Exam 1 Study Guide Qs

Question 1

How do you decrease myocardial O2 demand?

Answer 1

Limit epi to 0.04mg (~2.35 carpules)

Question 2

How do you treat an episode of angina pectoralis?

Answer 2

-patient’s myocardial O2 demand should be decreased and oxygen supply increased

Question 3

How do you decrease myocardial oxygen demand?

Answer 3

1. Anxiety reduction protocol
2. Profound local anesthesia before surgery
3. Limit epi to 0.04mg

Question 4

How do you increase patient’s O2 supply?

Answer 4

• Administer supplemental oxygen
  
  • Nasal cannula 3L/min
• Nitroglycerin tablets if necessary
  
  • causes coronary artery dilation, increasing amount of O2-rich blood to myocardium

Question 5

What are the clinical signs of acute MI?

Answer 5

• History of angina
• Squeezing, crushing pain similar to angina
• Pain not relieved by rest, nitrates or O2
• Cardiac dysrhythmia (EKG)
• HYPOtension
• Shock (cold, clammy, ashen grey)
• Denial

Question 6

What is the function of nitrates?

Answer 6

Dilate the coronary arteries to allow more O2-rich blood to access myocardium

Question 7

What is the function of beta-blockers and calcium channel blockers?

Answer 7

Beta blockers: decrease heart rate

Calcium channel blockers: decrease myocardial contractility

Question 8

How long should you delay surgery after a coronary artery bypass graft (CABG)?

Answer 8

Delay elective surgery for 1 month

Question 9

What combination is drugs is used for combination antiplatelet therapy?

Answer 9

Aspirin and thienopyridene

Question 10

What are the labs for a patient with Addison’s disease (primary adrenal insufficiency)?

Answer 10

• High ACTH (adrenocorticotropic hormone)
• Low aldosterone
• Low cortisol (causes weakness and fatigue)
• May get low sodium and high potassium serum levels
  *

Question 11

What are the labs for a patient with secondary adrenal insufficiency?

Answer 11

• Low ACTH
• Low cortisol
• Near normal levels of aldosterone

Question 12

What stimuli can provoke acute episodes of asthma? (6)

Answer 12

1. Airborne allergens - cause release of leukotrienes
2. Aspirin and NSAIDs
3. Occupational factors (ex: wood, dust, drugs)
4. Infection (esp. upper respiratory infection)
5. Exercise
6. Emotional stress/anxiety

Question 13

What tests are needed to definitively diagnose diabetes mellitus?

Answer 13

1. Fasting plasma glucose ≥ 126 mg/dL at least 2 times
2. Oral glucose tolerance test w/ 2-hour post-load glucose concentration of ≥ 200mg/dL and a time 0 glucose level ≥ 126 mg/dL

Question 14

What are the normal ranges for fasting and non-fasting blood glucose levels?

Answer 14

• Fasting: 65-100mg/dL
• Normal: 70-130mg/dL