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Cardiology 2023 1MB > Coronary Heart Disease > Flashcards

Coronary Heart Disease Flashcards

1
Q

Which artery is most often occluded in acute MI?

A

LAD artery

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2
Q

Name some characteristics of angina that aid diagnosis

A

Pain on exertion, relieved by rest
Visceral pain
Specific timing/trigger factor

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3
Q

Pain assoc. with pericarditis worsens upon sitting forward. True/False?

A

False

Eases upon sitting forward

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4
Q

Name coronary revascularisation procedures

A 
Coronary arterial bypass grafting (CABG)
Coronary angioplasty (PCI)
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5
Q

What steps are involved in CABG?

A

Median sternotomy

Take saphenous vein + internal mammary artery and attach to aorta DISTAL to site of blockage

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6
Q

What steps are involved in PCI?

A

Put patient on anticoagulant + antiplatelets
Catheter to ostium of coronary artery and then feed wire down vessel
Balloon on wire inflated to allow stent to attach to vessel
Ballon, catheter and wire removed, leaving stent in place to open artery

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7
Q

Which coronary revascularisation - CABG or PCI - has been proven to be better? Why?

A

CABG is more safe and has fewer adverse effects

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8
Q

Which arteries are commonly used for PCI?

A

Femoral

Radial

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9
Q

ECG interpretation - cardiac territories and vessels affected

A
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10
Q

NSTEMI can show T inversion or no changes in normla leads True/False

A

True

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11
Q

how long for trpoinin level to rise in the blood after MI

A

3h

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12
Q

calsssical presentation of STEMI NSTEMI Unstable angina

A

SOCRTIES

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13
Q

Diagnosis of STEMI

A

high ST elevation in adjacent chest and limb leads
LBBB
high trpopine

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14
Q

Diagnosis of NSTEMI

A

CHEST PAIN
abnormal ECG
high troponin

abnormal

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15
Q

other invstigations

A

FBC and CRP
D-Dimer
Cxr

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16
Q

GRACE score

A

patient with low risk and going for PCI SHOULD BE GIVEN Prasugrel or trigrelor. However pateitns with high risk bleeding are given PO clopidogrel 300g

17
Q

Managment for unstable angina

A

Similar to NSTEMI
asprin for all patietn and pateints with high GRACE score are given fondaparinux and early angiography

18
Q

investigations for post MI

A

ECHO
Cardiac ehabilitation
ischaemia test to assess for inducible ischaemia

19
Q

vertical arrathemia can happen post MI why

A

after reprfusion or cardaic catherisation

20
Q

where heart block happen in post MI

A

fllowing inferior infracts

21
Q

aneurysm happen where in post MI

A

fallowing an anterior MI
however it maybe silent fallowed by arrhtmias or embloic event

22
Q

post MI can casues ventricular spetec defect what are the symptoms

A

Hypotension
palpabel parasternal thrill

23
Q

What are the risk factors for plague formation BAD HART

A

BMI more or equal to 30 obesity
Age more or equal to 65
Diabetes
EtOH
An increase in LDL
Relatives with CAD who passed away from MI
Tobacco

24
Q

Pathology of stable angina ninja nerd

A

Stable plaque covers by strong fibrous cap

25
Q

Some of the features of subendocardial infection ninja nerd

A

Chest pain occurs at rest
Thrombus formation
Near Total occlusion of coronary vessels
Unreversed for at least 30 meant will cause infraction

26
Q

Categorized of acute coronary syndrome

A

Unstable angina
NSTEMI
STEMI

27
Q

Patients with prinzmetals angina should avoid ninja nerd

A

Beats blocker

28
Q

Depression of ST segment and inversion of t wave along with high Troponin e indicate Ninja nerd

A

NSTEMI

29
Q

Which coronary artery supply the inferior part of the heart ninja nerd

A

Marginal branch / RCA

30
Q

Patient under go stress test has baseline myocardial perfusion which drug should NOT be used to replicate stress

A

Dobutamine

31
Q

Elevated ST in II III AND aVF indicate ninja nerd

A

Inferior MI

32
Q

Aspirin is used in ischemia heart disease because ninja nerd

A

Inhibit TXA2 production

33
Q

What is the main feature of each of the fallowing drugs regards ischemia heart disease treatment
Beat blockers
Morphine
Nitroglycerin
Ca2 Blocker ninja nerd

A
  1. Decrease energy demand
  2. Contraindicated in
  3. Increase perfusion to ischemic tissues
  4. Should be avoided in decompensated heart failure patients
34
Q

Sever Chest pain with occlusion of 3 vessels which resvascularisation approach ninja nerd

A

CABG

Cardiology 2023 1MB (28 decks)

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