DIT Flashcards
pathogenesis of atherosclerosis
- endothelial damage
- Lipoprotein accumulation (LDL) in vessel wall
- Adhesion of monocytes and foam cells (macrophages)
- Factor release (puts, macrophages, inflammatory mediators, cytokines)
- Smooth muscle infiltration
- Lipid accumulation
How to dx PAD?
ABI < 0.9
Meds associated with HLD
- thiazide diuretics
- bblockers
- atypical antipsychotics
- protease inhibitors
- oral estrogens
Who needs statin therapy?
- clinical ASCVD (ACS, MI, Stroke/TIA, PAD, revascularizaiton)
- anyone LDL>190
- DM 40-75
- 10 year risk >7.5% age 40-75
MOA and target of statins
HMG-Coa reductase inhibitor
BEST drug to lower LDL
side effects and what labs to get before starting statin
myopathy/inhibits coenzyme q10 (increased CK, myalgia, cramping)
hepatic dysfunction
get LFTs before starting but not routinely
MOA and target ezetimibe
impairs dietary and biliary cholesterol at brush border
primarily lowers LDL
Side effects ezetimibe
myalgia and increased LFTs (like statin)
MOA and target of fibrates
decrease hepatic secretion of VLDL
primary effect on TRIGLYCERIDES
VLDL = triglycerides
side effects fibrates
same as statins and ezetimibe (myalgia LFT elevation)
Name some bile acid sequestrants
cholestyramine, colestipol, colesevelam
bile acid sequestrates target what?
LDL (but only lower 10%…statins more effective)
side effects bile acid sequestrants
GI side effects (bloating, cramping), LFT elevaiton
Which cholesterol med is best for increasing HDL
niacin
side effect niacin and how to rx
facial flushing
improves with ASA or NSAID, and time
target of omega 3 fatty acids (fish oil)
TGs
which cholesterol med can be used as an adjunct treatment of cdiff?
cholestyramine
what new heart sounds can you get during MI?
new systolic murmur
S3
S4
What additional finding besides ST changes can indicate STEMI?
new LBBB
After MI when does troponin elevate
elevates in 1-4 hours
stays elevated up to 1-2 weeks
When do Q waves (dipping before R wave) appear during MI?
appears within hours, deepens over 1-2 days and persists until weeks later
How doe ST segment and T waves change during MI
ST elevates hours after MI but is normal days after
T wave inverts after Day 1-2 returns to normal weeks later
ST changes in V2,3,4,5
anterior MI
LAD
ST changes V1, V2, V3
septal wall MI
LAD