a common medical emergency in the dental office.
FALSE
29
What are three forms of angina?
- Stable - Unstable - Variant (Prinzmetal's)
30
What is stable angina usually induced by?
Physical activity or stress (symptoms are usually worse in cold weather or after a large meal)
31
How long does the discomfort in the left area of the chest usually last for?
1-15 minutes
32
True/False: | Stable angina responds to nitroglycerine.
TRUE
33
True/False: Angina is considered stable if there has been no changes in frequency, etiology, or duration of symptoms in the last 30 days
FALSE | 60 days
34
True/False: | A patient with stable angina can receive dental care.
TRUE | appointments should be short and minimally stressful
35
True/False: | Unstable angina is between having stable angina and myocardial infarction (MI).
TRUE
36
Define Class I of unstable angina.
A new onset of severe angina with no pain at rest.
37
Define Class II of unstable angina.
Subacute angina within the past month, but not in proceeding 48 hours.
38
Define Class III of unstable angina.
Acute angina within 48 hours.
39
True/False: | Nitroglycerin may or may not anginal pain.
TRUE
40
True/False: | Patients with unstable angina are at high risk for MI.
TRUE
41
What is a contraindication of unstable angina?
A vasoconstrictor.
42
When does variant angina usually occur?
Usually while person is at rest and during odd hours during day or night (occurs spontaneously).
43
True/False: | Variant angina is more common in women under 25.
FALSE (women under 50)
44
True/False: | Variant angina has a high risk for CAD.
FALSE | low risk
45
What usually provides prompt relieve for a patient with variant angina?
Nitroglycerin
46
True/False: | Patients with variant angina have atherosclerosis.
FALSE | they may or may not have it
47
Etiology of variant angina is ________.
Transient spasm of coronary artery causing brief occlusion of vessels.
48
A patient with stable angina would have what type of generalized chest discomfort?
Pressure burning, heaviness, squeezing, choking.
49
True/False: | During stable angina discomfort radiates to the right shoulder, arm, neck, lower jaw, or tongue.
FALSE | radiates to the left
50
True/False: | A sign of stable angina is diaphoresis (perspiring profusely).
TRUE
51
What are some signs and symptoms of stable angina.
- Pallor (unhealthy pale appearence) - Nausea - Last 1-15 minutes - Increase pulse and BP
52
What are some signs and symptoms of unstable angina.
- Same symptoms as stable angina but may occur for no apparent reason - Intensity may be more acute - May last up to 30 minutes
53
What are some signs and symptoms of variant angina.
- Same symptoms as stable angina as well as palpitations, syncope, dyspnea. - More likely to occur at rest
54
How would you position a patient with angina?
Semi-supine or upright position.
55
How would you treat a patient with angina?
- Place in semi-supine or upright position - Assess ABC's - Administer oxygen (3-6 L/min via nasal cannula or non-re-breather bag) - Monitor vital signs - Administer sublingual or transmucosal nitroglycerin (dilates coronary blood vessels resulting in decreased cardiac work load)
56
Should you use the patients own medication during the treatment of angina?
Yes only if it is current.
57
How often should you administer the medication for the treatment of angina?
Administer 1 tablet every 5 minutes up to 3 doses (usually alleviates symptoms in 2-4 minutes.
58
What should you do if chest pain is not relieved in anginal patient after the second dose of medication?
Contact EMS.
59
If chest pain occurs in a patient with no known anginal history, what should you do?
Contact EMS immediately and follow the steps for treatment of an anginal patient.
60
What is Acute Myocardial Infarction(AMI)?
Necrosis of a portion of the myocardium due to the total or partial occlusion of a coronary artery.
61
What is AMI caused by?
Atherosclerosis, Thromus, or spasm.
62
True/False: | AMI may form rapidly or over a period of time?
TRUE
63
True/False: | MI can lead to cardiac arrest?
TRUE
64
``` True/False: Cardiac dysrhythmia(irregular heartbeat) cannot occur after MI. ```
FALSE | It may occur and it is a high risk for death.
65
What is a classic symptom of AMI?
Chest pain that lasts 20 minutes or longer.
66
True/ False: During AMI a patient may feel pressure, tightness, heaviness, burning, squeezing, crushing sensation of the chest and/or the lower 1/3 of the epigastrium(the upper middle region of the abdomen).
TRUE
67
True/ False: | During AMI the pain does not radiate down the arms, shoulders, jaw, or back. The pain tends to stay around the chest.
FALSE
68
What are some signs and symptoms of AMI?
- Weakness -Nausea - Dyspnea -Vomiting - Diaphoresis -Sense of impending doom - Irregular pulse -Clutching chest
69
True/ False: | Women show different sypmtoms of AMI than men?
TRUE
70
What are some symptoms of AMI that occur to women?
- Atypical Discomfort - Upper Abdominal Pain - Shortness of Breath - Fatigue
71
True/ False: | Diabetics suffer silent MI's.
TRUE
72
True/ False: | During AMI you may continue the dental procedure until patient cannot handle the pain any longer.
FALSE!
73
True/ False: | If a patient with a history of angina shows signs and symptoms of AMI you follow the protocol for angina?
TRUE
74
What should you do if a patient shows signs and symptoms of AMI but the patients has no history of angina?
Contact EMS immediately.
75
What should you do while waiting for EMS to arrive for a patient with AMI?
- Position patient comfortably(usually upright or semi-supine) - Assess ABC's - Administer oxygen(4-6 L/min. via nasal cannula) - Administer Nitroglycerine (3 doses over a 15 min. period) * **IF PAIN DIMINISHES AND THEN RETURNS, IT IS MOST LIKELY AMI.
76
How would you manage the patients pain during AMI?
by administering Nitrous Oxide if available.
77
If cardiac arrest occurs while waiting for EMS to arrive what should you do?
Perform CPR with the AED.
78
How long does it take for a chewed 325mg. aspiring to take into effect on a patient with AMI?
20 min.
79
Why would you give a patient with AMI 325mg. of aspirin?
because it has an antithrombotic (reduces formation of blood clots) effect.

Medical Emergencies (2 decks)

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