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Medical Emergencies > Ch.10 > Flashcards

Ch.10 Flashcards

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USMLE® Step 1 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
Q

What is angina pectoris?

A

Inadequate supply of oxygen to the heart

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26
Q

Angina pectoris is usually induced by an increase demand for oxygen. What is this usually caused by?

A

Atherosclerosis

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27
Q

True/False:

Occlusion of the artery can result in an infarction where the tissue non receiving blood dies.

A

TRUE

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28
Q

True/False:

Angina Pectoris is NOT a common medical emergency in the dental office.

A

FALSE

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29
Q

What are three forms of angina?

A
  • Stable
  • Unstable
  • Variant (Prinzmetal’s)
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30
Q

What is stable angina usually induced by?

A

Physical activity or stress (symptoms are usually worse in cold weather or after a large meal)

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31
Q

How long does the discomfort in the left area of the chest usually last for?

A

1-15 minutes

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32
Q

True/False:

Stable angina responds to nitroglycerine.

A

TRUE

33
Q

True/False:
Angina is considered stable if there has been no changes in frequency, etiology, or duration of symptoms in the last 30 days

A

FALSE

60 days

34
Q

True/False:

A patient with stable angina can receive dental care.

A

TRUE

appointments should be short and minimally stressful

35
Q

True/False:

Unstable angina is between having stable angina and myocardial infarction (MI).

A

TRUE

36
Q

Define Class I of unstable angina.

A

A new onset of severe angina with no pain at rest.

37
Q

Define Class II of unstable angina.

A

Subacute angina within the past month, but not in proceeding 48 hours.

38
Q

Define Class III of unstable angina.

A

Acute angina within 48 hours.

39
Q

True/False:

Nitroglycerin may or may not anginal pain.

A

TRUE

40
Q

True/False:

Patients with unstable angina are at high risk for MI.

A

TRUE

41
Q

What is a contraindication of unstable angina?

A

A vasoconstrictor.

42
Q

When does variant angina usually occur?

A

Usually while person is at rest and during odd hours during day or night (occurs spontaneously).

43
Q

True/False:

Variant angina is more common in women under 25.

A

FALSE (women under 50)

44
Q

True/False:

Variant angina has a high risk for CAD.

A

FALSE

low risk

45
Q

What usually provides prompt relieve for a patient with variant angina?

A

Nitroglycerin

46
Q

True/False:

Patients with variant angina have atherosclerosis.

A

FALSE

they may or may not have it

47
Q

Etiology of variant angina is ________.

A

Transient spasm of coronary artery causing brief occlusion of vessels.

48
Q

A patient with stable angina would have what type of generalized chest discomfort?

A

Pressure burning, heaviness, squeezing, choking.

49
Q

True/False:

During stable angina discomfort radiates to the right shoulder, arm, neck, lower jaw, or tongue.

A

FALSE

radiates to the left

50
Q

True/False:

A sign of stable angina is diaphoresis (perspiring profusely).

A

TRUE

51
Q

What are some signs and symptoms of stable angina.

A
  • Pallor (unhealthy pale appearence)
  • Nausea
  • Last 1-15 minutes
  • Increase pulse and BP
52
Q

What are some signs and symptoms of unstable angina.

A
  • Same symptoms as stable angina but may occur for no apparent reason
  • Intensity may be more acute
  • May last up to 30 minutes
53
Q

What are some signs and symptoms of variant angina.

A
  • Same symptoms as stable angina as well as palpitations, syncope, dyspnea.
  • More likely to occur at rest
54
Q

How would you position a patient with angina?

A

Semi-supine or upright position.

55
Q

How would you treat a patient with angina?

A
  • 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
Q

Should you use the patients own medication during the treatment of angina?

A

Yes only if it is current.

57
Q

How often should you administer the medication for the treatment of angina?

A

Administer 1 tablet every 5 minutes up to 3 doses (usually alleviates symptoms in 2-4 minutes.

58
Q

What should you do if chest pain is not relieved in anginal patient after the second dose of medication?

A

Contact EMS.

59
Q

If chest pain occurs in a patient with no known anginal history, what should you do?

A

Contact EMS immediately and follow the steps for treatment of an anginal patient.

60
Q

What is Acute Myocardial Infarction(AMI)?

A

Necrosis of a portion of the myocardium due to the total or partial occlusion of a coronary artery.

61
Q

What is AMI caused by?

A

Atherosclerosis, Thromus, or spasm.

62
Q

True/False:

AMI may form rapidly or over a period of time?

A

TRUE

63
Q

True/False:

MI can lead to cardiac arrest?

A

TRUE

64
Q 
True/False:
Cardiac dysrhythmia(irregular heartbeat) cannot occur after MI.
A

FALSE

It may occur and it is a high risk for death.

65
Q

What is a classic symptom of AMI?

A

Chest pain that lasts 20 minutes or longer.

66
Q

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).

A

TRUE

67
Q

True/ False:

During AMI the pain does not radiate down the arms, shoulders, jaw, or back. The pain tends to stay around the chest.

A

FALSE

68
Q

What are some signs and symptoms of AMI?

A
  • Weakness -Nausea
  • Dyspnea -Vomiting
  • Diaphoresis -Sense of impending doom
  • Irregular pulse -Clutching chest
69
Q

True/ False:

Women show different sypmtoms of AMI than men?

A

TRUE

70
Q

What are some symptoms of AMI that occur to women?

A
  • Atypical Discomfort
  • Upper Abdominal Pain
  • Shortness of Breath
  • Fatigue
71
Q

True/ False:

Diabetics suffer silent MI’s.

A

TRUE

72
Q

True/ False:

During AMI you may continue the dental procedure until patient cannot handle the pain any longer.

A

FALSE!

73
Q

True/ False:

If a patient with a history of angina shows signs and symptoms of AMI you follow the protocol for angina?

A

TRUE

74
Q

What should you do if a patient shows signs and symptoms of AMI but the patients has no history of angina?

A

Contact EMS immediately.

75
Q

What should you do while waiting for EMS to arrive for a patient with AMI?

A
  • 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
Q

How would you manage the patients pain during AMI?

A

by administering Nitrous Oxide if available.

77
Q

If cardiac arrest occurs while waiting for EMS to arrive what should you do?

A

Perform CPR with the AED.

78
Q

How long does it take for a chewed 325mg. aspiring to take into effect on a patient with AMI?

A

20 min.

79
Q

Why would you give a patient with AMI 325mg. of aspirin?

A

because it has an antithrombotic (reduces formation of blood clots) effect.

Medical Emergencies (2 decks)

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