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Cardiology > Ds Of Coronary Vasculature > Flashcards

Ds Of Coronary Vasculature Flashcards

1
Q

Ischemic HD types

A

Stable IHD / CHRONIC STABLE ANGINA(CSA)

ACS

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2
Q

IHD

A

CSA

ACS

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3
Q

ACS types

A

NSTE-ACS

STEMI

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4
Q

NSTE-ACS

A

Unstable angina

NSTEMI

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5
Q

Pathology

A

Atherosclerosis

Demand supply mismatch

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6
Q

Stable plaque

A

Intact fibrin layer

Reversible ischemia

Seen in stable IHD (CSA)

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7
Q

Unstable plaque

A

ACS il aan kanunnath

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8
Q

Cardiac biomarkers

A

Troponins I and T
CK MB isoenzyme
Others- myoglobin, LDH,copeptin,HFAP,IMA

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9
Q

HFAP

A

Heart fatty acid binding protein

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10
Q

IMA

A

Ischemia modified albumin

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11
Q

Risk factors of IHD

A

Modifiable
Non modifiable

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12
Q

Biomarkers negative in

A

CSA
UA

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13
Q

Biomarkers positive in

A

NSTEMI and STEMI

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14
Q

Troponins in blood detected after (also CK. MB)

A

4 hours il rises

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15
Q

Troponins remain raised for

A

5-7 days

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16
Q

Troponins remain raised for

A

5-7 days

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17
Q

CK MB lasts for

A

72 hours only (3 days)

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18
Q

Which only IHD relieved by rest

A

CSA

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19
Q

Best biomarker for reinfarction

A

Serial assessment of hs trop I or T

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20
Q

Re infarction

A

> 20% increase in 1st and 2nd sample 3hours apart

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21
Q

First biomarker to be elevated

A

Myoglobin (2hours)
HFAP 30 min
IMA 15 min

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22
Q

TMT protocol

A

Mod bruce

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23
Q

Treatment of CSA

A

Acute management
Prevention of further episodes
Address risk factors
If not responding…PCI/CABG

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24
Q

Acute management

A

Short acting nitrates
Sublingual nitroglycerin 0.3 to 0.6 mg upto 3 times 5 min apart

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25
Q

Prevention of further episodes

A

Antianginal therapy
Antithrombotic therapy

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26
Q

Anti anginal therapy

A

Beta blocker
Non DHP CCBs
Long acting nitrates
Other drugs…ranolazine,trimetazidine, ivabradine,nicorandil

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27
Q

Must give drug in anti anginal therapy

A

Beta blocker

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28
Q

Antithrombotic therapy

A

Single antiplatelet…Aspirin 75mg lifelong

Dual anti only if indicated

29
Q

P2Y12 inhibitor

A

Clopidogrel 75mg,prasugrel

30
Q

ECG changes in non STE ACS

A

St depression
T inversion

31
Q

Q wave in STEMi

A

Subacute phase
Old MI

32
Q

Treatment of NSTEMI or UA

A

Pain relief
Risk stratification
Choice of management strategy
Initation of antithrombotic therapy
Prevention of recurrance

33
Q

Pain relief

A

Iv nitroglycerin infusion (short acting)
Iv morphine

34
Q

Risk stratification

A

TIMI OR GRACE scoring

35
Q

Strategy

A

Immediate invasive
Early
Conservative

36
Q

We don’t do ____in Nstemi

A

Fibrinolysis

37
Q

We don’t do ____in Nstemi

A

Fibrinolysis

38
Q

Anti thrombotic therapy

A

Antiplatelet therapy
Anticoagulant therapy

P and c enn ortho

39
Q

Antithrombotic therapy aan loading dose

A

To stabilise the plaque

40
Q

Loading dose

A

Aspirin 300mg
Clopidogrel 300mg
Atorvastatin 80mg

41
Q

Whatever choice of management strategy loading dose is given to all 3 groups but

A

In immediate and early invasive, clopidogrel 600mg is given in loading dose of 3 drugs

42
Q

Complications of stent

A

Stent thrombosis
Restenosis

43
Q

Anticoagulant therapy

A

To prevent further propagation of thrombus

44
Q

Anticoagulants

A

UFH..unfractionated heparin
LMW H

45
Q

Ideally

A

UFH 5000 units i.v stat
Followed by
1000 units per hour infusion

For 48hours (2days)

46
Q

Resource limited no infusion pump

A

UFH 5000 units iv Q6H for 5 days

47
Q

Immediate and early invasive
Anticoagulant done till

A

PCI is completed

48
Q

Prevention of recurrance

A

*antiplatelet
*Atorvastatin
*Beta blocker
*aCe or arbs
Long acting nitrates
Address the risk factors

49
Q

Complications of MI

A

Arrythmias
Sudden death
Reinfarction
Heart failure
Cardiogenic shock
MR
Ventricular septal rupture
Cardiac rupture
Dresslers syndrome
Lv aneurysm
Embolism
Pericarditis

50
Q

Dresslers syndrome

A

Post mi pericarditis

51
Q

Management of STEMi

A

Pain relief
Loading dose of antiplatelets
Revascularization(***extra one)
Anticoagulant therapy
Prevention of recurrance

52
Q

Only change in loading dose

A

Clop 600mg in STEMi

53
Q

Immediate step is

A

Revascularization

54
Q

Revascularization

A

PCI
Fibrinolysis

55
Q

STEMI thrombus

A

Fibrin rich clot

56
Q

NSTEMI thrombus

A

Platelet rich

57
Q

Fibrinolysis aka

A

Thrombolysis

58
Q

PCI can be given upto

A

Panthrandu manikkoor

59
Q

Fibrinolysis upto

A

12 hours beyond which bleeding risk more than benefit

60
Q

Types of PCI

A

Primary
Rescue
Elective

61
Q

Fibrinolysis in STEMi drugs

A

Streptokinase
Alteplase
Tenecteplase

62
Q

Streptokinase

A

1.5million units one hour infusion

63
Q

Alteplase

A

15mg iv bolus f/b
0.75mg/kg iv over 30min
F/b
0.5mg/kg iv over 60 min

64
Q

Tenecteplase

A

30mg iv single dose bolus

65
Q

Tenecteplase

A

30mg iv single dose bolus

66
Q

After successful thrombolysis

A

Anticoagulant infusion

67
Q

All ACS should be

A

Done elective PCI

68
Q

All ACS should be

A

Done elective PCI

Cardiology (3 decks)

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